Effects of Racism Create Lifelong Health Consequences for Children

For children who experience racism, the health consequences can be lifelong. From mental health issues such as depression and anxiety to physical health problems like hypertension and chronic disease, those who experience discrimination based on the color of their skin or ethnicity can suffer the costs well into adulthood.

In August 2019, the American Academy of Pediatrics (AAP) released a policy statement on ‘The Impact of Racism on Child and Adolescent Health.’ In the statement, the AAP said “racism is a social determinant of health that has a profound impact on the health status of children, adolescents, emerging adults and their families.”

Racism and discrimination are a regular topic of concern for Anu Partap, M.D., M.P.H., medical director of the Center for Prevention of Child Abuse and Neglect at Cook Children’s Medical Center. She says living with the stress of chronic racism can be detrimental and similar to the stress children feel growing up in a home with domestic violence or living with parents who suffer from addiction.

“Negative assumptions or biases based on physical traits are extremely harmful since traits like skin color are seen as part of our identity,” said Dr. Partap. “For a child to feel anything but proud, and to feel instead that people see them as less able, less smart, less kind or worse - a threat - because of race or ethnicity, creates a feeling of being ‘on guard’ similar to living in physical danger, all the time.”

Living with this kind of worry has a physiological impact on the body, including an increase in cortisol, the primary stress hormone. Cortisol is the body’s natural alarm system and can cause your blood pressure to go up and your heart to race. While this alarm system is excellent at getting the body moving in an emergency, prolonged exposure to cortisol can lead to inflammation and affect brain development.

“When our body produces more stress hormone levels chronically, a whole host of health problems can arise,” Dr. Partap explained. “For example, when that stress interferes at school, it can affect learning, friendships, and even graduation. So you can see how much ripple-effect racism, at an individual level, can have throughout a lifespan. For this reason, experiencing racism is considered an adverse childhood experience and social determinant of health.”

Children who experience racism can also struggle with their mental health. According to Kia Carter, M.D., medical director of psychiatry at Cook Children’s Medical Center, depression and anxiety are common issues that can arise when children feel targeted, bullied or left out because of their race or ethnicity.

“The long term consequence is self-esteem. If you’re worried about being accepted by a group or whatever the concern is, that can affect self-esteem and lead to mood changes, feeling hopeless or worthless and then anxiety,” said Dr. Carter. “I think anxiety is a big concern. If you’re always feeling worried about whether you are going to be accepted by other people, that can lead to becoming more withdrawn and not even attempting to go out and experience new things.”

She says her team sees many children who come from traumatic environments, often related to some sort of prejudice or bias, who are consequently anxious about being in their own home environments. The most important thing for these patients, and all children of color, is to learn positive adaptive coping skills at a young age in preparation for any future incidents that may cause stress and discomfort.

“Parents need to instill in their children from a very young age that they are important, so that when they do experience bias or prejudice, they don’t automatically believe something is wrong with them,” said Dr. Carter.

Dr. Partap and Dr. Carter are both physicians of color and parents. They agree that children need to feel pride in their identity, as well as safe to talk about race at home.

“My daughter had an incident on the playground one day where a girl described her to another child as the black girl with braids and my daughter thought that she was being racist,” said Dr. Carter. “When we talked about it, we talked about how that’s not racist, that’s a description. I think it’s important to allow your child to process that and talk about what racism actually is, because it does exist and you never know when your child will come across something like that.”

While we still have a long road ahead in the fight against racism, Dr. Partap says she’s seen progress in her lifetime.

“Growing up in the ‘70s in the Midwest, I often watched people make fun of my parents because of their dark-skin or for being Indian or their accent. When I was young, people frequently just stared and asked “what are you?” I accepted that as normal,” Dr. Partap explained. “My children, who are mixed race, have never had those experiences. But unfortunately, peers who don’t know they’re mixed race have said unkind things about Indians to them or about their “Indian half.” We‘ve had to discuss how to call it out, not feel shame, and not escalate. So the issue isn’t gone, but our kids have a better chance now of learning the right way to live today than we did ‘yesterday’.”

So what can parents do to ensure progress in this critical area continues?

Our experts have the following advice:

• Talk to your children about racism and other biases based on personal attributes
• Celebrate differences and nurture pride
• Create safe dialogue for discussion
• Confront your own implicit biases

Talk to your children about racism and other biases based on personal attributes

Acknowledge that people are treated differently based on the color of their skin and share examples of this happening. Have conversations about race and cultural differences regularly, as part of normal conversation.

Biologically, we share 99.9% of our genes, meaning we are one race. Instill in children of all ages that people are people and should not be treated differently based on the color of their skin.

Celebrate differences and nurture pride

If you’re raising a child who identifies as a racial minority, you have tremendous impact on how positively the child sees themselves. Take the time to nurture their pride in their identity. By helping children feel just as equal, valued and celebrated, you create a tremendous protective layer on their self-esteem, creating resiliency as they move through life.

It’s also important for all children to be exposed to different experiences and people from different walks of life. Engage your child in new and different activities as well as cultures that may be different from their own.

Create safe dialogue for discussion

Either regularly or when there’s more public dialogue, like now, check-in with your children to challenge and guide their views, not only on skin color, but gender, disability, mental health, religion, sexual orientation, income etc.

Help children feel comfortable talking about racism and cultural differences, whether it’s something they have experienced, witnessed or are confused or concerned about.

Confront your own implicit biases

Routinely notice your own interactions or reaction to people who are different from you and ask yourself – ‘What assumption did I make? What is my belief based upon, subconsciously?’ If you made a negative assumption, begin challenging it. Learn more about others through safe conversations.

An easy example of implicit bias, provided by Dr. Partap, is to consider what you think about people if you hear they live in a house, a tent or an RV. Negative or positive views are examples of implicit bias which may be influenced by past experiences, something you’ve heard or seen on TV or read online. In reality, you don’t know the values, behaviors, needs or beliefs of the people in those different homes. But when we offer or withhold opportunities, kindness, benefits, resources or support, based on assumptions about where they live, this behavior comes from a place of implicit bias. 

Another important thing to keep in mind is that other people may have experiences that differ from your own.

“People from minority groups have typically had a series of past traumatic experiences starting early in life or even in adulthood if they move to a new community,” Dr. Partap explained. “Sometimes those experiences lead people to avoid reaching out for help, even for serious needs, because they fear they’ll be treated unfairly or misunderstood. When that happens, and people continue without help, it can leave that stress response and inflammatory system revved up. And that takes a toll on the developing brain, in which case you see issues with mood, sleep, learning, play or in adulthood for example with hypertension, chronic disease, or poor mental health.”

Dr. Partap says tackling racism is as basic to public health as clean water and healthy food and that a culture of safety and security is essential to healing.

“All ‘-isms’ are harmful to a safe and healthy society,” Dr. Partap added. “Racism logically places the largest percentage of us at risk. And science tells us, the risk to health is real across the life spectrum.”