You want to talk about trauma? Let’s talk about racism
“Taking the trauma of racism into account is crucial to understanding and implementing trauma-informed care. If you want to talk about trauma, you should talk about racism.” — Dr. Amanda J. Calhoun, The Council on School Health Newsletter, American Academy of Pediatrics.
Full article originally published in the Summer 2019 edition of the COSH newsletter. The text of the article is below:
You Want to Talk About Trauma? Let’s Talk About Racism
Amanda Calhoun, MD, MPH Psychiatry Resident, PGY-1, Yale School of Medicine, Albert J. Solnit Adult/Child integrated residency track
“I wish I was white and had straight hair. Then, I would be smarter and prettier.” My heart broke when these words were spoken by my friend’s 5-year old daughter after her first week of school. Her mother and I had been waiting for that moment and we’d known it would come. Those same words had been uttered by so many other African-American girls we knew--us included. We knew that the trauma of racism would catch up to her, but it was always sad to see it catch up so soon.
If a pediatrician, teacher, or any other individual desires to truly give trauma-informed care to children, whether in schools or in clinics, it is imperative that they themselves become informed and educated about the impacts of racism. The American Academy of Pediatrics’ recent policy statement discusses racism as an important social determinant of health and a chronic stressor to minority communities.1 Although the word “racism” is sometimes used interchangeably with prejudice, the definition of racism referred to in this case is the systematic structuring of opportunities and assigned value based on the social interpretation of one’s skin color. As early as preschool, racial differences in treatment are evident. Studies have shown that black preschoolers are disproportionately targeted for suspension, and another study suggests that whites begin to perceive black boys as dangerous as early as 5 years of age.2 A report released by Georgetown University surveyed 325 adults. Compared to white girls of identical age, black girls were perceived to be more “adult” and sexually mature, and require less support, protection, and nurturing as young as five years old.3 Children who are exposed to racism are linked to higher rates of obesity, greater susceptibility to illness, worsened sleep, and lower self-esteem.4 Racism is an unpredictable, chronic stressor that many children of color are forced to endure in the United States. Racism is trauma. One cannot hope to fully connect with children, especially minority children, without addressing it.
How can non-minorities, who have never experienced racism (not prejudice, but racism) help children recover from the trauma of it? First, encourage the recruitment of minorities when choosing a team to deliver trauma-informed care. Second, acknowledge that it exists and introduce it into conversation. Just as a teacher might check in to ask how a child is adjusting to school, they can also ask that child about their experiences with racism and how they are coping with its effects. Third, it is imperative that adults giving trauma-informed care learn the levels of racism, namely: institutional, interpersonal, and internalized. Understanding how to help students navigate their growth and progression through childhood and adolescence and helping to minimize trauma must include helping them to navigate the experience of being a minority in the United States. Fourth, teachers and other adults should work to ensure that they are not contributing to racism with their own biases. Many children will experience racist interactions in school, either from teachers or from peers. The relationship between students and teachers influences their comfort in school, test scores, and even grade point averages.5-7 Studies have shown that African-American children are more likely to receive worse behavioral reports when they have a white teacher, compared to an African-American teacher.8 Data has also shown teachers to underestimate the performance abilities of Latino and African-American students, which has actually been shown to lead to lower grades and school enrollment.9 These racist biases result in internalized racism and are harmful to students of color. Multiple studies looking at the impact of these stereotypes and racist mindsets found that African-American students performed worse on tests when they had to begin by identifying their race versus when they did not, while white and Asian students performed better when asked to identify their race.10 Taking the trauma of racism into account is crucial to understanding and implementing trauma-informed care. If you want to talk about trauma, you should talk about racism.
References for this piece can be found in the References Supplemental File.
