Children who identify as Black or multiracial report significantly higher exposure to adverse childhood experiences, which places them at greater risk for poor mental and physical health outcomes. These disparities and increasing awareness of racism as an adverse childhood experience has resulted in the American Academy of Pediatrics, American Psychological Association, and other groups declaring racism a public health crisis. To provide high-quality care, providers who engage with patients and families impacted by systemic racism must be aware of its role in health disparities. This requires clinicians to have the knowledge and skills to discuss racism with colleagues, patients, and families. To promote clinicians’ competence to engage in these discussions, this article 1) sensitizes providers to historical and contextual factors that inform experiences with anti-Black racism and health disparities and 2) offers strategies to address anti-Black racism in clinical care.Embracing the process of brave, informed conversations about race represents a pathway for building trust between providers and patients, a key component of various health outcomes. Additionally, these foundational skills of reflection, cultural humility, and bias recognition will be needed to engage in allyship and advocacy both within and beyond the exam room.

In 2019, just one-half of Americans received their influenza vaccine, despite it being safe, effective, and important in preventing serious infection, hospitalization, and death. Black children receive fewer influenza vaccines than their White counterparts. Vaccine hesitancy can hinder influenza vaccine uptake and is partially fueled by ongoing systemic racism and historical abuse leading to medical mistrust in communities of color. Building trust may enhance the transfer of reliable vaccine information and may move people along the spectrum of vaccine intention. We sought to partner with faith-based organizations through a community influenza vaccination event to increase vaccination rates. By leveraging the reach and expertise of trusted voices, such as church “first ladies” and local community leaders, we were able to administer 600 pediatric influenza vaccines between 2016 and 2019. In addition, this event served as a platform to assess whether youth attendees had a place for regular medical care (“medical home”) (>80% did in each year assessed) and to conduct preventive screenings. Most children, as reported by their caregivers, had recent medical check-ups (85% in 2016, 84% in 2017, and 82% in 2018). Of the children screened, more than one-third had an abnormal body mass index and one-half had abnormal dentition. By partnering with organizations that are well-embedded in the local community, such as faith-based organizations, health care groups may be able to maximize the impact of their health promotion campaigns.

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