Maternal Experiences of Racial Discrimination, Child Indicators of Toxic Stress, and the Minding the Baby Early Home Visiting Intervention

Abstract

Background: Racism is a significant source of toxic stress and a root cause of health inequities. Emerging evidence suggests that exposure to vicarious racism (i.e., racism experienced by a caregiver) is associated with poor child health and development, but associations with biological indicators of toxic stress have not been well studied. It is also unknown whether two-generation interventions, such as early home visiting programs, may help to mitigate the harmful effects of vicarious racism.Objective: The purpose of this study was to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and to test whether relationships are moderated by prior participation in Minding the Baby (MTB), an attachment-based early home visiting intervention.Methods: Ninety-seven maternal-child dyads (n = 43 intervention dyads, n = 54 control dyads) enrolled in the MTB Early School Age follow-up study. Mothers reported on racial discrimination using the Experiences of Discrimination Scale. Child indicators of toxic stress included salivary biomarkers of inflammation (e.g., C-reactive protein, panel of pro-inflammatory cytokines), body mass index, and maternally reported child behavioral problems. We used linear regression to examine associations between maternal experiences of racial discrimination and child indicators of toxic stress and included an interaction term between experiences of discrimination and MTB group assignment (intervention vs. control) to test moderating effects of the MTB intervention.Results: Mothers identified as Black/African American (33%) and Hispanic/Latina (64%). In adjusted models, maternal experiences of racial discrimination were associated with elevated salivary interleukin-6 and tumor necrosis factor-α levels in children, but not child body mass index or behavior. Prior participation in the MTB intervention moderated the relationship between maternal experiences of discrimination and child interleukin-6 levels.Discussion: Results of this study suggest that racism may contribute to the biological embedding of early adversity through influences on inflammation, but additional research with serum markers is needed to better understand this relationship. Improved understanding of the relationships among vicarious racism, protective factors, and childhood toxic stress is necessary to inform family and systemic-level intervention.

A Cross-sectional Study of Perceived Stress and Racial Discrimination Among a National Sample of Young Men Who Have Sex With Men

“…children of caregivers exposed to racism have elevated levels of inflammation (Condon et al, 2021) and poor socioemotional and mental health outcomes compared with children not exposed to vicarious racism (Heard-Garris et al, 2018). Exposure to vicarious racism may also threaten a child or adolescent's sense of safety and fairness in society and bring about unintended consequences to their mental and physical health (Brody et al, 2006;Dominguez et al, 2008;Heard-Garris et al, 2018).…”

“…There is evidence to suggest that children as young as age 3 years recognize racial groups and may display differential treatment of one another based on race (Feagin & Van Ausdale, 2001; Gee et al, 2012). Moreover, because the lives and development of children and adolescents are closely intertwined with the experiences of their family or caregivers (Heard-Garris et al, 2018), they are particularly vulnerable to vicarious racism (indirect or second-hand exposure to racism) and its effects on health (Condon et al, 2021; Heard-Garris et al, 2018). Our study found that over 50% of YMSM experienced vicarious racism in their lifetime, and such exposure was associated with increased levels of perceived stress, after controlling for race/ethnicity and other confounding factors.…”

“…Our results substantiate previous findings stating that exposure to racial discrimination can vicariously affect others, giving rise to adverse health consequences that extend beyond the immediate victim (Heard-Garris et al, 2018; Martz et al, 2019). For example, prior research found that the children of caregivers exposed to racism have elevated levels of inflammation (Condon et al, 2021) and poor socioemotional and mental health outcomes compared with children not exposed to vicarious racism (Heard-Garris et al, 2018). Exposure to vicarious racism may also threaten a child or adolescent's sense of safety and fairness in society and bring about unintended consequences to their mental and physical health (Brody et al, 2006; Dominguez et al, 2008; Heard-Garris et al, 2018).…”

“…Evidence suggests that exposure to interpersonal racial discrimination may also act as a psychosocial stressor disrupting normal biological responses or processes through a stress-mediated pathway (Williams & Chung, 2004; Wright et al, 2020). Similarly, exposure to indirect or vicarious racism (e.g., hearing or observing acts of racism or discrimination; Martz et al, 2019) is associated with elevated levels of inflammation (Condon et al, 2021) and poor socioemotional and mental health outcomes among the children of caregivers who are exposed to racism (Heard-Garris et al, 2018). Although there exist a large body of literature on racism and its manifestations in society, more research is needed to identify the ways in which racism drives health inequalities and poor health outcomes among marginalized populations.…”

“…Racism is a multidimensional construct and may present in a myriad of forms and operates through multiple pathways to influence population health (Condon et al, 2021; Williams & Chung, 2004; Williams et al, 2019). For instance, institutional racism may present as structural barriers that limit access to goods and services or create social marginalization of environments that result in racial/ethnic health inequalities, whereas interpersonal racism or racial discrimination may present as harmful biases, assumptions, or beliefs reinforcing bigotry and hostility (Condon et al, 2021), triggering negative physiological responses or health behaviors (Williams et al, 2019). Evidence suggests that exposure to interpersonal racial discrimination may also act as a psychosocial stressor disrupting normal biological responses or processes through a stress-mediated pathway (Williams & Chung, 2004; Wright et al, 2020).…”