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Addressing racism with patients: How pediatricians can promote health, healing :

December 1, 2020

Editor's note: For more coverage of the 2020 AAP Virtual National Conference & Exhibition, visit For the latest news on COVID-19, visit

Pediatricians should be talking to their patients about racism and advising parents to do the same, Ashaunta T. Anderson, M.D., M.P.H., FAAP, said during a presentation at the AAP Virtual National Conference.

“Think of the race talk like the sex talk. If you don’t talk to your children about sex, they will still get information about it that is important for their health,” Dr. Anderson said. “It’s the same with race. If you don’t talk about it, they are still taking in information about race that could impact their health down the line.”

Research has shown that racism can have adverse psychological and physiological effects in children and teens. Studies also have identified strategies that are protective.

Dr. Anderson, assistant professor of pediatrics at the University of Southern California, and Howard Stevenson, Ph.D., Constance Clayton Professor of Urban Education at the University of Pennsylvania, discussed some of those strategies during the session titled “Talking to Kids About Racism.” 

Dr. Anderson explained a concept called racial socialization, which refers to how messages from parents, teachers, doctors, the media, social media and others educate children about race as it relates to their identity, relationships with others and race-based social hierarchy.

Some racial socialization strategies can increase self-esteem, behavioral competence and the quality of mother-child interactions while decreasing depression and anger. Other strategies, however, are associated with negative outcomes.

  • Cultural pride reinforcement. Children are encouraged to develop pride and knowledge about their cultural background. Research has shown that this strategy provides the most benefits, increasing cognitive skills and anger control while decreasing problem behaviors and anxiety.
  • Preparation for bias. Children are told that people might treat them differently because of their skin color, and they are given tools to cope with these situations. This strategy is better for older children.
  • Promotion of mistrust. Children are told to avoid specific groups. This strategy can lead to poorer academic and socioemotional outcomes.

Dr. Anderson explained how pediatricians can incorporate effective racial socialization strategies into their anticipatory guidance.

When discussing screen time with patients and parents, for example, pediatricians can bring up that children may see racialized content. They can advise parents to look through the content with their children and help them understand what they are seeing.

Additionally, when discussing school readiness, pediatricians can suggest parents find books with positive messages about their culture — promoting reading and reinforcing cultural pride.

Lastly, pediatricians can ask about race-related bullying if they believe it’s relevant to their patient.

“Continue to find ways to make the work you are already doing do double duty,” Dr. Anderson said. “If you’re talking about bullying or screen time, mention race and make sure that parents are helping them navigate those messages by providing resources for them to move forward.”

Dr. Stevenson offered another method to combat racism’s physiological effects: racial literacy. He described racial literacy as the ability to read, recast and resolve racially stressful encounters.

Reading the moment involves interpreting what is happening. Recasting employs mindfulness to help youths assess their stress level, identify what part of their body is affected and then use strategies like breathing and self-talk to reduce their stress. Resolving helps children face the moment instead of running away.  

“Through racial literacy, we can make our socially just attitudes, socially just actions.”

While racial literacy cannot be perfected in a 15-minute appointment, Dr. Stevenson said it’s essential that pediatricians are aware of the physical stress brought on by racist encounters.

When talking with White families, pediatricians can assure them that having conversations about race is not racist, Dr. Anderson said.

“Many parents have concerns that if they talk about race or point out that this person is this race or this person is a different race, that identification alone will cause children to hold racist ideas,” she said. “It’s important for parents to understand that you want to have conversations about race because if you don’t, you create this vacuum that will be filled in other ways.”

Registered attendees can access the session through Jan. 31, 2021, at

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