Structuring Poverty: How Racism Shapes Child Poverty and Child and Adolescent Health

Abstract

Black, Native, and Latinx populations represent the racial and ethnic groups most impacted by poverty. This unequal distribution of poverty must be understood as a consequence of policy decisions-some that have sanctioned violence and others that have created norms-that continue to shape who has access to power, resources, rights, and protections. In this review, we draw on scholarship from multiple disciplines, including pediatrics, public health, environmental health, epidemiology, social and biomedical science, law, policy, and urban planning to explore the central question-What is the relationship between structural racism, poverty, and pediatric health? We discuss historic and present-day events that are critical to the understanding of poverty in the context of American racism and pediatric health. We challenge conventional paradigms that treat racialized poverty as an inherent part of American society. We put forth a conceptual framework to illustrate how white supremacy and American capitalism drive structural racism and shape the racial distribution of resources and power where children and adolescents live, learn, and play, ultimately contributing to pediatric health inequities. Finally, we offer antipoverty strategies grounded in antiracist practices that contend with the compounding, generational impact of racism and poverty on heath to improve child, adolescent, and family health.

Keywords: capitalism; pediatric health; poverty; structural racism.

Figure 1.

Structural racism is a product of white supremacy and capitalism. Structural racism is defined as “differential access to societal goods, services, and opportunities by race” and it manifests in unequal access to power, resources, rights, and protections. Racial inequality fundamentally shapes the settings in which children live, learn, and play, and in turn, shapes intergenerational health outcomes at the individual, family, and community level. Together, structural racism, white supremacy, and capitalism create poverty and poor health, and concentrate poverty and poor health among racial and ethnic minorities. * Unequal access to power, resources, rights, and protections by race, reinforces notions of white racial dominance (white supremacy) and racial subjugation provides the social hierarchy that capitalism requires and exploits for profit accumulation.

Figure 2

Children and Adolescents in Poverty by Race and Ethnicity, 2019