Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago (N Heard-Garris and K Kan), Chicago, Ill; Northwestern University Feinberg School of Medicine (N Heard-Garris and K Kan), Chicago, Ill; Mary Ann & J. Milburn Smith Child Health Outcomes, Research and Evaluation Center Stanley Manne Children's Research Institute, Ann and Robert H. Lurie Children's Hospital of Chicago (N Heard-Garris, K Kan, and L Perez-Cardona), Chicago, Ill.
Palo Alto Medical Foundation (R Boyd), San Francisco, Calif.
Acad Pediatr. 2021 Nov-Dec;21(8S):S108-S116. doi: 10.1016/j.acap.2021.05.026.
Black, Native, and Latinx populations represent the racial and ethnic groups most impacted by poverty. This unequal distribution of poverty must be understood as a consequence of policy decisions-some that have sanctioned violence and others that have created norms-that continue to shape who has access to power, resources, rights, and protections. In this review, we draw on scholarship from multiple disciplines, including pediatrics, public health, environmental health, epidemiology, social and biomedical science, law, policy, and urban planning to explore the central question-What is the relationship between structural racism, poverty, and pediatric health? We discuss historic and present-day events that are critical to the understanding of poverty in the context of American racism and pediatric health. We challenge conventional paradigms that treat racialized poverty as an inherent part of American society. We put forth a conceptual framework to illustrate how white supremacy and American capitalism drive structural racism and shape the racial distribution of resources and power where children and adolescents live, learn, and play, ultimately contributing to pediatric health inequities. Finally, we offer antipoverty strategies grounded in antiracist practices that contend with the compounding, generational impact of racism and poverty on heath to improve child, adolescent, and family health.
黑种人、原住民和拉丁裔人群代表了受贫困影响最大的种族和族裔群体。这种贫困的不平等分布必须被理解为政策决策的后果——一些政策批准了暴力，而另一些政策则制定了规范——这些决策继续影响着谁有权获得权力、资源、权利和保护。在这篇综述中，我们借鉴了儿科学、公共卫生、环境卫生、流行病学、社会和生物医学科学、法律、政策和城市规划等多个学科的学术成果，探讨了一个核心问题——结构性种族主义、贫困与儿科健康之间存在怎样的关系？我们讨论了历史和当今的事件，这些事件对于理解美国种族主义和儿科健康背景下的贫困至关重要。我们挑战了将种族化贫困视为美国社会固有特征的传统范式。我们提出了一个概念框架，来说明白人至上主义和美国资本主义如何推动结构性种族主义，并塑造了儿童和青少年生活、学习和玩耍的地方的资源和权力的种族分配，最终导致儿科健康的不平等。最后，我们提供了基于反种族主义实践的反贫困策略，这些策略应对了种族主义和贫困对健康的累积性、代际影响，以改善儿童、青少年和家庭的健康。
