Brown. All of these individuals, as well as those involved in their deaths, were once children. They were impressionable, watching and learning from everyone around them. They all started out with the same innocence and potential with which every child is born. Yet somewhere along the way, the innocence was lost, and tragic circumstances intervened, resulting in the deaths that have brought renewed attention to the deeply engrained racism in our country. As we move forward with newfound momentum to make long-lasting change, we as pediatricians must address the role we have in fighting racism on an individual, as well as a systemic, level.When it comes to individual racism, there is no population more impressionable and affected by their surroundings than our nation's children. Anyone who spends time with children knows that they are constantly absorbing all that is said and done around them. Even when we may prefer that they remain ignorant, they are ongoing witnesses to how we treat one another. A child is not born racist, but rather they learn from any adult or child around them from a very early age. As we embark on a journey of selfreflection and self-improvement, we must acknowledge that one of the most meaningful approaches we can take to combating racism as academic pediatricians is to encourage parents to raise anti-racist children in our clinical roles and to promote educational and research agendas that inform this mission. To do this, we must take responsibility for the racist culture in which children are raised and affirm that racism is an issue that impacts children at each stage of development and can be fought from the earliest moments in childhood.The health disparities related to racism are rampant and well documented, especially in children and their mothers. Black children are impacted by racism before they are even born. There is ongoing evidence suggesting that maternally experienced racism and the accompanying stress may be related to increased preterm birth in Black mothers. 1 The compounding stress that Black mothers experience secondary to racism is also associated with disparities in early childhood growth and development. 2 A child's understanding of race is influenced by his or her experiences throughout development. After birth, babies look equally at faces of all races. However, by the age of 3 months, babies start to show a preference for faces that match the race of their caregivers. 3 As early as age 3 years, children have been shown to start demonstrating anti-Black and pro-White biases when choosing playmates. 4 Then, when children reach kindergarten age, Black and Hispanic children show no preference between their own racial group and White children, while White children demonstrate preference toward their own racial peer group. [5][6][7] These experiences lead to deeply internalized attitudes about race, even in young children. This concept was first demonstrated in the 1940s with the well-known "doll tests." Dr. Kenneth and Dr. Mamie Clark were psychologists who showed that,...

Patients present to primary care clinics with a variety of experiences, including exposure to adverse childhood experiences (ACEs) and other social determinants of health. The pervasive impact of early adversity on later healthcare outcomes has resulted in the development of trauma-informed care principles that can be applied to healthcare settings. The primary aim of this study is to improve understanding of patient and staff experiences within a trauma-informed urban healthcare setting to guide considerations and recommendations when implementing such a model. A phenomenologic approach was taken using an interpretivist paradigm to collect qualitative data by conducting patient and staff focus groups. The following themes were identified: the communal experience of significant trauma, lack of continuity of care and time for each appointment, the importance of a sense of community and standardization and normalization of asking about trauma, development of social support networks, and creating a safe and non-judgmental healthcare space. Based on findings, considerations for implementing a trauma-informed healthcare model are provided.

Objective-To describe data on interpregnancy intervals (IPI), defined as the timing between a live birth and conception of a subsequent live birth, from a subset of jurisdictions that adopted the 2003 revised birth certificate. Because this information is available among revised jurisdictions only, the national representativeness of IPI and related patterns to the entire United States were assessed using the 2006-2010 National Survey of Family Growth (NSFG).Methods-Birth certificate data are based on 100% of births registered in 36 states and the District of Columbia that adopted the 2003 revised birth certificate in 2011 (83% of 2011 U.S. births). The ''Date of last live birth'' item on the birth certificate was used to calculate months between the birth occurring in 2011 and the previous birth. These data were compared with pregnancy data from a nationally representative sample of women from the 2006-2010 NSFG.Results-Jurisdiction-specific median IPI ranged from 25 months (Idaho, Montana, North Dakota, South Dakota, Utah, and Wisconsin) to 32 months (California) using birth certificate data. Overall, the distribution of IPI from the birth certificate was similar to NSFG for IPI less than 18 months (30% and 29%), 18 to 59 months (50% and 52%), and 60 months or more (21% and 18%). Consistent patterns in IPI distribution by data source were seen by age at delivery, marital status, education, number of previous live births, and Hispanic origin and race, with the exception of differences in IPI of 60 months or more among non-Hispanic black women and women with a bachelor's degree or higher.