Children of color are systematically disadvantaged by our health care system. Across pediatric diagnoses, Black children are more likely to be hospitalized, experience severe illness complications, and die.1–9  The American Academy of Pediatrics identifies racism as a key driver of health inequities.10,11  Addressing structural racism, “the structures, policies, practices, and norms resulting in differential access to the goods, services, and opportunities of society by race,”12  requires understanding and targeting the mechanisms through which it perpetuates disparities.

Pediatric subspecialties are uniquely positioned to leverage the infrastructures of multicenter, national research collaboratives (eg, Children’s Oncology Group, Children’s Hospitals Neonatal Consortium, Pediatric Emergency Care Applied Research Network, and Pediatric Acute Lung Injury and Sepsis Investigators) to systematically identify areas for intervention. Hereafter, we use pediatric oncology as a paradigmatic population to describe 3 pathways13  through which structural racism leads to inferior outcomes: access to care,...

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