PEDIATRICS
WHY PEDIATRICIANS ARE CALLED TO BE
LEADERS IN ANTI-RACISM
AUTHOR Ariel Carpenter, MD
The first patient of the day was an
8-year-old Black girl with worsening
childhood obesity. She had
been struggling for years with
gradual weight gain. Despite efforts
by her mother, she was beginning
to show signs of insulin resistance
and high blood pressure. The visit
focused on healthy dietary interventions and increasing physical
activity. I discussed how early interventions could significantly
reduce her risk of poor health outcomes later in life. Her mother
understood, but also admitted that buying and preparing healthy
food was a challenge. Her partner, the patient’s father, had passed
away from gun violence last year, leaving her mother with three
children to care for—alone. Recently, they’d had to move, and were
now even farther from the closest grocery store – which is an hour
away, round-trip, on public transportation. Her mother was working
multiple jobs, overwhelmed and exhausted.
Pediatricians spend countless hours counseling patients in similar
situations, encouraging lifestyle changes, understanding challenges,
trying to intervene early and turn the tide. What we don’t
often say and don’t highlight, is the single most important factor
in this patient’s life and many others: racism.
We tend to consider the role of race only in its overt examples
and ignore the pervasive and subtle influence it has on daily life.
Systemic racism affects countless facets of our charges’ lives. Children
of color are more likely to suffer from higher rates of infant
death, gun violence, childhood obesity, youth incarceration and
mental health disorders. Recent studies published in Pediatrics
found children of color suffer from decreased treatment of sepsis
and more frequently receive less than optimal pain reduction following
fracture in pediatric emergency departments. The roots of
these, and many other issues that touch health care, can frequently
be tied back to the systems and privileges tied to racism. It is time
pediatricians rise to the challenge of becoming anti-racist leaders, a
role in which we are uniquely positioned to influence our patients’
lives for the long term.
Following the deaths of Breonna Taylor and George Floyd, our
country and profession is facing a nationwide reckoning on racism,
a reckoning that spotlights physicians’ responsibility to educate
ourselves, while calling out racism, even in its subtle and systemic
8 LOUISVILLE MEDICINE