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Most understand that systemic racism in the healthcare industry has been a problem for a long time — it continues today.
Recent research has shown that Latino and black children are more likely to die of childhood cancers than their white counterparts.
Still, some medical organizations realize this gap, which has led to some progress .
The American Academy of Pediatricians initiated a call to action in its recent policy statement earlier this week, which aims to reduce the impact of racism and improve health equity for all children.
“While progress has been made toward racial equality, the impact of racism on communities of color is wide-reaching, systemic and complex,” Dr. Maria Trent, lead author of the policy statement, said in a press release.
The document brings attention to the role of racism in child and adolescent development as well as healthcare. Additionally, researchers investigated why disparities in health outcomes associated with a patient’s race.
“A combination of strategies will be needed to begin untangling the thread of racism throughout the fabric of our society and to improve the health of all children.
Impact of Racism on Child and Adolescent Health
Racism, which is a social determinant of health, has a profound influence on the health status as well as outcomes of children, adolescents, emerging adults, and their families.
Unfortunately, many Latino children are already at risk of not getting the proper care, services, and environment they need for healthy formative development, according to a Salud America! Research Review:
Although race used in these ways has been institutionalized, linked to health status, and impeded our ability to improve health and eliminate health disparities, it remains an important a powerful measure that must be better measured, carefully used, and potentially replaced to mark progress in pediatric health disparities research, states the policy brief.
“As a pediatrician, I know that when children are stressed, it impacts their health and development,” said Dr. Jacqueline Dougé, a co-author of the statement.
“When children experience chronic stress, they are flooded with stress hormones such as cortisol that, after prolonged exposure, leads to inflammatory reactions. This can harm children’s health in the short term, but also creates long-term health problems like heart disease, diabetes, and depression.”
Furthermore, Latinos and other minorities face many obstacles to opportunity across the lifespan due to racial bias in policies, institutions, and systems, which additionally contribute to health inequity such as inequality in education, life expectancy, employment, income, arrest rates, homelessness, and more.
While many strides have been made in the pursuance of racial equity, the evidence continues to support that adverse impact of racisms on health is clear. Moreover, the well-being through implicit and explicit biases, systematic racism, and interpersonal relationships makes an impact, too.
Previous policy statements have focused on a variety of issues that go hand-in-hand with racism, including poverty and trauma/adverse childhood experiences, housing inequity, and immigration status.
The policy requests that pediatricians first reflect on their own biases and incorporate structural and individual-level strategies that enhance professional practice.
“It’s important, as child health professionals, that we examine our own biases and work with families to gain their trust and confidence,” Dr. Dougé said.
“We must be prepared to counsel families of all races on the effects of exposure to racism. That includes talking with victims, bystanders, and perpetrators about managing their circumstances and health.”
5 Ways Pediatricians Can Reduce Racial Bias To Improve Children’s Health
The AAP believes pediatricians share a role in helping improve the conditions where children live, learn and play, by listening to families, creating culturally safe medical homes and advocating within their communities, states the press release.
According to the APP, pediatricians can tackle and improve the effects of racism children as well as adolescents:
- Create a culturally safe medical home, using evidence-based tools to improve their communications with families and training clinical and office staff in culturally competent care.
- Engage community leaders to create safe playgrounds and healthy food markets to reduce disparities in obesity and undernutrition in neighborhoods affected by poverty.
- Advocate for federal and local policies that support implicit bias training in schools and robust training of educators to improve disparities in academic outcomes and disproportionate rates of suspension and expulsion.
- Encourage community-level advocacy to develop policies that advance social justice.
- Collaborate with first responders and community police and share expertise on child and teen development and mental health, considering potential differences in culture, gender, and background.
“As a nation, we have made great strides in tackling other major challenges, and this one should be no different. This is an area where we can – and must – make a difference,” said Dr. Trent.
Why Racial Equity Matters
Research shows that when the physician is the same race/ethnicity as their patients, the patient’s overall satisfaction is more significant.
There must be a more diverse healthcare workforce that can meet the health needs of diverse racial and ethnic backgrounds to continue reducing racial inequities. This can be done by:
- Encouraging policies and programs that increase the numbers of racial and ethnic minority family medicine physicians, pediatricians, pediatric providers, and medical students, such as Exito!.
- Offering continuing education for practicing pediatricians on how to decrease implicit biases and improve safety and quality in the health care delivery system.
There are, too, other ways to reduce racial inequities as a whole.
Communities must work with governments and community-based organizations. They also have to advocate for initiatives that reduce bias and inequities — in not only health but the justice and educational systems, which are a result of systematic racism.
“This work is incredibly important for the AAP, for pediatricians, and for children, and it will remain a priority for our organization,” said AAP President Kyle Yasuda, MD, FAAP.
“As a pediatrician, I know that when we help children grow up healthy and with equal access to opportunities, we improve all of society.”