Academic journal article
By Pachter, Lee M.; Bernstein, Bruce A.; Szalacha, Laura A.; Coll, Cynthia Garcia
Health and Social Work , Vol. 35, No. 1
Child Health--Social Aspects
Child Health--Psychological Aspects
Health Care Disparities
Racism can be defined as negative beliefs, attitudes, actions, or behaviors that are based on phenotypic characteristics or ethnic affiliations. It assumes an inherent superiority or inferiority on the basis of perceived group attributes. Racism is often conceptualized as including beliefs and attitudes (racial prejudice) and actions and practices (racial discrimination) (Clark, Anderson, Clark, & Williams, 1999). It can occur on individual, internal, or structural (institutional) levels, and it can be either subtle or obvious (Jones, 2000). Racism can be conceptualized as a toxic stressor that may affect health and well-being (Clark et al., 1999; King, 2005; Meyer, 2003; Sanders Thompson, 2002).
There are important reasons for studying racism, particularly as it relates to the behavioral and emotional health of children. Racism as a stressor may produce negative biological or psychological responses. It may also explain within-group variability in health status and health outcomes. And if racism is determined to be related to negative outcomes, then interventions and preventive strategies could be developed to limit its effects (Clark et al., 1999).
Racism's effects on health and well-being may occur through multiple pathways. According to Williams, Lavizzo-Mournay, and Warren (1994), it can contribute to discrepancies in socioeconomic status (which result in differential health outcomes), it can create differential exposures to risk factors and available resources (for example, the quality and quantity of medical care), and it can adversely affect psychological or physiological functioning.
Data from the literature on adult health show that minorities who perceive themselves as being targets of racial discrimination have poorer outcomes in the areas of mental health; hypertension and cardiovascular disease; and various health-related behaviors, including tobacco, alcohol, and substance use (Paradies, 2006; Williams, Neighbors, & Jackson, 2003).
There are few data on the physical, emotional, or behavioral effects of racism on children. Garcia Coil et al. (1996) proposed an ecological model for the study of minority child behavioral and developmental competencies. In this integrative model, the effects of social position factors (for example, race, social class, ethnicity, gender) are mediated through social stratification processes such as segregation, racism, and discrimination. These, in turn, act to influence other environmental factors such as neighborhoods, schools, and health care (factors that significantly influence the contexts of children's lives) .These environmental factors (in concert with the other macro-level factors) affect other cultural, family, and individual-level variables that contribute to the quality of child health and development.
Although this model has gained a significant following in the child development arena, relatively little research has been conducted on the specific role of racism in child health and development, particularly as it pertains to minority children. A recent comprehensive review of the medical, public health, and social science literature on the relationship between racism and child health found only 40 papers presenting empirical studies on the effects of racism on child health conditions (Pachter & Garcia Coll, 2009). Of these 40 papers, 65 percent (26) reported on the effects of racism on behavioral and mental health conditions such as depression (Brody et al., 2006), anxiety (Sellers, Caldwell, Schmeelk-Cone, & Zimmerman, 2003), self-esteem (Wong, Eccles, & Sameroff, 2003),behavioral problems (Szalacha et al., 2003), and substance (alcohol, tobacco, drug) use (Terrell, Miller, Foster, & Watkins, 2006; Whitbeck, Hoyt, McMorris, Chen, & Stubben, 2001). Most of these studies demonstrated a positive association between children's and youths' perceptions of racism and these conditions. Other studies showed a significant association between adverse birth outcomes (prematurity and low birth weight) and maternal perceptions of racism (Collins, David, Handler, Wall, & Andes, 2004; Mustillo et al. …