Petition to Develop and Include Pediatric Competency Requirements Regarding Racism and Its Effects on Child Health
Petition to the American Board of Pediatrics:
Objective: To petition the American Board of Pediatrics (ABP) to include competencies regarding the effects of racism on health outcomes for children and families.
Significance: Inclusion in the ABP competencies commits pediatricians at all levels of practice to remain up-to-date with the historical, generational, health, educational, and economic effects of systemic racism and bear responsibility to equip providers with tools to recognize and address racism at individual, institutional, and societal levels.
Context: Literature describing the effects of racism on child health has been growing steadily over the last 20 years. Research shifted from acknowledging racial disparities to examining these disparities and their root causes. Pediatricians must shift our efforts to understanding that race is a social, not a biological, construct and racism is the driver of health disparity. By recognizing the power and bias in the perception of the majority or dominant culture, pediatricians can mitigate the adverse effects of racism with regard to healthcare, health research, training, and practice.
Recommendation: Sign our petition to the American Board of Pediatrics.
WE, the undersigned, representing pediatricians across the professional continuum and throughout our nation;
EXPRESSING grave concern about our society’s history of systemic racism and its contribution to health disparities,
CONSIDERING the well-established associations between racism and adverse outcomes across the lifecourse;
OBSERVING that the ABP content specifications omit race or racism. For example:
-- General Pediatrics mentions “ethnicity” once, in a specification making an implicit link between ethnicity and genetic/physiologic difference despite the well-established knowledge that race and ethnicity are social constructs which serve as very poor proxies for biological differences. The specification reads: “recognize the ethnic differences in the development of lactase and sucrase maltase deficiency.”
-- Developmental-Behavioral Pediatrics glaringly omits content on racism and its impact on child health and development and the interaction of these factors with disability, contributing to poorer developmental outcomes for multiply marginalized children.
GUIDED BY, all healthcare practitioners and institutions pledge a responsibility to treat patients, prevent injustice and to do no harm, either through acts of omission or commission;
GUIDED BY the American Academy of Pediatrics 2019 policy statement “The Impact of Racism on Child and Adolescent Health,” establishing racism as a core determinant of child health and calling on pediatricians to engage in individual and systems levels approaches to adopt strategies to ameliorate inequities caused by racism;
RECOGNIZING that addressing race and racism in pediatric healthcare is overdue and is a public health emergency, and that “failure to address racism will continue to undermine health equity for all children, adolescents, emerging adults and their families;”
AFFIRMING that the American Board of Pediatrics’ serves a far greater purpose than developing examination content, via the established guiding principles, including:
• Accountability to all children and their families as it guides professional self-regulation and certifies pediatricians,
• Ensuring that ABP certification sets rigorous standards for competencies essential to child health,
• Prioritizing the work that the organization is uniquely positioned to do,
• Continually evaluating and improving, based on changing trends in child health, stakeholder feedback, and advances in knowledge, assessment, technology, and care delivery,
• Welcoming diverse backgrounds, experiences, and perspectives to inform its work;
WE CALL UPON the American Board of Pediatrics to develop in-depth content specifications on racism and its impact on the health of children and adolescents,
REQUEST the American Board of Pediatrics to immediately establish a task force for General Pediatrics and each Sub-board to review and update specifications and identify the unique content for each specialty;
FURTHER REQUEST that these content specifications include at least competencies related to individual implicit bias, structural inequities, systems assessment and interventions, individual assessment and interventions, and research considerations;
FURTHER REQUEST that maintenance of certification cycle in 2021 include specifications on racism’s effect on child health to ensure immediate dissemination of this content.
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