The Impact of Racism on Child and Adolescent Health

Trent, Maria; Dooley, Danielle G.; Dougé, Jacqueline

doi:10.1542/9781610024310-part06-ch22

Cited by 30 publications

(25 citation statements)

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“…Race/Racism: Structural racism, discrimination, and conscious and unconscious biases have unjustly placed Black, Brown, and Native American youth at a disproportionate disadvantage compared with their peers. 17 18 19 20 Structural racism has led to unfair housing practices, educational segregation, and economic and health disparities 21 including varying rates of teenage pregnancy. 22 Thus, while racism increases the risk of teen pregnancy, it also has been shown to place adolescents at higher risk of adverse mental health outcomes.…”

Section: The Socio-ecological Model Applied To Expectant and Parentin...mentioning

confidence: 99%

Understanding the Psychological Impacts of Teenage Pregnancy through a Socio-ecological Framework and Life Course Approach

Tebb¹,

Brindis

2022

Semin Reprod Med

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The relationship between mental health and teenage pregnancy is complex. Mental health can be both an antecedent and contributing factor to teenage pregnancy and a concurrent factor wherein pregnancy itself can contribute to depression. Expectant and parenting teens (EPT) are faced with the simultaneous challenges of pregnancy and parenting while navigating the developmental tasks of adolescence which increases their risk for mental health problems. In addition, adolescents growing up in stressful community or home situations where their parents experienced depression, further places them and their children at greater risk of repeated patterns over time. However, adverse mental health outcomes are not inevitable. The socio-ecological model combined with a life course perspective provides a framework for understanding the complexity of risk and protective factors at multiple levels that influence knowledge, attitudes, behaviors, and other health outcomes later in life and across generations. This approach has important implications for reducing adolescents' risk of an unintended/mistimed pregnancy and improving mental health and other outcomes for EPT. This paper describes the prevalence of mental health problems in EPT and using a socio-ecological framework and life course perspective explains variations in mental health outcome among EPT. Implications for interventions and innovative approaches are also discussed.

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Section: The Socio-ecological Model Applied To Expectant and Parentin...mentioning

confidence: 99%

Understanding the Psychological Impacts of Teenage Pregnancy through a Socio-ecological Framework and Life Course Approach

Tebb¹,

Brindis

2022

Semin Reprod Med

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“…Based upon prior research [2,[28][29][30][31][32][33], the following participant and family characteristics were included in the multivariable models as confounding variables: participant age at the time of measurement of each potential predictor, sex, race/ethnicity, Wechsler [34,35] Full-Scale Intelligence Quotient (FSIQ) and family SES, using annual household income and household density.…”

Section: Parɵcipant Health (Yaphiv)mentioning

confidence: 99%

“…Many factors are known to influence adaptation to adversity: relationships with parents/caregivers and other adults; friends and romantic partners; intelligence and problemsolving skills; self-control, emotional regulation and planning; and self-efficacy and motivation [2]. Risks to optimal development include maternal education less than high school, parental divorce or death, single-parent family, perceived individual and structural racism and witnessing violence [2,28]. Family socio-economic status (SES) is related to physical health and achievement of societal milestones, such as high school graduation, postsecondary education and sustained employment; thus, poverty and low SES, whether chronic or of recent onset, confer risks to development and are considered major stressors for children, adolescents and families [23,[29][30][31][32].…”

Section: Introductionmentioning

confidence: 99%

Ageing with HIV: a longitudinal study of markers of resilience in young adults with perinatal exposure to HIV, with or without perinatally acquired HIV

et al. 2022

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Introduction Medical challenges, including perinatally acquired HIV (PHIV), can be considered adversity with the potential to compromise individuals’ ability to meet societal expectations across the lifespan. Studies suggest that resilience, defined as positive adaptation in the context of adversity, helps individuals overcome challenges and improve their quality of life. Few longitudinal studies have examined resilience in young adults with perinatally acquired HIV (YAPHIV) or perinatal HIV exposure, uninfected (YAPHEU). We examined three young adult milestones, which can affect the life‐long quality of life, as markers of resilience: high school graduation, postsecondary education and current employment. Methods Analyses included YAPHIV and YAPHEU, ages 19–27 years, followed in longitudinal cohort studies: Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol (AMP) (7–17 years) and AMP Up (≥18 years). Factors known to influence the attainment of milestones (outcomes) were examined: executive function, cognitive efficiency (working memory and processing speed), behavioural/social‐emotional functioning, parent/caregiver mental/physical health and cumulative risk. HIV disease markers for YAPHIV were examined. The most recent AMP assessment was used for each factor; outcomes were measured at AMP Up 1‐year follow‐up. Separate robust Poisson regression models were used to assess associations of each factor with each outcome; PHIV status was explored as an effect modifier of each association. Results Participants (N = 315; YAPHIV = 228): 58% female, 67% Black and 27% Hispanic. Compared to YAPHEU, YAPHIV were older and from families with higher median income and fewer symptoms of parent/caregiver mental health/substance use disorders. Proportions of YAPHIV and YAPHEU, respectively, who achieved each milestone were comparable: 82% versus 78% for high school graduation (p = 0.49), 45% versus 51% for postsecondary education (p = 0.35) and 48% versus 54% for current employment (p = 0.32). Higher cognitive efficiency was positively associated with postsecondary education and current employment. Higher executive function, age‐appropriate behavioural/social‐emotional functioning and lower cumulative risk were associated with academic milestones. Among YAPHIV, positive associations were: higher current CD4 with postsecondary education and lower nadir CD4 with current employment. PHIV status did not modify any association. Conclusions YAPHIV and YAPHEU demonstrated resilience, attaining at least one young adult milestone. Cognitive, behavioural and social resources to support resilience in childhood and adolescence may provide the foundation for continued achievement throughout adulthood.

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“…Patient public insurance status has been shown to be associated with higher all-cause in-hospital mortality, (18) and in our study was measured as a binary variable (private insurance vs. public or no insurance (0.25% of encounters were for uninsured patients). A patient's experience of racism from provider teams has been shown to impact outcomes in several clinical domains, (19)(20)(21) and thus could also impact outcomes following an RRT, so we examined the potential to include race/ethnicity as a covariate in our models as well.…”

Section: Covariatesmentioning

confidence: 99%

Association Between Language Use and ICU Transfer and Serious Adverse Events in Hospitalized Pediatric Patients Who Experience Rapid Response Activation

McDade

Olszewski

et al. 2022

Front. Pediatr.

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BackgroundHospitalized patients and caregivers who use a language other than English have worse health outcomes, including longer length of stay, more frequent readmissions, and increased rates of in-hospital adverse events. Children who experience clinical deterioration (as measured by a Rapid Response Team event) during a hospitalization are at increased risk for adverse events and mortality.MethodsWe describe the results of a retrospective cohort study using hospital records at a free-standing, quaternary children's hospital, to examine the association of language of care with outcomes (transfer to intensive care, adverse event, mortality prior to discharge) following Rapid Response Team event, and whether increased interpreter use among patients who use a language other than English is associated with improved outcomes following Rapid Response Team event.ResultsIn adjusted models, Rapid Response Team events for patients who use a language other than English were associated with higher transfer rates to intensive care (RR 1.1, 95% CI 1.01, 1.21), but not with adverse event or mortality. Among patients who use a language other than English, use of 1-2 interpreted sessions per day was associated with lower transfer rates to intensive care compared to use of less than one interpreted session per day (RR 0.79, 95% 0.66, 0.95).ConclusionRapid Response Team events for hospitalized children of families who use a language other than English are more often followed by transfer to intensive care, compared with Rapid Response Team events for children of families who use English. Improved communication with increased interpreter use for hospitalized children who use a language other than English may lead to improvements in Rapid Response Team outcomes.

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The Impact of Racism on Child and Adolescent Health

Cited by 30 publications

References 0 publications

Understanding the Psychological Impacts of Teenage Pregnancy through a Socio-ecological Framework and Life Course Approach

Understanding the Psychological Impacts of Teenage Pregnancy through a Socio-ecological Framework and Life Course Approach

Ageing with HIV: a longitudinal study of markers of resilience in young adults with perinatal exposure to HIV, with or without perinatally acquired HIV

Association Between Language Use and ICU Transfer and Serious Adverse Events in Hospitalized Pediatric Patients Who Experience Rapid Response Activation

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