Achieving Equity in Child and Adolescent Mental Health by Addressing Racism Through Prevention Science

Abstract

Prevention science is a multidisciplinary field dedicated to promoting public health and reducing early risk factors that lead to negative health outcomes. It has been used to successfully improve child and family mental health and well-being, including for families affected by adversity. Despite advances in prevention efforts, major public health inequities remain for Black, Indigenous, and other People of Color (BIPOC) children and families, in part because of equity-implicit “one-size-fits-all” approaches that do not directly address racism which in part underlies the very health concerns these efforts aim to prevent. Structural racism not only introduces additional risk for negative health outcomes for BIPOC families but also it reduces access to prevention-focused programs and policies, thus perpetuating inequities across generations. Adopting an equity-explicit, antiracist lens that attends to the effects of structural racism can strengthen the impact of prevention efforts by more effectively improving child and family health, reducing access barriers, and effecting multigenerational change for BIPOC families experiencing various levels of adversity. Evidence-informed recommendations for applying antiracist prevention science include the following: explicitly incorporating an understanding of structural racism within prevention science methods and theory (e.g., risk and resilience frameworks); establishing and fostering truly equitable community partnerships; diversifying the field through mentorship of BIPOC scholars and clinicians focused on child and family well-being; assembling diverse transdisciplinary research teams to address child health inequities in a family-centered manner; attending to intersectionality; and using implementation science to promote access and sustainability for all families.