Perceived racism and discrimination in children and youths: an exploratory study.
There are important reasons for studying racism, particularly as it relates to the behavioral and emotional health of children. Racism as a stressor may produce negative biological or psychological responses. It may also explain within-group variability in health status and health outcomes. And if racism is determined to be related to negative outcomes, then interventions and preventive strategies could be developed to limit its effects (Clark et al., 1999).
Racism's effects on health and well-being may occur through multiple pathways. According to Williams, Lavizzo-Mournay, and Warren (1994), it can contribute to discrepancies in socioeconomic status (which result in differential health outcomes), it can create differential exposures to risk factors and available resources (for example, the quality and quantity of medical care), and it can adversely affect psychological or physiological functioning.
Data from the literature on adult health show that minorities who perceive themselves as being targets of racial discrimination have poorer outcomes in the areas of mental health; hypertension and cardiovascular disease; and various health-related behaviors, including tobacco, alcohol, and substance use (Paradies, 2006; Williams, Neighbors, & Jackson, 2003).
There are few data on the physical, emotional, or behavioral effects of racism on children. Garcia Coil et al. (1996) proposed an ecological model for the study of minority child behavioral and developmental competencies. In this integrative model, the effects of social position factors (for example, race, social class, ethnicity, gender) are mediated through social stratification processes such as segregation, racism, and discrimination. These, in turn, act to influence other environmental factors such as neighborhoods, schools, and health care (factors that significantly influence the contexts of children's lives) .These environmental factors (in concert with the other macro-level factors) affect other cultural, family, and individual-level variables that contribute to the quality of child health and development.
Although this model has gained a significant following in the child development arena, relatively little research has been conducted on the specific role of racism in child health and development, particularly as it pertains to minority children. A recent comprehensive review of the medical, public health, and social science literature on the relationship between racism and child health found only 40 papers presenting empirical studies on the effects of racism on child health conditions (Pachter & Garcia Coll, 2009). Of these 40 papers, 65 percent (26) reported on the effects of racism on behavioral and mental health conditions such as depression (Brody et al., 2006), anxiety (Sellers, Caldwell, Schmeelk-Cone, & Zimmerman, 2003), self-esteem (Wong, Eccles, & Sameroff, 2003),behavioral problems (Szalacha et al., 2003), and substance (alcohol, tobacco, drug) use (Terrell, Miller, Foster, & Watkins, 2006; Whitbeck, Hoyt, McMorris, Chen, & Stubben, 2001). Most of these studies demonstrated a positive association between children's and youths' perceptions of racism and these conditions. Other studies showed a significant association between adverse birth outcomes (prematurity and low birth weight) and maternal perceptions of racism (Collins, David, Handler, Wall, & Andes, 2004; Mustillo et al., 2004).
One of the concerning issues discussed in the literature review just cited is the fact that many of these studies did not use measures of perceptions of racism that were developed for children or were sensitive to the contexts in which children live their lives. Few questionnaires or surveys were developed and tested on children and teenagers. In general, little is known about the occurrence of racism in children.
Few studies have even addressed whether racism is a common occurrence in children's lives, and there are no studies describing the contexts in which children and youths may experience racism and other forms of discrimination. Although there are data on the experiences of racism in adults, children's social worlds are obviously very different than adults' are, and one cannot extrapolate data gathered with adults to children.
Because little is known about the occurrence of racism in children and youths, we decided to begin to study the effects of racial prejudice and discrimination in children with an analysis of how common children perceive racism to be and under what circumstances they perceive racism in their everyday lives. The goal of this study therefore was to describe the contexts and frequency of perceived racial discrimination in a diverse group of children and youths.
Children between the ages of eight and 18 years were recruited from the following sites: four Boys and Girls Club Centers in Hartford, Connecticut, a community-based minority health advocacy organization in Hartford that runs after-school programs for youths in the city of Hartford, a summer school program for high school youths in Providence, Rhode Island, and a high school in Providence. Although we do not have individual- or family-level data on socioeconomic status, these sites serve children from predominantly poor and urban settings. Study participants were identified and recruited by program personnel, and both individual children and their parents completed informed consent forms. The Institutional Review Board at the Connecticut Children's Medical Center approved this project.
Once enrolled, each participant completed a 23-item questionnaire. This questionnaire was initially developed by conducting qualitative, open-ended interviews with minority children and adolescents from Hartford between the ages of nine and 16 about their experiences with racism. These interviews, each lasting 45 minutes to an hour, were recorded, transcribed, and analyzed for recurring themes. We were particularly interested in the contexts and situations in which children experienced racism. Results of these qualitative interviews were used to develop the questionnaire used in this study.
The opening statement of the questionnaire read as follows:
When people are racially discriminated against, they are treated badly, not given respect, or are considered inferior because of the color of their skin, because they speak a different language or have an accent, or because they come from a different country or culture. For each of the following situations, think whether you have ever in your life felt discriminated against because of your color, language or accent, or because of your culture or country of origin, and answer the following questions:
This was followed by a series of 23 questions describing settings or contexts in which children and youths may have experienced discrimination (see Table 1). Participants were asked if they ever experienced discrimination in each of the 23 particular contexts or settings. If the response to an item was affirmative, subquestions were asked to determine the frequency of discrimination (once, twice, about once a year, about once a month, weekly) and the reason for the discrimination, that is, the participant's attribution. Possible responses to the reason/attribution question ("Why do you think this happened?") included "my race," "my ethnicity or culture," "the color of my skin," "my language," "my accent," "my age," "my sex/gender," "the clothes I wear" "the music I listen to," and "other (describe)." We included these response categories to acknowledge that children and youths may perceive discrimination for reasons other than racism; although we were specifically interested in racism and racial discrimination, we felt it was also important to inquire about other nonracialforms of discrimination. Respondents could select more than one attribution response. In presenting the results in this article, we refer to general discrimination to include all reasons for discrimination and racism or racial discrimination to refer to discrimination specifically based on race, color of skin, ethnicity/culture, language, or accent. In addition to the questionnaire just described, a demographic form that included information about the respondent's age, gender, educational level, and self-described ethnic affiliation was also administered.
Our analyses included calculations of the percentages of informants who answered questions regarding discrimination positively, mean numbers of items answered positively, most common situations in which informants perceived discrimination, and differences in these analyses by race/ethnicity, gender, and age group. Statistical analyses of categorical items were conducted by use of Fisher's exact test; differences among means were compared by analysis of variance. Bonferroni adjustments were used for all multiple comparisons. SPSS for PC 15.0 was used for all analyses.
Two hundred and seventy-seven children completed the questionnaire. Eighty-five (31 percent) of the respondents self identified as African American, 104 (38 percent) as Latino (29 percent Puerto Rican, 4 percent Dominican, 5 percent Latino not specified), 53 (19 percent) as multiracial/multicultural, 20 (7 percent) as West Indian/Caribbean, 10 (4 percent) as European American, and five (2 percent) as other (see Table 2). The "other" category included three Chinese or Southeast Asian participants, one Native American participant, and one Cape Verdean participant. Of the 53 respondents who were multiracial/multicultural, 36 (68 percent) self-identified as multicultural with all identities being of color (that is, African American, Latino, West Indian/Caribbean, Chinese, Southeast Asian, Native American, or CapeVerdean [multicultural minority/ minority]), 10 (18 percent) self-identified as being multicultural consisting of white and a group of color (multicultural minority/majority), and three (6 percent) self-identified as multicultural with all identities defined as white (multicultural majority/majority). Given the small sample sizes of the multiracial/multicultural, West Indian/Caribbean, European American, and other groups, we only performed subgroup analyses on the two largest groups: African American and Latino. Other sample demographics are presented in Table 2.
Experiences with Racism
Two hundred and forty-five of the 277 respondents (88.4 percent) reported that they had experienced racial discrimination in at least one of 23 situations. Respondents answered an average of six items on the 23-item questionnaire affirmatively (see Figure 1), and 11.6 percent answered more than half of the questions (12 or more) affirmatively.
Attributions of Discrimination
The reasons or attributions for discrimination are presented in Table 3. The most commonly perceived forms of racial discrimination were racial remarks or being called an insulting name (51 percent and 45 percent of the participants experienced these, respectively). One-third to one-half of the respondents perceived racial discrimination at school (for example, being accused of something they didn't do; being treated badly or unfairly by a teacher because of race, ethnicity, color of skin, language, or accent) as well as at shops and restaurants (followed around by security guards or store clerks, received poor or slow service at a restaurant).
There were very few significant differences in the occurrence of perceived racism when it was analyzed separately by ethnicity. Comparing the two largest racial/ethnic groups in this study--African Americans and Latinos--there were no significant differences in the occurrences of racial discrimination, with the exception of two items: "You had the feeling that someone was afraid of you" and "You're called on less in class by teachers." In both these situations, African Americans responded affirmatively more often than Latino respondents [40 percent compared with 25 percent (p = .029) and 12 percent compared with 3 percent (p = .021), respectively].
There were variations in why African American and Latino children felt they were being racially discriminated against (that is, race, ethnicity, color of skin, and language or accent). For seven questions, Latino children were significantly more likely than African American children to attribute racism as a response to language or accent (items 4, 6, 12, 13, 15, 18, and 23 on Table 1); for one question, Latino children were significantly more likely than African American children to attribute racism as a response to their ethnicity (item 9), and for one question, African American children were significantly more likely than Latino children to attribute racism as a response to their race (item 16).
There were no differences in prevalence of racial discrimination by gender, with the exception of the item: "Have you ever seen your parents or other family members treated unfairly or badly because of the color of their skin, language, accent, or because they come from a different country or culture?" Forty-three percent of female respondents answered this item affirmatively, compared with 31 percent of male respondents (p = .046).
[FIGURE 1 OMITTED]
There were some differences in prevalence of perceived racial discrimination by age (dichotomized as seven to 13 years versus 14 to 18 years). Older children were significantly more likely to have perceived racism in the following situations: being followed closely by security guards or store clerks at a store, being treated unfairly by a police officer, people holding bags tightly when you pass by, being the recipient of a racial remark, or someone being rude to you (all ps < .002).
The results of this exploratory study show that racism and discrimination are common aspects of many children of color's lives. Eighty-eight percent of the 277 children and teenagers who completed the survey experienced at least one situation that they perceived as being attributable to racial discrimination. This finding illustrates the commonality of perceived racism and racial discrimination in minority youths. Its inclusion in the integrative, ecological model describing the potential influences on minority child development proposed by Garcia Coil et al. (1996) seems appropriate. Results of the present study support the fact that racism and discrimination are issues that many children of color face and may have potential effects on these children's health and development.
The majority of the youths in this sample had been recipients of a racial remark, and 45 percent had been called an insulting name due to race, ethnicity or culture, color of their skin, or language or accent. Here, we provide examples of these incidents taken from the qualitative interviews from which the questionnaire was developed:
She [a teacher] was real racist. Like, black people, she called us "ignorant," that we won't learn nothing, that we'd always be here for the rest of our lives. (15-year-old African American girl) He said, "That's why you're so black, you look like this stool when it was burnt." I almost turned it around and said, "What are you talking about, you're the same color as me, so you're talking about yourself." (nine-year-old African American girl)
This last example is interesting because it is an example in which the perpetrator of the perceived racist incident was also a minority. Discrimination can occur between members of majority and minority groups, between minority groups, between majority groups, and within groups.
As expected, the venues in which racism is experienced represent the social settings and contexts where children lead their lives--in schools and their communities, among peers, and with adults and authority figures. Perceived racial discrimination in areas of commerce was also common--for example, getting poor service at restaurants and the feeling of being closely followed around by security guards or clerks in stores:
You'd be shopping, and like they'd be right behind you looking at you, the people that work there. They'd be right there just waiting; they ask you do you need any help? And you say, "No, I'm just looking." They would just stay there and look at you. (16-year-old Puerto Rican girl)
Perceived unfair treatment from authority figures, such as teachers and police officers, was also noted. As one 15-year old African American girl related,
In the mall ... I got a taste of redneck cops who don't like black people. My cousin got rolled on [jumped] ... and we had to help her ... and we all got arrested. And my friend, she's fully black, but you would never tell that she was black, you would think that girl is white, she got the pretty hair and everything ... and they was treating them all nice, like they let them out of the handcuffs, [but] they wouldn't let me out of my handcuffs; the cop was going off, he was grabbing me and stuff like that, he was yelling at me.
Perceived racist incidents can be obvious or subtle. For example, this 16-year-old biracial male (black mother, white father) related this:
Like I'll hear white people, they'll see a group of black people and they won't go near them because they think they're going to rob them. Like a girl was talking the other day, she says when she goes out to the mall or something she's scared of black people. She'll see a black girl looking at her, and she'll try to stay away, she'll look at the ground and walk by fast.... It's always on my mind. Like it's because I'm different than they are, because I'm different than everyone else in the class. Like ifa teacher, if they tell me to do something, sometimes I wonder. Like if I do something and someone after me does the exact same thing and they don't say anything to that person but they say something to me I tend to wonder, did they say something to me 'cause, you know, I'm different than everybody else in the class?
It is of interest to note that ambiguous situations (that is, situations in which a person is not quite sure whether he or she is a target of race-based discrimination) such as this one may have greater health effects than does overt racial discrimination (Chen & Matthews, 2001; Crocker, Voelkl, Testa, & Major, 1991; Lazarus & Folkman, 1984).
Many youths feel that they are accused of things that they did not do in school. Although feelings of persecution at school (in particular at the hands of authorities, such as teachers and administrators) are probably common, and could be considered normal from a developmental perspective, this study highlights that minority youths may have additional attributional issues to process and consider when they find themselves in these situations.
Few differences were noted among different racial/ethnic groups regarding the occurrence of discrimination. Although we had a diverse group of respondents, we did not have large enough sample sizes to do extensive between-group analyses--we were only able to investigate differences between the two largest groups: Latinos and African Americans. There were few differences noted in occurrences, and some distinctions regarding the attributions for those occurrences (for example, race versus language) in these two groups. It appears in this exploratory study that the commonalities of being a minority in the United States outweigh major subgroup differences. However, studies with larger samples are needed to explore subtle and potentially interesting differences.
Our sample also included a group of multiracial/ multicultural children. Although we did not have adequate sample sizes of these groups to allow us to analyze them separately, we decided to disaggregate our multiracial/multicultural subsample on the basis of minority/majority, minority/minority, or majority/majority status, and we recommend that others use this or similar approaches, because the term multicultural describes a diverse and heterogeneous group, particularly with regard to the social, behavioral, and emotional issues that contribute to self-identity.
The results of this exploratory study should be interpreted with certain limitations in mind. We did not use a psychometrically validated instrument to measure perceptions of racism. However, the items that were included in our questionnaire seem to have face validity and were developed by analyzing information from qualitative, ethnographic, semi-structured interviews with minority children and youths. Another limitation is that our study sample was one of convenience and was predominantly poor and from the inner city. The experiences of racism from the perspective of middle- and upper-class minorities, as well as minorities in different neighborhood and community settings, need to be included in future studies. It is likely that the profile of racism in these contexts may be very different than it is in poor, urban settings (Tatum, 1987). Also, as noted earlier, we did not have large enough samples of respondents who were West Indian/Caribbean, multiracial/multicultural, Native American, or from other groups. Therefore we were not able to analyze potential group differences other than between the African American and combined Latino groups. An interesting area of future investigation would be to look at similarities and differences in experiences among these other groups. For example, although African American and West Indian/Caribbean youths may share much by being people of color and members of minority groups in the United States, different cultural and historical backgrounds may result in different perspectives about racism (Waters, 1999). In the same vein, different Latino subgroups may have distinct views of and approaches to discrimination, again dependent on different cultural, historical, political, and social class contexts. Even within groups, difference may occur on the basis of many sociodemographic factors, such as family composition, parenting and racial socialization attitudes of parents, social class, migration/immigration issues, and acculturation.
Although our sample was predominantly composed of children with minority ethnic/racial affiliations, we did have a small number of majority white children (although not enough to analyze separately). White children can be recipients of racially motivated discrimination, and, therefore, future studies need to take this into account as well.
Our results also indicate that children and youths experience discrimination that is attributable not only to race and ethnicity, but also to other attributes such as age, gender, and various aspects of youth culture. Although the specific focus of this study was racism and racial discrimination, respondents were able to indicate other reasons for perceived discrimination. We consider racism to be a subtype of general discrimination, and results suggest that it is a common attribution in our group of respondents.
Racism remains an understudied factor in research on child health status and child health disparities. On a systemic level, racism can be seen as a social stratification mechanism that contributes to inequality in care, with resulting disparities in outcomes. The literature on health disparities refers to this type of institutional racism as a potential source of inequality. There are many fewer data on the effects of personal racism on the individual level and its relationship to health and illness. Studies in adults have shown effects of personal racism on cardiovascular health, mental and behavioral health, diabetes, and self-reported general health status (Paradies, 2006; Williams et al., 2003). The literature on children is very limited and almost exclusively related to behavioral and mental health (Pachter & Garcia Coil, 2009). The mechanism by which racism may affect health is through its role as a stressor that may have adverse psychological and biophysiological sequelae (Clark et al., 1999; Sussman, 2007). The present study shows that perceptions of racism are salient issues in children's lives. We did not study the relationship between perceptions of racism and health or health care outcomes, however. Future study is needed to identify the specific health consequences of perceived racism and the processes and mechanisms through which its effects are manifested.
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Lee M. Pachter, DO, is professor, Department of Pediatrics, Drexel University College of Medicine and St. Christopher's Hospital for Children, 3601A Street, Philadelphia, PA 19134; e-mail: firstname.lastname@example.org. Bruce A. Bernstein, PhD, is associate professor, Department of Pediatrics, University of Connecticut School of Medicine, and Department of Anthropology, University of Connecticut, Hartford. Laura A. Szalacha, EdD, is associate professor, College of Nursing and Health Innovation, Arizona State University, Phoenix. Cynthia Garcia Coll, PhD, is professor, Department of Education, Brown University, Providence, RI. This project was supported by Grant K23 HDO40348 from the National Institute of Child Health and Human Development to Lee M. Pachter. The authors thank the administration and staff at Boys and Girls Clubs of Hartford, CT; the Hispanic Health Council; the Brown Summer High School; and the Metropolitan Regional Career and Technical Center, Providence, RI. Thanks are also extended to all the children who participated in this study and their parents.
Original manuscript received June 23, 2008
Final revision received March 18, 2009
Accepted May 19, 2009
Table 1: Situations and Contents in Which Perceived Racism or Discrimination May Occur 1. Being watched closely or followed around by security guards or store clerks at a store or the mall 2. Got poor or slow service at a restaurant or food store 3. Were treated badly by a bus driver 4. Got poor or slow service at a store 5. Were treated unfairly by a police officer 6. Accused of something you didn't do at school 7. Unfairly called down to the principal's office 8. Got grades you didn't deserve 9. Treated badly or unfairly by a teacher 10. Watched more closely by security at school 11. Someone didn't want to be friends with you 12. You had the feeling that someone was afraid of you 13. Someone called you an insulting name 14. People hold their bags tight when you pass them 15. Someone made a bad or insulting remark about your race, ethnicity, or language 16. Someone didn't want to play or hang out with you 17. Someone was rude to you 18. People assume you're not smart or intelligent 19. You didn't get the respect you deserved 20. You weren't chosen for a sports team 21. Teachers assume you're not smart or intelligent 22. You're called on less in class by teachers 23. Have you ever seen your parents or other family members treated unfairly or badly because of the color of their skin, language, accent, or because they come from a different country or culture? Table 2: Sample Characteristics (N = 277) Variable n (%) Ethnicity Latino 104 (38) Puerto Rican 78 (75)(a) Dominican 12 (12)(a) Latino not specified 14 (13)(a) African American 85 (31)(a) West Indian/Caribbean 20 European American 10 (4) Multicultural 53 (19) Multicultural minority/minority 36 (68)(b) Multicultural minority/majority 10 (18)(b) Multicultural-majority/majority 3 (6)(b) Multicultural not specified 4 (8)(b) Other 5 (2) Gender Female 147 (53) Male 130 (47) Age (pears) 7 1 (1) 8 12 (4) 9 25 (9) 10 27 (10) 11 24 (9) 12 19 (7) 13 42 (15) 14 38 (14) 15 34 (12) 16 31 (11) 17 18 (6) 18 6 (2) (a) This figure represents percentage of Latino respondents, not of the entire sample. (b) This figure represents percentage of multicultural respondents, not of the entire sample. Table 3: Prevalence of Perceived Discrimination, by Attribution (Racism or Other) (N = 277) Happened Happened Because for Other of Reasons Racism Only Item (a) (%) (b) (%) Someone made a racial remark 51 1 Called an insulting name 45 20 Followed by security guards at store 42 12 Accused at school of something you didn't do 37 36 Racist incident with parents/family 37 2 Treated badly/unfairly by teacher 36 15 Poor/slow service at restaurant 35 20 Someone was rude to you 34 26 Someone assumed you're not intelligent 30 12 Someone was afraid of you 29 18 Treated unfairly by police 27 7 Poor/slow service at store 24 10 Didn't get respect 23 10 Treated badly by bus driver 20 13 Got grades you didn't deserve 20 13 Called unfairly to principal's office 18 17 Someone didn't want to be friends with you 18 17 Teachers assume you're not intelligent 17 3 People hold bags tight when you walk by 16 2 Watched more closely by security at school 12 5 Someone didn't want to play/hang out 9 16 Called on less in class 8 7 Weren't chosen for team 5 8 (a) Includes race, ethnicity, color of skin, and language or accent. (b) Includes age, gender, clothes, music listened to, and other.
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|Author:||Pachter, Lee M.; Bernstein, Bruce A.; Szalacha, Laura A.; Coll, Cynthia Garcia|
|Publication:||Health and Social Work|
|Date:||Feb 1, 2010|
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