It seems a poignant sign of the times that the nation’s major association of pediatricians felt impelled to issue a report on the detrimental effects of racism on the health of young people and families. In a paper released last week, the American Academy of Pediatrics worries over persistent racism — and suggests ways to offset it in the doctor’s office, the health clinic, and the schoolhouse.
“Racism is a social determinant of health that has a profound impact on the health status of children, adolescents, emerging adults, and their families,” says the academy paper issued last week. “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 pediatrics academy, which has 67,000 members nationwide, formed a task force in August 2017 to address racism. Its 2019 report doesn’t mention President Trump or refer to clashes, both rhetorical and physically violent, that have captured headlines, though surely the heated public discourse over race and immigration served as context.
The academy paper, which has an appendix of 180 research references, describes race as a “social construct rooted in history.’’ It says that “flawed science’’ has underpinned attitudes and policies based on “notions of racial superiority.”
Both institutional and person-to-person racism, says the report, contributes to toxic stress in the lives of many black, Hispanic, and American Indian youth. “Prolonged exposure to stress hormones, such as cortisol, leads to inflammatory reactions that predispose individuals to chronic diseases,’’ says the report.
In its section on schools, the academy report touches on matters familiar to educators and education policymakers: bullying, disciplinary practices, achievement gaps, chronic absenteeism, student-teacher relationships. Pediatricians monitor educational attainment as an indicator of successful development, it says.
The report declares that “students who had a positive perception of a school’s racial climate had higher academic achievement and fewer disciplinary issues.” It points to studies showing that “a positive, strong racial or ethnic identity and parental engagement in families is protective against the negative effects of racial discrimination on academic outcomes.”
The academy doesn’t weigh in on the status of school desegregation, which held the promise of both affording equitable academic opportunity to black youth and of narrowing the societal racial fault line as young people got to know each other. As a recent Century Foundation study showed anew, the achievement gap closed during the peak years of school desegregation in the 1970s and ’80s — a trend stymied by resegregation.
The report, however, cites government initiatives that have made a difference in enhancing healthy lives among young people: for example, food stamps, housing assistance, and child health insurance. The academy task force calls on pediatricians to advocate for safe playgrounds, healthy food markets, and increased school-based mental health services in their communities.
Aside from addressing educational and other public policy matters, the academy task force has advice for pediatricians: “examine their own biases,” “create a culturally safe medical home,” “train clinical and office staff in culturally competent care,” “integrate positive youth development approaches, including racial socialization.”
Even as it speaks directly to their own medical-professional members, the American Academy of Pediatricians has offered sensible guidance generally applicable in education and other youth-focused institutions during this troubling moment along the nation’s racial fault line.