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'Dismantle racism at every level’: AAP president :

June 1, 2020

AAP leaders have condemned the racism that has incited protests in recent days and are calling on pediatricians to recommit to rooting out inequities that threaten children’s health at all ages.

“We must dismantle racism at every level, from individual to institutional to systemic,” said AAP President Sara “Sally” H. Goza, M.D., FAAP. “Our nation did not get here overnight, and the road to progress and healing will be long and difficult, but the work we have before us is essential. Our children’s future will be built on these moments of reckoning.”

The killing of George Floyd is the latest evidence that racism persists and that much work remains to address inequalities in the nation’s education, employment, judicial and health care systems. Children exposed to discrimination can develop toxic stress that affects their physical, mental and behavioral health throughout their lives.

“Racism harms children’s health, starting from before they are born," Dr. Goza said. “A growing body of research supports this, and we cannot ignore the impact.”

In its 2019 policy statement The Impact of Racism on Child and Adolescent Health, the AAP provides guidance for pediatricians, calling on them to counsel families on the effects of racism and ensure patients are treated with respect. It also lays out an agenda calling for equitable policies at the local, state and federal level to reduce disparities and advance social justice.

“In the 90-year history of the AAP, advancing child health has often meant fighting for social justice,” said AAP CEO/Executive Vice President Mark Del Monte, J.D. “The mission of the AAP cannot be accomplished when structural racism deprives too many children of a fair chance and an equitable future. Out of our grief and anger, we can strive to recommit to the AAP mission and follow it where it leads. We have always taken on complex threats to children’s health, and we don’t flinch from this one.”

As wrenching images of Floyd’s death and the subsequent protests continue to dominate television news and social media, the AAP encourages parents to proactively engage their children around these traumatic events, taking into account their age and development.

Nia Heard-Garris, M.D., M.Sc., FAAP, chair of the AAP Section on Minority Health, Equity and Inclusion, and Jacqueline Dougé, M.D., M.P.H., FAAP, a co-author of the AAP policy on racism, recommend asking children what they know and have seen, validating their feelings, watching for changes in their behavior, placing limits on what they see in media and discussing the history of racism in the U.S. Additional advice is available at

“Parents can acknowledge that people are treated differently based on the color of their skin and where they live, and share examples of this happening,” Dr. Dougé said. “Parents can also model how to make a positive difference. For example, perhaps your family can call your city council person or superintendent to advocate for issues faced by communities of color. Adults can also confront their own bias and model how they want their children to respond to others who may be different than them.”

The AAP holds that racism harms everyone, including children of all races and ethnicities. It is not a conversation that can be avoided, said Joseph L. Wright, M.D., M.P.H., FAAP, a member of the AAP Board of Directors and immediate past chair of the AAP Task Force on Addressing Bias and Discrimination.

“These are conversations many African-American families have had to have for generations,” Dr. Wright said. “But if this is not something other families have discussed yet, what is happening right now is an essential and unavoidable, teachable moment. If we are to progress in this country, it’s going to be because we help our children, adolescents and young adults learn not just that racism exists, but that it is something all of us can work together to dismantle. Racism is not inexorable.”

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