How to Discuss Race with Kids | Dr. Amna Husain
Dr. Amna Husain: Hey everybody. So it's April 21st, and we just came off on the heels of Derek Chauvin's trial, learning that he is guilty for the death and murder of George Floyd. It seems like a big step in a progressive direction for this country, especially after such a heavy last year.
However, this was within the context as a pediatrician of seeing many other minority killings, of Adam Toledo or Daunte Wright, for example. At the same time that that verdict was being read for Derek Chauvin, we learned about Ma'Khia Bryant, who was also shot fatally by police, a 16 year old black girl. So for me, it was very important to talk about this topic today, about discussing race with our children, because it is literally everywhere. You might take one step forward, but it seems like we're taking two steps back, and that's not really going to change until we change it on a generational level. So I hope this video is helpful for you. I really did try to approach this from a personal topic and how I approach it for my daughter.
I'm Dr. Amna Husain here, Board Certified Pediatrician, Board Certified Lactation Consultant, and mom. Today, we're actually going to be talking about a very important topic and a topic that has been on the front of my mind for the last couple of months actually, almost probably all of 2020, and that as a parent is how to discuss racism with my child, how to discuss race, and how to actively be more anti-racist rather than passively saying, "I'm not racist," because the events of 2020 have shown us and honestly, the events even before 2020, that just to say, "I'm not racist," is not enough. We have to take more active steps, not only in our thoughts and our inward behaviors, but in our outward behaviors. And that includes how we parent.
Maybe that means catching yourself in your language to make sure exactly what you're saying, that you're not including any stereotypes, because our kids, they hear everything. If you're an employer, maybe that means trying to break down the biases and stereotypes you have when it comes to hiring somebody new. If you're a parent, maybe that means that you're also trying to be more cognizant of your child's circle of friends. Try not to stereotype your child's circle of friends, make sure that they're diverse, and make sure that you are including your child in all types of activities so that they get to learn more about other cultures as well.
In medicine, that means being aware of your biases and not letting it affect the way you provide medical care.
Paper published in September, 2020 on physician patient racial discordance and how it affects newborn mortality rates. The bottom line here, and this is pretty alarming, is that when black physicians take care of black newborns, those black newborns tend to fare better. I linked the paper down below, but I highly recommend you read it. It was a large study done over the period of 1992 to 2015. The study concluded was black newborns were twice as likely to die than white newborns in the first year of life. Now, of course there's many other confounding factors. Black women are a higher likelihood of having premature births, preeclampsia, their social determinants of health like inequities in terms of being able to access health care. There's a lot of different factors here, but the study looked at over a 100,000 babies. There was over 1000 black newborns who passed away in the first year of life versus 490 white newborns. So like I said, almost double.
Then they went back and looked at did these babies have black physicians or white physicians? Now for the purposes of this study, no other races were included so we did not include anybody besides black infants or white infants, no Hispanic infants. I'm sure the data might change if we knew that, but for this reason we did not include any non-black or non-white physicians as well.
What we found was a significant reduction rate when black physicians took care of black newborns. Now that's not the say that black newborns still as a whole did not fare as well as white newborns in the first year of life. And that is a separate issue that we in general need to discuss in the field of medicine and not just discuss but address. But in general, why is this happening? We don't know. The paper doesn't say why. It just goes into this is something that's there and we need to address it. So is it a failure in communication? Are there stereotypes that exist there? Is there an issue in the decision-making process? Why is this happening?
That's for us to figure out, but I want you to know that this racial discordance is not just present in the medical world. Economic papers have been published that show that students seem to perform better when there's a racial concordance, so the student is the same race as the teacher. We know that even incarceration rates can be, incarceration periods and sentences can be higher if their judge is a different race than the person who is on trial.
So that says a lot. Racism is present in many communities, not just the US, but in the US right now we are seeing a huge crisis. And it's up to us as parents to change the fabric of that. Not just for ourselves, but for our children. I want you to know is it's okay to feel awkward when you're having these conversations. It might feel forced and that's okay. This isn't something we like to necessarily talk about every day. This is a topic that makes us maybe feel a little uncomfortable and it's okay to feel uncomfortable. Get comfortable with feeling a little uncomfortable, and the more we have these conversations, the more they will start to feel natural to us.
Secondly, I want you to realize you may have to modify this for your child's developmental age. So for example, my daughter is three, and we've thought about this in many different ways. We use books, movies, toys, to talk about racism, and in general differences in race, because it's not enough to just not pretend it's there. We should actively, again, be more anti-racist, in our behaviors, in our thoughts, and how we parent.
So my daughter has figurines of all her Disney princesses, and one day she was playing with Tiana and she said to me, or she maybe said to her out loud to herself, "I don't like Tiana." And I immediately perked up my ears and said, "Why?" And then she said, "I don't like her green dress." Well, as a parent, I could maybe go two directions. One, I could just kind of let it slide and be like, "Oh, okay. She only talked about the dress." But I wanted to kind of scratch the surface a little bit more. She's three years old now, but at that time she was actually two and a half. And I scratched the surface a little bit more instead, "Do you like Tiana? Does Tiana look like Aurora?" And she said, "No." And I said, "What's the difference?" And she of course talked about their dress, that Aurora has a pink dress.
She wasn't quite there yet. We have been trying to talk about it more and more, but again, she was two and a half. And using her toys, that was a great way to sort of open up conversation that maybe I wasn't ready to have or hadn't even thought of having. A few days later, it came up again, "I don't like Tiana." "Why don't you like Tiana?" "I don't like her green dress." I like Mulan's pink dress." "Okay." Well, we used it again to talk about what are other differences. Again, small conversations, small steps, so that you don't begin to feel as awkward, it becomes more natural for you as a parent. And like I said, use the things around you as launching points. So be more active in the toys you buy or be more active in the books you're buying. I'm going to have a list of books down below in the show notes that talk about how to discuss racism or different ways to bring up race with your child. What about movies? Use that as a good time to talk about stereotypes or villains that might be in the movies or different characters. What are the stereotypes that exist out there?
And on that note, when we discuss things like Black Lives Matter, I want you guys to know it's not that we're saying other lives don't matter. That was never at the crux of the issue. We're talking about inequities and pointing out inequities where they exist. And I think that that's a wonderful thing to teach our kids, because what we want them to do is not just grow up in a sheltered world, but we want them to grow up seeing where inequities, problems, or issues are there so that they can grow up to solve those issues and see those issues as a problem. If you grow up in a sheltered life, you'll never know those inequities exist, or those issues are actually a problem.
Again, it's not enough to just not be racist, but we have to be actively anti-racist. So we've talked about a lot, but my strategy is when it feels forced or when it feels awkward is have a plan. Go in with a strategy, but don't be so planned out that you can't stray. So be flexible. Again, maybe if your child decides to take the conversation in a different direction, roll with that. It's totally okay. Make sure you use the tools around you. Again, if you're going to watch the news then do it in a thoughtful manner. Maybe if your child is too developmentally young, to understand the news, maybe you process the news first, and then you talk to your child about it, but make sure you are smart in the way you present your information.
Again, not really sugar coating, but trying to be more thoughtful and break it down into their developmental level. Remember, racism is a socially transmitted disease, passed down generation to generation, and we are in a amazing crossroads right now where we can make the decision to actually better our society and help our children be better fabrics of society.
And it's up to us, I'm in my 30s today, and, yes, it's awkward for me to have these conversations too. And it's awkward for me to identify any biases or stereotypes that I have. Certainly as a pediatrician, that article really struck me about black newborns having a higher mortality rate or tending to fare worse when a white physician took care of them.
The moral of the story here, obviously, isn't that black babies can only have black doctors take care of them. That's not practical and that doesn't solve an issue. It's for us to realize what our inequities and medical biases are. And that's exactly what we as pediatricians are telling parents to do. Recognize your biases, recognize your stereotypes, try to break them down, be a good role model, and be more active in the discussions. Maybe they weren't discussions you had when you were a child, and that's okay. We can change things and be a different parent than the parent that raised us. And, again, racism is a socially transmitted disease. So it's up to us to stop it in our tracks or do the best we can to really prevent it from worsening.