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

Monique Jindal; Elizabeth Barnert; Nathan Chomilo; Shawnese Gilpin Clark; Alyssa Cohen; Danielle M Crookes; Kiarri N Kershaw; Katy Backes Kozhimannil; Kamila B Mistry; Rebecca J Shlafer; Natalie Slopen; Shakira F Suglia; Max Jordan Nguemeni Tiako; Nia Heard-Garris

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

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

Lancet Child Adolesc Health. 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
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.

Publication types

Review

MeSH terms

Child
Emigration and Immigration
Health Equity*
Health Status Disparities
Humans
Policy
Racism* / prevention & control
United States