Structural racism occurs when public policies, institutional practices, cultural norms, and other procedures perpetuate inequities for racial and ethnic minorities. The effects of structural racism are not isolated. Instead, they send ripples through SDH, leading to systemic inequities. These disparities carry on through generations and widen racial divides.
Residential segregation is an example of structural racism affecting ethnic and racial minorities. It is a major contributor to the health disparities between white Americans and Black Americans because different neighborhoods have vastly different social and economic resources. Residential segregation can translate into educational segregation because most public schools fund programming through income collected from local property taxes. An impoverished neighborhood is more likely to have underfunded schools. Students attending high-poverty schools are less likely to receive a high-quality education or even to graduate from high school. These disparities lead to poor employment opportunities, barriers to healthcare access, housing instability, and food insecurity. And the cycle continues.
The Effects of Systematic Racism on the Social Determinants of Health. A KidsMates Graphic.
Parental incarceration affects racial and ethnic minorities with disparity. Black Americans have a 1 in 4 risk of having a parent incarcerated during their childhood, seven times the risk of white Americans. In addition to the systemic inequities resulting from structural racism, children of incarcerated parents face destabilizing stresses that threaten almost every aspect of their social determinants of health.
The Effects of Parental Incarceration on the Social Determinants of Health. A KidsMates Graphic.
Health & Healthcare:
Parental incarceration, an adverse childhood experience, leads to toxic stress. Prolonged exposure to toxic stress causes damage to a child’s developing brain and body, which leads to lifelong negative health impacts - ranging from heart disease and cancer to suicide.
Children of incarcerated parents experience many barriers to healthcare access and frequently receive suboptimal quality of care. Their families are often uninsured or underinsured and commonly have systems mistrust. The net effect of these circumstances is that children with an incarcerated parent are less likely to receive necessary healthcare support. The problem is compounded by provider bias and the absence of pediatric guidelines for the management of children of incarcerated parents.
Children of incarcerated parents are at increased risk of academic failure (repeating a grade or dropping out of high school). They are more likely to be truant and experience disciplinary action in the school setting. Few educators are trained to address the needs of this at-risk community.
Social & Community Context:
Children with an incarcerated parent face the loss of a parent and the reality of forced separation from that parent. These children rarely receive the same level of family and social support that children dealing with other forms of parental separation are afforded. For example, when a parent dies, the community usually rallies around the family.
Shame and stigma are hallmarks of parental incarceration. Children with an incarcerated parent experience stigma by association, which occurs when a person is isolated (or fears isolation) due to his or her relationship with an incarcerated individual. The stigma of having an incarcerated parent is so extreme that the fear of stigma alone can cause significant distress. When labeled by that relationship, children are frequently subjected to discrimination, bullying, and social isolation.
Children of incarcerated parents often come from a background of economic hardship prior to their parent’s incarceration. Loss of income and forfeiture of assets can exacerbate or create socioeconomic disadvantages. As a result, poverty, housing instability, and food insecurity are commonplace in this community.
Neighborhood & Built Environment:
As a result of their high rates of poverty, children of incarcerated parents often live in disinvested neighborhoods that lack structures to support healthy lifestyles (for example, playgrounds and parks). They also are more likely to be exposed to environments that have poor air quality and that lack access to healthy food choices ("food deserts").