The Impact of Racism on Child and Adolescent Health

Abstract

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.

Racialized Experiences Differentiate Food Security Among African American Adults

“…acism is an underlying problem structuring population health in the United States (Johnson-Agbakwu et al, 2020;Poteat et al, 2020), and this point has been formally recognized in statements issued by national professional organizations as well as over 150 cities, counties, and states across the country (Krisberg, 2021;Serchen et al, 2020;Trent et al, 2019) The COVID-19 pandemic beginning in 2020 further highlighted links between racialized social factors or social determinants of health (SDH)-such as crowded housing, transportation limitations, workforce characteristics-and racial inequities in COVID-19 cases, hospitalizations, and death (Figueroa et al, 2020;Maness et al, 2021;Ogojiaku et al, 2020).…”

Racial and Economic Adversity Differences in Stress Markers and Immune Function Among Urban Adolescents

“…Moreover, they also are more likely to experience these adverse exposures at much earlier ages (Maguire-Jack et al, 2020), which may contribute to a more significant cumulative burden over time, as well as the potential for more harmful effects because of exposure during a sensitive developmental period (Shonkoff et al, 2021). These increased exposures stem from centuries of structural racism and discriminatory practices historically embedded in our housing, education, health, and correctional systems with significant negative and inequitable health and social consequences for communities, families, and people of color (Bailey et al, 2017;Goosby et al, 2018;Shonkoff et al, 2021;Trent et al, 2019). Research investigating the contribution of these multiple adversities at distinct developmental time periods and across the life span to racial inequities in physiological stress and health is critical for informing effective prevention and intervention efforts.…”

“…acial inequities in health are pervasive in the United States as Black/African Americans are more likely than their White counterparts to experience poor birth and pregnancy outcomes, infectious and chronic disease, and premature mortality (National Academies of Sciences, Engineering, and Medicine, 2017). Racism and the associated systematic exposure to adverse social conditions (e.g., poverty, residential and educational segregation, unsafe housing and living environments, violence) are hypothesized to be the root causes of racial inequities in health that often begin early in life and persist across the life span (Bailey et al, 2017;Goosby et al, 2018;Shonkoff et al, 2021;Trent et al, 2019). Life course and stress theories posit that the chronic stress associated with racism and adverse exposures negatively affects health through the damage to organs and tissues that occurs because of recurrent and prolonged activation of physiological stress response systems and subsequent immune dysregulation.…”

“…Because Black/African American children and adolescents are more likely than their White peers to experience poverty as a consequence of racism (National Academies of Sciences, Engineering, and Medicine, 2019;Trent et al, 2019), deprivation of material and social resources associated with poverty may be one explanation for the racial differences observed in physiological stress (Trent et al, 2019). In addition, researchers have found low socioeconomic status (SES) to be directly associated with irregularities in cortisol concentration and latent viral infection (Deer et al, 2018;DeSantis et al, 2015;Dowd et al, 2012).…”