Expert consensus and guidance for integrating discussions of racism in pediatric care

Extensive research shows the link between exposure to racism during childhood and adolescence and increased risks of depression and metabolic health issues, such as obesity, diabetes and heart disease. Conversely, racial socialization, described as behaviors and practices that teach children about race and ethnic identity, has shown potential in mitigating these negative effects, and discussions like these could be effective in pediatric clinics, according to the first expert consensus guidance on this topic published in Pediatrics.

Over the years, numerous calls to action have been made to address racism in medicine. However, there's been little guidance on how to have these conversations within clinical settings. Pediatric clinicians, in particular, have a unique opportunity to incorporate crucial conversations about race and racism into clinical visits, as these interactions occur during key developmental stages of a child's life."

Nia Heard-Garris, MD, MBA, MSc, senior author, researcher and pediatrician at Ann & Robert H. Lurie Children's Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine

Dr. Shawnese Clark, lead study author, and research team conducted the consensus study. It involved a panel of pediatric clinicians and psychologists with expertise in racism and child health, as well as parents and adolescents with lived experience of racism. They identified overarching themes to consider before, during, and after discussions with patients, as well as barriers that clinicians may encounter.

Consensus was reached on the necessity for pediatric clinicians to have a thorough understanding of the systemic nature of racism and the importance of both learning from patients and addressing intersectionality during these conversations. Panelists agreed on the short- and long-term benefits these conversations could bring to patient appointments, including building greater trust and affirmation.

"Racism is a strong determinant of health and longevity of life so talking about it, feeling affirmed and perhaps even receiving support will go a long way to social, mental, and emotional wellbeing of patients and care providers too," said one panelist.

Panelists also emphasized the potential negative consequences if clinicians lack adequate training.

"As research in this field continues to evolve, it is imperative to maintain ongoing dialogue about the key principles guiding conversations about race and racism, and to equip clinicians with the necessary tools to provide care that fully considers the impact of race on the patient population," said Dr. Heard-Garris.

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