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Addressing Adultification of Black Pediatric Patients in the Emergency Department: A Framework to Decrease

Amie Koch1, Arthi Kozhumam1

  • 1Duke University, Durham, NC, USA.

Health Promotion Practice
|October 25, 2021
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Summary

Adultification, where Black children are perceived as older than they are, negatively impacts their health. Addressing this bias in emergency departments requires systemic changes and trauma-informed care to reduce medical mistrust.

Keywords:
childrenhealth disparitieshealth promotionracismtrauma-informed care

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Area of Science:

  • Public Health
  • Health Equity
  • Child Health

Background:

  • Systematic racism and structural discrimination significantly harm Black individuals' health.
  • Adultification, perceiving children as older than their age, is an unrecognized form of racism impacting Black children's health and safety.
  • The emergency department (ED) is a critical setting where these disparities manifest.

Purpose of the Study:

  • To implement the Racism as a Root Cause framework within healthcare systems.
  • To identify strategies for healthcare providers and systems to dismantle inequities and address the adultification of Black children in the ED.
  • To promote recognition of adultification bias and its negative health impacts.

Main Methods:

  • Utilized the Racism as a Root Cause framework to analyze ED practices.
  • Employed ICD-10-CM Diagnosis Code Z60.5 (Target of adverse discrimination) to identify instances of perceived discrimination.
  • Advocated for trauma-informed care and systemic changes in ED policies, communication, and training.

Main Results:

  • Adultification is a prevalent, often unrecognized bias harming Black children's health in the ED.
  • Recognizing adultification requires training, communication, and reflection among healthcare staff.
  • Utilizing specific diagnostic codes can help identify and address discrimination.

Conclusions:

  • Dismantling adultification bias in the ED is essential for reducing health inequities for Black children.
  • Trauma-informed care is crucial for all interactions involving Black children and families in the ED.
  • Conscious efforts are needed to decrease adultification bias to prevent perpetuating medical mistrust and negative healthcare experiences.