Welcome to the first article in the newest Monthly Feature, “Equity, Diversity, and Inclusion.” The articles included in this feature will highlight areas in which bias, discrimination, racism, and inequity have impacted the health and wellbeing of children and their families. “#NotMyAriel: Reflections of Growing Up in a World That Favors Whiteness” eloquently captures the spirit and intent of this new feature. As leaders in our communities, we have the privilege and responsibility to be forces for change. Everyone benefits when we take a moment to see something from another person’s perspective, and as we learn from one another, we become better equipped to work together. We hope that through the articles presented in this new Monthly Feature, we can continue, or sometimes begin for the first time, to see our world through different lenses and collaborate to create a more equitable future. Please see the Author Guidelines for information about submission to the Equity, Diversity, and Inclusion Monthly Feature (https://pediatrics.aappublications.org/page/author-guidelines).

Allison Lopez, Editor

Diversity, Equity, and Inclusion

#NotMyAriel, they tweeted last July when Disney announced the casting of a Black actress as Ariel in the live-action version of the Little Mermaid. Reading these tweets, I was transported back to my younger self, wishing I could trade my dark skin and thick black hair for an alabaster complexion, blonde hair, and blue eyes. I painfully recalled the first guy I dated and the mockery from his friends. “How could you find her attractive? She’s so dark.”

Following the tragic killing of George Floyd, my twitter feed now abounds with #Blacklivesmatter, #diversitymatters, and #antiracism, a stark contrast to the racist rhetoric that fueled #notmyariel, only a year before. I wonder, will this be the moment that racism becomes all of our problem rather than a problem of only the oppressed? And will we finally maintain our ideals long enough to make sustainable change, change that will undoubtedly impact our nation’s children?

Representation in books and movies indirectly shows children where their opportunities begin and end, with white characters often depicted in roles such as CEOs, doctors, or military officials and Black characters shown as criminals, athletes, or entertainers. It was not until 2009 that Disney cast a Black princess. Princess Tiana, however, a struggling restaurateur, perpetuated the age-old norm of portraying people of color in subservient roles. Before this, Black character depictions included a naked Black child brushing a white woman’s hair and filing her nails in Disney’s Fantasia and, more recently, Oscar from Shark Tale, who was referred to as a “little hustler fish,” living in the “ghetto” part of the reef, and wearing “bling.”

This lack of positive representation of people of color actually harms child development. Research reveals that youth often internalize these negative images of people within their racial group, ultimately impacting their self-esteem and resilience. In the 1940s, psychologists Kenneth and Mamie Clark conducted “the doll test,” in which children, ages 3 to 7, were asked to identify dolls as “good” or “bad” and indicate which doll they preferred to play with. Sixty-five percent of Black children preferred the white doll. One child even pointed to the dark-skinned doll and exclaimed, “That’s a n—–. I’m a n—–.” The results of this experiment were subsequently used by the Supreme Court in support of school desegregation in Brown versus the Board of Education, to showcase the detrimental effects of racial segregation on the mental health of children.1  Seventy years later, the controversial nature of casting a Black woman as the Little Mermaid shows just how much work remains to be done.

In contrast, positive representation yields positive results. Instilling cultural pride among Black children has been linked to less psychological distress, improved self-esteem, and higher academic achievement.2  Such evidence supports the American Academy of Pediatrics’ recent recommendation to enhance diversity in children’s literature as one approach to mitigating the detrimental impact of racism on child health.3  This recommendation further highlights the importance and timeliness of casting a Black actress as Ariel, despite critics’ protests. With antiracism at the forefront of people’s minds, diverse booklists are just a quick google search away. Classic books such as “Corduroy” show a young Black girl enjoying an everyday activity with her mom such as shopping, while newer titles, such as “Hair Love,” depict a Black father styling his daughter’s hair, debunking the commonly held false belief that Black fathers lack involvement in their children’s lives.4 

The argument for increased representation, however, does not just serve children of color. White children, just like minority children, grow up and learn what it means to be a member of their racial group. Seeing positive examples of people of color reduces white children’s prejudices and can decrease anxiety about interacting with other races.5  Furthermore, regardless of race, children who are exposed to diversity are more likely to enroll in college and have higher test scores, improved self-confidence, and enhanced leadership skills.6 

As our nation trudges through what many are calling a racial “awakening,” children are more frequently overhearing conversations and viewing images related to racism and police brutality. Although some pediatricians may feel this is not our lane, as fierce advocates for the health and wellbeing of children, we must not shy away from addressing the impact of systemic racism on our patients. Researchers show that as early as 3 to 6 months, children notice differences in skin color; by ages 3 to 4, children can express explicit forms of racism such as name-calling and teasing; and by ages 10 to 12, many become set in their beliefs.7  Pediatricians must educate themselves and use these stages of racial identity development to provide anticipatory guidance. Children’s books can serve as a nonthreatening and informative medium for having such conversations. Through national programs such as Reach Out and Read, we can advocate for and select diverse books for our clinics.

We must also encourage families to not avoid such crucial conversations surrounding race and racism. Although Black families often have “the talk,” non-Black families must also find a parallel to filter and interrogate the deluge of racialized messages their children receive. We can practice this within our own homes and within the walls of our clinics, using resources such as embracerace.org or Conscious Kid on Instagram, to name a few. For pediatricians who are fearful of these discussions or perhaps do not think their experiences reflect that of their patients, we must tap into the same empathy and humility that we use when caring for a child with autism or a child with kidney failure, experiences that we often cannot directly relate to, yet still find ways to provide support and guidance for. Claiming ignorance, citing fear, and being silent are no longer options.

Maybe if I had seen more dark-skinned Disney princesses, Barbies, and female leaders, I would not have yearned for a different identity and struggled with my self-worth. Maybe if these images had been the standard, my parents would not have discouraged my participation in sports that exposed me to too much sun and therefore darker skin. This remake is one of many opportunities to subtly tell young girls of color that they too can be anything they want in this world: a world that tends to favor whiteness.

Whether via a movie or a book, stories are the mirrors that allow children to see themselves, the windows that let children take a few steps in someone else’s shoes, and the maps that guide them to find their place in the world. What are the images that we want our children to see and remember? And do we want stereotypes dictating our children’s interactions with people who are different from them? Although children may not be born racist, they are born into a society in which systemic racism is embedded. It is our responsibility as we care for children to acknowledge the legacy of racism and support parents and their children in an effort to dismantle it. In The Little Mermaid, Ariel sings, “I just don’t see how a world that makes such wonderful things could be bad.” We must ask ourselves, is this really a world full of such wonderful things, if it’s a world for only some of our children, rather than all of them?

FUNDING: Dr Jindal is funded under the National Institutes of Health T32 Training Grant (Interdisciplinary Training in Trauma and Violence, T32HD94687-2; primary investigators: Jacquelyn Campbell, PhD, and Tina L. Cheng, MD, MPH). Funded by the National Institutes of Health (NIH).

     
  • AAP

    American Academy of Pediatrics

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Competing Interests

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.