Racism and Child Health: A Review of the Literature and Future Directions

Department of Pediatrics and Anthropology, University of Connecticut School of Medicine, Connecticut Children's Medical Center, 282 Washington Street, Hartford, CT 06106, USA.
Journal of developmental and behavioral pediatrics: JDBP (Impact Factor: 2.13). 07/2009; 30(3):255-63. DOI: 10.1097/DBP.0b013e3181a7ed5a
Source: PubMed


Racism is a mechanism through which racial/ethnic disparities occur in child health. To assess the present state of research into the effects of racism on child health, a review of the literature was undertaken.
A MEDLINE review of the literature was conducted between October and November 2007. Studies reporting on empirical research relating to racism or racial discrimination as a predictor or contributor to a child health outcome were included in this review. The definition of "child health" was broad and included behavioral, mental, and physical health.
Forty articles describing empirical research on racism and child health were found. Most studies (65%) reported on research performed on behavioral and mental health outcomes. Other areas studied included birth outcomes, cardiovascular and metabolic diseases, and satisfaction with care. Most research has been conducted on African-American samples (70%), on adolescents and on older children, and without a uniformly standardized approach to measuring racism. Furthermore, many studies used measures that were created for adult populations.
There are a limited number of studies evaluating the relationship between racism and child health. Most studies, to date, show relationships between perceived racism and behavioral and mental health. Future studies need to include more ethnically diverse minority groups and needs to consider studying the effects of racism in younger children. Instruments need to be developed that measure perceptions of racism in children and youth that take into account the unique contexts and developmental levels of children, as well as differences in the perception of racism in different ethnocultural groups. Furthermore, studies incorporating racism as a specific psychosocial stressor that can potentially have biophysiologic sequelae need to be conducted to understand the processes and mechanisms through which racism may contribute to child health disparities.

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    • "While such reviews exist among adults (Paradies, 2006b; Pascoe & Smart Richman, 2009; Williams & Mohammed, 2009) the applicability of the findings of these reviews to the unique developmental needs and contexts of children and young people requires further examination. One nonsystematic review published in 2009 identified 40 articles on racism and child health, 70% of which considered African American populations (Pachter & Garcia Coll, 2009). However, as demonstrated below, this review included only a little over half of the studies published at that time. "
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    ABSTRACT: Racial discrimination is increasingly recognised as a determinant of racial and ethnic health inequalities, with growing evidence of strong associations between racial discrimination and adult health outcomes. There is a growing body of literature that considers the effects of racial discrimination on child and youth health. The aim of this paper is to provide a systematic review of studies that examine relationships between reported racial discrimination and child and youth health. We describe the characteristics of 121 studies identified by a comprehensive search strategy, including definitions and measurements of racial discrimination and the nature of reported associations. Most studies were published in the last seven years, used cross-sectional designs and were conducted in the United States with young people aged 12-18 years. African American, Latino/a, and Asian populations were most frequently included in these studies. Of the 461 associations examined in these studies, mental health outcomes (e.g. depression, anxiety) were most commonly reported, with statistically significant associations with racial discrimination found in 76% of outcomes examined. Statistically significant associations were also found for over 50% of associations between racial discrimination and positive mental health (e.g. self esteem, resilience), behaviour problems, wellbeing, and pregnancy/birth outcomes. The field is currently limited by a lack of longitudinal studies, limited psychometrically validated exposure instruments and poor conceptualisation and definition of racial discrimination. There is also a need to investigate the complex and varying pathways by which reported racial discrimination affect child and youth health. Ensuring study quality in this field will allow future research to reveal the complex role that racial discrimination plays as a determinant of child and youth health.
    Social Science [?] Medicine 12/2012; 95. DOI:10.1016/j.socscimed.2012.11.031 · 2.89 Impact Factor
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    • "The study provides an important first step in understanding the physiological mechanisms that may underlie youths' experiences of discrimination and has the potential of propelling researchers into identifying the mechanisms underlying racial/ethnic health disparities in the U.S. These findings come as no surprise given that discrimination has long been theorized as a salient and impactful stressor for ethnic and racial minority youth living within the U.S (Pachter and García Coll, 2010). "
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    ABSTRACT: Perceived discrimination remains a salient and significant environmental stressor for ethnic and racial minority youth. Although many studies have examined the impact of racial/ethnic discrimination on mental health symptomatology and physical health, little is known of the potential physiological processes underlying such experiences, especially during adolescence. In an attempt to understand how varying perceptions of discrimination relate to functioning of the hypothalamic-pituitary-adrenal axis (HPA axis), the current study examined the relation between Mexican American adolescents' (N = 100, M(age) = 15.3 years old) perceptions of discrimination and aspects of their diurnal cortisol profiles. Three salivary samples (wakeup, +30 waking, bedtime) were collected across 3 days (total of 9 samples). Utilizing multi-level modeling, results revealed that adolescents' perceived discrimination related to greater overall cortisol output (area under the curve; AUC) after controlling for other life stressors, depressive symptoms, family income, acculturation level, daily stress levels and daily behaviors. Findings also revealed that perceived discrimination was marginally related to a steeper cortisol awakening response (CAR). Together, these findings suggest that perceived discrimination is a salient and impactful stressor for Mexican American adolescents. Understanding the physiological correlates of discrimination can provide insight into larger health disparities among ethnic and racial minority individuals.
    Hormones and Behavior 02/2012; 61(4):541-8. DOI:10.1016/j.yhbeh.2012.01.018 · 4.63 Impact Factor
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    • "There is a paucity of nationally representative prevalence studies of ethnic discrimination among adolescents. Experiencing ethnic discrimination has been associated with a range of adverse physiological, physical, psychological, and behavioural outcomes among adult and adolescent populations including: poor self-reported overall health status [4,11-14]; depression, somatic complaints, anxiety and psychosis [3,7,12-21]; and risk-taking behaviours such as smoking, increased alcohol consumption, and use of other psychoactive substances [14,20-23]. Experiencing discrimination has also been shown to be associated with ethnic disparities in access to, and quality of care [14]. "
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    BMC Public Health 01/2012; 12(1):45. DOI:10.1186/1471-2458-12-45 · 2.26 Impact Factor
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