African-American youth: essential prevention strategies for every pediatrician

National statistics of morbidity and mortality warrant our urgent attention to the issue of effective prevention strategies among African-Americans. Implicit, explicit, and often internalized messages of inferior value, negative expectations, and expendability remain a part of everyday life for African-American youth. This sociopolitical disenfranchisement has a direct impact on their health and development and on our ability to provide effective preventive and therapeutic intervention. Pediatricians enjoy a deserved perception of expertise in those areas that bear directly on the healthy physical and psychosocial development of all children. We have not heretofore optimally exploited this perceived and real expertise in prevention efforts among African-American children. We ourselves are in need of reeducation. We need to first shatter the insidious conceptual barriers of our own impotence as well as the perceived impotence of African-American patients in our collective abilities to inspire and affect change. On a patient-by-patient basis, among our regional pediatric communities and in the public policy arena, we can be involved in the process that restores to our African-American patients a sense of full citizenship and potential within our society. Without adoption of this process of sociopolitical reenfranchisement, our best-intended efforts at prevention in this community will always tragically fall short of their full and critically needed potential.