Policy solutions to eliminate racial and ethnic child health disparities in the USA

doi:10.1016/S2352-4642(23)00262-6

Review

. 2024 Feb;8(2):159-174.

doi: 10.1016/S2352-4642(23)00262-6.

Policy solutions to eliminate racial and ethnic child health disparities in the USA

Affiliations

¹ Department of Medicine, University of Illinois Chicago School of Medicine, Chicago, IL, USA. Electronic address: mjindal@uic.edu.
² Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA.
³ Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
⁴ Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁵ Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA; Department of Sociology and Anthropology, College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA.
⁶ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁷ Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
⁸ Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Office of Extramural Research, Education, and Priority Populations, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, MD, USA.
⁹ Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA; Center on the Developing Child, Harvard University, Boston, MA, USA.
¹⁰ Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
¹¹ Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
¹² Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Institute for Policy Research, Northwestern University, Chicago, IL, USA.

PMID: 38242598
PMCID: PMC11163982
DOI: 10.1016/S2352-4642(23)00262-6

Review

Policy solutions to eliminate racial and ethnic child health disparities in the USA

Monique Jindal et al. Lancet Child Adolesc Health. 2024 Feb.

. 2024 Feb;8(2):159-174.

doi: 10.1016/S2352-4642(23)00262-6.

Authors

Affiliations

¹ Department of Medicine, University of Illinois Chicago School of Medicine, Chicago, IL, USA. Electronic address: mjindal@uic.edu.
² Department of Pediatrics, David Geffen School of Medicine at UCLA, University of California, Los Angeles, CA, USA.
³ Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN, USA.
⁴ Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁵ Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA; Department of Sociology and Anthropology, College of Social Sciences and Humanities, Northeastern University, Boston, MA, USA.
⁶ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁷ Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
⁸ Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Office of Extramural Research, Education, and Priority Populations, Agency for Healthcare Research and Quality, US Department of Health and Human Services, Rockville, MD, USA.
⁹ Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Boston, MA, USA; Center on the Developing Child, Harvard University, Boston, MA, USA.
¹⁰ Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA.
¹¹ Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.
¹² Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, USA; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Institute for Policy Research, Northwestern University, Chicago, IL, USA.

PMID: 38242598
PMCID: PMC11163982
DOI: 10.1016/S2352-4642(23)00262-6

Abstract

Societal systems act individually and in combination to create and perpetuate structural racism through both policies and practices at the local, state, and federal levels, which, in turn, generate racial and ethnic health disparities. Both current and historical policy approaches across multiple sectors-including housing, employment, health insurance, immigration, and criminal legal-have the potential to affect child health equity. Such policies must be considered with a focus on structural racism to understand which have the potential to eliminate or at least attenuate disparities. Policy efforts that do not directly address structural racism will not achieve equity and instead worsen gaps and existing disparities in access and quality-thereby continuing to perpetuate a two-tier system dictated by racism. In Paper 2 of this Series, we build on Paper 1's summary of existing disparities in health-care delivery and highlight policies within multiple sectors that can be modified and supported to improve health equity, and, in so doing, improve the health of racially and ethnically minoritised children.

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Conflict of interest statement

Declaration of interests AC has a contract with Organon & Co (previously part of Merck) as a clinical trainer for the Nexplanon contraceptive device. In this role, she provides training and education to resident physicians at her institution in the use of the subdermal implant device. She does not receive payment or any other form of incentive from Organon & Co in this role NH-G is the co-owner of XNY Genes. All other authors declare no competing interests.

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References

1. Bonilla-Silva E Rethinking racism: Toward a structural interpretation. Am Sociol Rev 1997:465–480.
1. Slopen N, Heard-Garris N. Structural racism and pediatric health—a call for research to confront the origins of racial disparities in health. JAMA pediatrics 2022;176(1):13–15. - PubMed
1. Ansley FL. White supremacy (and what we should do about it). Critical white studies: Looking behind the mirror. 1997:592–595.
1. Krieger N. Discrimination and health. Social epidemiology. 2000;1:36–75.
1. Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: Evidence and interventions. The Lancet. 2017;389(10077):1453–1463. - PubMed

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[1] Bonilla-Silva E Rethinking racism: Toward a structural interpretation. Am Sociol Rev 1997:465–480.

[2] Bonilla-Silva E Rethinking racism: Toward a structural interpretation. Am Sociol Rev 1997:465–480.

[3] Slopen N, Heard-Garris N. Structural racism and pediatric health—a call for research to confront the origins of racial disparities in health. JAMA pediatrics 2022;176(1):13–15. - PubMed

[4] Slopen N, Heard-Garris N. Structural racism and pediatric health—a call for research to confront the origins of racial disparities in health. JAMA pediatrics 2022;176(1):13–15. - PubMed

[5] Ansley FL. White supremacy (and what we should do about it). Critical white studies: Looking behind the mirror. 1997:592–595.

[6] Ansley FL. White supremacy (and what we should do about it). Critical white studies: Looking behind the mirror. 1997:592–595.

[7] Krieger N. Discrimination and health. Social epidemiology. 2000;1:36–75.

[8] Krieger N. Discrimination and health. Social epidemiology. 2000;1:36–75.

[9] Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: Evidence and interventions. The Lancet. 2017;389(10077):1453–1463. - PubMed

[10] Bailey ZD, Krieger N, Agénor M, Graves J, Linos N, Bassett MT. Structural racism and health inequities in the USA: Evidence and interventions. The Lancet. 2017;389(10077):1453–1463. - PubMed

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Policy solutions to eliminate racial and ethnic child health disparities in the USA

Affiliations

Policy solutions to eliminate racial and ethnic child health disparities in the USA

Authors

Affiliations

Abstract

Conflict of interest statement

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Abstract

Conflict of interest statement

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