How Racism Can Affect Child Development

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What could our society look like if racial disparities in health and learning outcomes didn’t exist? According to extensive studies, the U.S. would save billions in health care costs alone. The value of realizing the potential contributions of so many people around the world who are impaired by—or die from—preventable chronic illnesses is enormous, and the human costs are incalculable.

Advances in science are presenting an increasingly clear picture of how significant adversity in the lives of young children can disrupt the development of the brain and other biological systems. These early disruptions can undermine young children’s opportunities to achieve their full potential. And, while they may be invisible to those who do not experience them, there is no doubt that both systemic racism and interpersonal discrimination can lead to chronic stress activation that imposes significant hardships on families raising young children.

It’s time to connect these dots. This infographic explains in basic terms how racism in particular gets “under the skin” and affects learning, behavior, and lifelong health. There is much more to say, but by starting with a shared understanding, we can work together toward creative strategies to address these long-standing inequities.

Sources

Panel 1

Forde, A.T., Crookes, D.M., Suglia, S.F., & Demmer, R.T. (2019). The weathering hypothesis as an explanation for racial disparities in health: a systematic review. Annals of Epidemiology, 33, 1-18.e3

Panel 2

Geronimus, A.T., Hicken, M., Keene, D., & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among blacks and whites in the United States. American Journal of Public Health, 96(5), 826-833.

McEwen, B.S. (1998.) Protective and damaging effects of stress mediators. New England Journal of Medicine, 338(3), 171-9.

Panel 3

Williams, D.R., & Wyatt, R. (2015). Racial Bias in Health Care and Health: Challenges and Opportunities. JAMA 314(6): 555-556.

Williams, D.R., Mohammed, S.A., Leavell, J., & Collins, C. (2010). Race, socioeconomic status and health: Complexities, ongoing challenges and research opportunities. Annals of the New York Academy of Sciences, 1186, 69.

Panel 4
Agency for Healthcare Research and Quality (2019). 2018 National Healthcare Quality and Disparities Report. Rockville, MD. AHRQ Pub. No. 19-0070-EF https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2018qdr-final-es.pdf

Manuel J. I. (2018). Racial/Ethnic and Gender Disparities in Health Care Use and Access. Health Services Research, 53(3), 1407-1429.

Panel 5

Heard-Garris, N.J., Cale, M., Camaj, L., Hamati, M.C., & Dominguez, T.P. (2018). Transmitting trauma: A systematic review of vicarious racism and child health. Social Science & Medicine, 199, 230-240.

Pachter, L.M., & Coll, C.G. (2009). Racism and child health: a review of the literature and future directions. Journal of Developmental and Behavioral Pediatrics, 30(3), 255-263.

Clark, R., Anderson, N.B., Clark, V.R., & Williams, D.R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54(10), 805- 816.

Panel 6

Trent, M., Dooley, D.G., & Dougé, J. (2019). The impact of racism on child and adolescent health. Pediatrics, 144(2), e20191765.

Williams, D. R., & Cooper, L. A. (2019). Reducing Racial Inequities in Health: Using What We Already Know to Take Action. International Journal of Environmental Research and Public Health, 16(4), 606.

Panel 7

Collins, C., Asante-Muhammed, D., Hoxie, J., & Nieves, E. (2017). The road to zero wealth: How the racial wealth divide is hollowing out America’s middle class. Washington, DC: Prosperity Now and Institute for Policy Studies.

Weir, K. (2016). Policing in Black & White. Monitor on Psychology, 47(11). Retrieved from http://www.apa.org/monitor/2016/12/cover-policing

Panel 8

National Scientific Council on the Developing Child. (2020). Connecting the Brain to the Rest of the Body: Early Childhood Development and Lifelong Health Are Deeply Intertwined: Working Paper No. 15. Retrieved from www.developingchild.harvard.edu

Full Text of the Graphic

Years of scientific study have shown us that, when children’s stress response systems remain activated at high levels for long periods, it can have a significant wear-and-tear effect on their developing brains and other biological systems. This can have lifelong effects on learning, behavior, and both physical and mental health.¹

A growing body of evidence from both the biological and social sciences connects this concept of chronic wear and tear to racism.² This research suggests that constant coping with systemic racism and everyday discrimination is a potent activator of the stress response. This may help us understand the early origins of racial disparities in chronic illness across the lifespan.

The evidence is overwhelming: Black, indigenous, and other people of color in the U.S. have, on average, more chronic health problems and shorter lifespans than whites at all income levels.³

People of color receive unequal treatment when they engage in systems like health care and education, and also have less access to high-quality education and health services, economic opportunities, and pathways to wealth accumulation.⁴ All of these reflect ways in which the legacy of structural racism in the U.S. has created conditions that disproportionately undermine the health and development of children and families of color.

Multiple studies have documented how the stresses of everyday discrimination on parents or other caregivers, such as being associated with negative stereotypes, can have harmful effects on caregiving behaviors and adult mental health.⁵ And when caregivers’ mental health is affected, the challenges of coping with it can cause an excessive stress response in their children. But we can prevent lasting harm if we work together.

To address these challenges, we must not only provide needed services for all young children and families, but also create new strategies to address “upstream” inequities that systematically threaten the health and well-being of young children of color and the adults who care for them.⁶

This means actively searching for and reducing unseen, restrictive biases in ourselves and in economic and social policies through initiatives such as fair hiring and lending practices, housing and home ownership programs, anti-bias training, and community policing initiatives.⁷

It’s clear that science cannot address these challenges alone. But science-informed thinking combined with expertise in changing entrenched systems and the lived experiences of families raising young children under a wide variety of conditions can be a powerful catalyst of more effective strategies.⁸

For sources and more information: https://developingchild.harvard.edu/racism-and-ecd