The American Academy of Pediatrics is committed to addressing the factors that affect child and adolescent health with a focus on issues that may leave some children more vulnerable than others. Racism is a social determinant of health that has a profound impact on the health status of children, adolescents, emerging adults, and their families. Although progress has been made toward racial equality and equity, the evidence to support the continued negative impact of racism on health and well-being through implicit and explicit biases, institutional structures, and interpersonal relationships is clear. The objective of this policy statement is to provide an evidence-based document focused on the role of racism in child and adolescent development and health outcomes. By acknowledging the role of racism in child and adolescent health, pediatricians and other pediatric health professionals will be able to proactively engage in strategies to optimize clinical care, workforce development, professional education, systems engagement, and research in a manner designed to reduce the health effects of structural, personally mediated, and internalized racism and improve the health and well-being of all children, adolescents, emerging adults, and their families. STATEMENT OF THE PROBLEM Racism is a "system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call 'race') that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources." 1 Racism is a social determinant of health 2 that has a profound impact on the health status of children, adolescents, emerging adults, and their families. 3-8 Although progress has been made toward racial equality and equity, 9 the evidence to support the continued negative impact of racism on health and well-being through implicit and explicit biases, institutional structures, and interpersonal relationships is clear. 10 Failure to address racism will

reopened. During influenza outbreaks, reopening has been associated with the risk of epidemic resurgence. The best solution for the COVID-19 pandemic is not known. It has been suggested that children who test positive on serologic tests that identify IgG against SARS-CoV-2 could beadmittedtoschool.Itissupposedthatpositivitycouldallowtheidentificationofchildrenwhohavealreadybeeninfected,canbeconsidered protected, and can attend school without posing risks per se to other children. However, the use of this procedure can be strongly criticized. The sensitivity of the presently available antibody tests is suboptimal. Most children have an asymptomatic infection, and as the immune response to SARS-CoV-2 infection has been found to be greater the more serious the disease is, it seems likely that most children will have a low antibody titer that is inadequate for obtaining positivity on tests with relatively low sensitivity. 10 Moreover, even when IgG levels are measured, it is not possible to state whether children are protected or how long the protection may last. The antibody protective level and secondary immune response to SARS-CoV-2 are not known. Taken together, these factors seem to indicate that most children with IgG positivity cannot be identified and, even if identified, cannot be considered protected for the long term. Other criteria, such as a systematic adoption of face masks with some lessons on this issue and on all hygiene measures for COVID-19 prevention, screening with temperature measurements, or closing classrooms with infected students, must be followed when school is resumed.

Fever is a common childhood condition that is often misunderstood and incorrectly managed by parents. This study uses a questionnaire about fever administered to a convenience sample of Spanish-speaking-only parents bringing their child to a hospital-based urban pediatric clinic. The questionnaire elicits information about definition and cause of fever, concerns about fever, methods of temperature measurement, and treatment modalities used by the parents. Latino parents have numerous misconceptions about fever and its role in illness. Educational interventions should target fever definition, clarification of cause and potential harm of elevated temperatures, temperature monitoring, and safe treatment modalities. Owning a thermometer is strongly associated with correct knowledge of temperature values. Providing parents with a thermometer and educating them about its proper use may lead to an increase in appropriate monitoring and medical treatment of the febrile child.

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