Children of color need better trauma screening

The following essay — one of four to be published this week — appeared in the recently released 2018 KIDS COUNT Data Book, Taking Stock: Considering the Future of Child Well-Being and Family Opportunity in Connecticut.   It is published by The Connecticut Association for Human Services (CAHS), an affiliate of the Annie E. Casey Foundation’s KIDS COUNT network, a group of child advocacy and research organizations using data to promote smart policies on issues affecting children and families. CAHS tracks and reports on indicators of child and family well-being.

Wizdom Powell.

There is ample evidence affirming that racial and ethnic disparities beginning in early childhood persist over an individual’s life-course. Many of these disparities are linked to adverse childhood experiences (ACEs) that if properly detected could be amenable to treatment.

Right now, there is a child or youth experiencing a potentially traumatizing event like cyberbullying, physical abuse, neglect, sexual assault, and community violence. In fact, according to recent estimates compiled by the Substance Abuse and Mental Health Services Administration, nearly 9 out of 1,000 children in the U.S. on average are victims of child abuse and neglect. One in four high school students have been in at least one physical fight.

Alarmingly, researchers estimate that each year the number of youth requiring hospital treatment for physical assault-related injuries would likely fill every seat in nine stadiums. The harsh reality is that many racial and ethnic minority children are not being screened for ACEs because they are simply out of touch with the formal healthcare system.

For over a decade, I have worked to advance health equity for boys (and men) of color (BMoC) – who are at significant risk for a number of behavioral health outcomes linked to ACEs (e.g., suicide and opioid overdose deaths). This work has led me to schools, barbershops, nightclubs, and street corners. Working in the black men of color health equity space has revealed a number of insights about how data can be used to disrupt and amplify ‘single stories’ about the root causes of health disparities.

What I have learned is that boys generally have a more difficult time disclosing emotion, and this makes it harder for them to get adequate support for ACEs. Boys from racial/ethnic minority groups struggle in similar ways with emotion disclosure. However, they are also often grappling with making emotion disclosures in contexts that respond to them in disproportionately harsher ways.

Far too many are displaying trauma symptoms in schools that are met with apathy, a one-way ticket on the school-to-prison pipeline, or an inadequately prepared healthcare and social services workforce. Compelling evidence suggests that black boys are more likely than other students to be punished by preschool teachers. It is not hard to imagine these collective factors leading to poorer and disparate health outcomes among boys of color later on.

It would be easy to view data documenting health disparities in this underserved population with a deterministic lens. Yet, we would be in a better position to act if we viewed them as by-products of larger social conditions (e.g., poverty and structural disadvantage).

Focusing on the social conditions driving racial/ethnic disparities in BMoC would mean attending to our growing deficits in opportunities for youth employment and providing trauma-informed health services in communities. Doing so would also mean viewing community violence perpetrated by youth as a symptom of systems failure and developing a clinical community integration strategy to address them as such.

Even more importantly, addressing these fundamental causes might help to bridge the empathy gap for black men of color who talk candidly to me about feeling profoundly invisible yet also highly visible because of data points that mark and problematize them.

All around are signs that our nation’s demographic profile is changing. If childhood health disparities among racial/ethnic minority populations are not addressed, they could have profound impacts on our nation’s capacity for economic growth and innovation. However, I think that along with the economic imperative is a moral one. At this moment in our nation, it is critically important to ponder Kwame Anthony Appiah’s question “what will future generations condemn us for?” My answer is simple: our failure to ensure that all of our children have the same opportunities to be their healthiest.

Wizdom A. Powell, Ph.D. is the Director of the Health Disparities Institute at the University of Connecticut.

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