Racial Inequity – It Cannot Be Whitewashed

Robert Saul, MD writes that racism is a problem for all, but particularly for children.

I recently heard a campaign ad by US Senator Tim Scott (SC) seeking reelection. In the ad, he strives to emphasize that no racism exists and that all we need to do is to embrace each other and move forward. To accentuate his point, he notes that his grandfather grew up in the segregated South and that he quit school in the third grade to pick cotton and generate income for the family. And that his grandfather held no ill thoughts for his lot in life and taught Tim to love one another. It took me several times to unpack this ad before I realized that Sen. Tim Scott is, by and large, oblivious to the message that he touts.

• Love for each other is critical to rebuild our society that has been torn at the seams with discord, lies, and destructive behaviors that have eroded trust. So, this part of the message is to be embraced.
• But does he realize what he just said?
o Only one generation away, he notes that his grandfather grew up in a society that purposely subjugated and suppressed the hopes and dreams of fellow humans based on the color of their skin.
o He notes that his family’s financial well-being was so crushed that his grandfather had to quit school in the third grade to make money for the family.
o He notes that his grandfather was engaged in child labor under the probable control of some not-so-benevolent cotton farmer. Even if it is a family farm, it is still child labor.
o He notes that his grandfather had to relinquish his chance at educational growth due to the circumstances in our society, circumstances that were out of his control and circumstances that were “designed” to perpetuate this cycle. Just because one grandson rose to become a US Senator doesn’t justify the continuance of such a system.

Racism is a problem for all but particularly children, especially Tim Scott’s grandfather as a child. Those affected are raised in an environment that has lifetime effects and usually multiple effects across generations. The easy thing to do is to sit back and just hope that society does better. But those that care for children are not allowed that “luxury.” They must engage to make a difference.


Those affected by racism are raised in an environment that has lifetime effects and usually multiple effects across generations. The easy thing to do is to sit back and just hope that society does better. Click To Tweet


The American Academy of Pediatrics recently released a policy statement on racism.1 As the professional organization representing over 67,000 pediatric providers, they are compelled to address factors that leave some children more vulnerable than others. The statement identifies racism as a “system of structuring opportunity and assigning value based on the social interpretation of how one looks (‘race’) that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities and saps the strength of the whole society through the waste of human resources.” Now that is a mouthful but note the three main points—1) disadvantage to those targeted, 2) advantage to those not targeted, and 3) potential social discord and decreased productivity. And the failure to address racism affects the health and well-being of all children, their families and their communities.

The statement goes on to detail the impact of racism—health inequities, chronic stress, poverty, and the unequal application of justice. With regard to the latter, those that are familiar with the work of Bryan Stevenson of the Equal Justice Initiative are reminded that the “opposite of poverty is not wealth; the opposite of poverty is justice.” But all of the specific factors require significant engagement if we want to make a change.

The childhood experiences of racism are recognized to occur at three levels – 1) institutional, 2) personal, and 3) internalized. Institutional (or structural) racism refers to the social structures that continue the disadvantages for some and the advantages for others and perpetuate the system that allows it. These social structures can include neighborhoods, educational sites, pockets of poverty and legal means. When these institutional factors occur, they are real barriers. And when these barriers are present, these experiences become very personal. And then more often than not, these personal experiences become internalized by the folks living under specter of racism.


“The childhood experiences of racism are recognized to occur at three levels – 1) institutional, 2) personal, and 3) internalized.”


The skeptical reader (like Senator Tim Scott) will say that this vicious cycle no longer exists in our society, that all of the past social ills have been corrected. The skeptical reader would be wrong. As a pediatrician for now over 40 years, I can accurately attest to the continued problems with racism that need our constant attention. A path forward for health professionals and community activists and policy makers is well articulated in the AAP’s policy statement.

Yet each of us has a role beyond reading and trying to implement an important policy statement. The new book by Ibram X. Kendi, history professor at American University, tells us that it is not sufficient to say, “I am not a racist.” Such a passive stance goes against our moral and religious teaching. We have to be active in our stance against racism and bigotry and institutional barriers that perpetuate keeping one group of citizens at a continued disadvantage. We have to be anti-racist—that is, we have to be “one who is supporting an anti-racist policy through their actions and expressing anti-racist ideas.” It is insufficient to say that “I don’t have a racist bone in my body” or “some of my best friends are people of color.” We have to be on the front lines opposing racism at every turn.


It is insufficient to say that 'I don’t have a racist bone in my body' or 'some of my best friends are people of color.' We have to be on the front lines opposing racism at every turn. Click To Tweet


I am proud of my professional organization for taking a strong stand against racism and outlining some significant actions to make a difference. I challenge the rest of us to do the same. It is not easy, and at times it seems to go against what might be ingrained into our culture. Change is always hard, but our humanity demands our willingness to be engaged in this work of reducing racial inequities.

Racism has existed and still exists when one considers the multiple measures (lower mean family incomes, lower financial value of housing, decreased educational attainment, decreased generational wealth, increased percentage of incarceration and so many others) that still demonstrate how the past (“the segregated South”) has not been erased and cries out for change. The past and present cry out for concerted efforts to address racism and seek solutions that can move us all forward. Senator Scott’s whitewashing of the past and the uncomfortable present only serves to ignore the issues and to perpetuate the inequities.

1. https://publications.aap.org/pediatrics/article/144/2/e20191765/38466/The-Impact-of-Racism-on-Child-and-Adolescent


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