Racism: A Social Determinant of Health

June 5, 2020
The Texas Pediatric Society, the Texas Chapter of the American Academy of Pediatrics, is deeply saddened and incensed by recent events which so distressingly reminded us of the racism that continues to pervade our country.  While it was the needless death of George Floyd that has brought this back to the forefront, racism and its long-term implications for the children for whom we provide care should never be far from our mind.  Like poverty, housing insecurity, and other adverse childhood experiences, racism is another social determinant of health that must be addressed by pediatricians. 

According to the AAP policy statement, The Impact of Racism on Child and Adolescent Health, despite some gains, “…children raised in African American, Hispanic, and American Indian populations continue to face higher risks of parental unemployment and to reside in families with significantly lower household net wealth relative to white children in the United States, posing barriers to equal opportunities and services that optimize health and vocational outcomes.” 

As a chapter we have addressed racism and its subsequent health inequities largely through the work of our committees.  However, it is time for TPS to be more intentional in our approach to racism.  This is a call to action for us to implement many of the recommendations from the AAP policy statement both as individual pediatricians and as a chapter.  I encourage you to read the policy statement and to begin to incorporate many of the recommendations within your individual practice. 

Our children spend much of their time within the education system, and their success in school has long-term implications for their health.  As an organization we need to be even more active legislatively in monitoring and supporting bills that promote a diverse teacher workforce.  Just as it has been shown in healthcare that patients experience better outcomes when cared for by someone from a similar background, so is the likelihood of graduation from high school by a student taught by someone from a similar background, even if only once in their early grades.  Many of us encourage our patients to consider careers in medicine; we should do the same in encouraging them to become teachers.  Perhaps we could even consider establishing a scholarship or funded project that addresses diversity in teaching and education for the benefit of our children.

We need to educate ourselves and be willing to have frank discussions.  Our annual meeting is an excellent opportunity to have a plenary session addressing this critical topic followed by break-out sessions that allow us to explore meaningful measures in which we can engage to improve the health inequities caused by racism. 

A workgroup will be established to explore the above ideas. TPS recognizes that there is a history of racism even within medicine, and we will work to educate and develop strategies to promote equity in our profession.  The recent lives lost should not just become memories but should serve as an impetus for us to do more.   A few positive stories from the news this week have shown some police chiefs and officers joining with peaceful protesters to express their solidarity against police brutality and racism.  As TPS, the Texas Chapter of the American Academy of Pediatrics, and as individual pediatricians, it is time for our voice to be heard, and we should actively demonstrate that we believe racism is a social determinant of health that should no longer be tolerated.  

Tammy Camp, MD
TPS President