Conception to First Year of Life

The earliest manifestations of interpersonal and structural racism on Black children’s development occur while they are still in the womb. Chronic stress experienced by mothers before and during pregnancy leads to lower birth weights for Black babies, which may decrease their chance of reaching their first birthday.

Numerous research studies have linked mothers’ experiences with racism and discrimination to their babies’ low birth weight.

One 2004 study found that asking Black mothers about the level of discrimination they experienced was the most significant predictor of the likelihood that their child is born underweight.

Dr. Richard David, one of the co-authors of the paper, underscored the importance of their findings in a 2017 NPR interview.

“[We knew that] there was something about growing up Black in the United States and then bearing a child that was associated with lower birth weight,” Dr. David said. “It turned out that as a predictor of a very low birth weight outcome … racial discrimination questions were more powerful than asking a woman whether or not she smoked cigarettes."

A 2014 study published in the American Journal of Public Health found that the link between racism and discrimination and low birth weights was chronic stress.

Specifically, they found that Black women reported experiencing chronic stress 20% to 30% more than white women. The study defined chronic stress as having experienced issues such as an inability to pay bills, not having health insurance, living in a neighborhood with high poverty and unemployment rates or having a low income.

Researchers in this study conducted four rounds of interviews with women, the first when women were between 11 and 19 and the last when women were between 24 and 32. Only women who gave birth during this time period were considered in the study.

The study found that mothers who had experienced high levels of chronic stress in the years before they became pregnant as well as during their pregnancy gave birth to babies with below-average birth weights. Specifically, a one-unit increase in chronic stress correlated with a 200-gram decrease in birth weight for the firstborn children.

The average birth weight for newborns is between 5 pounds, 8 ounces, or approximately 2500 grams, and 8 pounds, or approximately 3600 grams. Any child born less than 5 pounds, 8 ounces is considered low weight. As the chronic stressors experienced by mothers continue to compound, a child’s birth weight is likely to be lower than the average.

While low-weight babies can be healthy, they may also have serious health problems. Generally, birth weights are used as a predictor for infant survival and infant’s subsequent health, according to the 2014 study.

One way to measure infant survival is infant mortality rates, which are a measure of the likelihood of a child dying before reaching the age of 1. Black children have a 2.3 times higher infant mortality rate than white children. Specifically, Black Americans’ infant mortality rate is 10.8 per 1,000 births, while white Americans’ infant mortality rate is 4.6 per 1,000 births.

According to a 2021 analysis by the U.S. Department of Health and Human Services, low birth weights continue to be a major explanatory factor for why disparities in infant mortality rates exist.

The health complications that arise from being underweight help explain why low birth rates are such an important explanatory factor, according to the University of Rochester Medical Center.

Amongst the complications the center identifies is respiratory distress syndrome, which causes breathing problems and requires treatment to achieve proper lung function. The center also identified intraventricular hemorrhage, which is bleeding in the brain that can be mild and resolve itself or severe and lead to brain damage, and necrotizing enterocolitis, which affects a baby’s intestines and can lead to feeding problems and swelling of the belly.

Black children, therefore, first experience the impacts of racism and discrimination while they are still in the womb. As Black mothers face chronic stressors during their lifetime and throughout their pregnancy, they may give birth to low-weight babies that struggle to survive and develop during their first year of life.

Ages 2 to 3

After reaching their first birthday, Black babies continue to face barriers to their development. The first three years of life are crucial for brain development. As a result, the nutrient deficiencies and disparities in access to proper housing experienced by Black children are particularly damaging to children’s behavioral and physical development.

Toddlers' brains are rapidly developing because they have a higher number of synapses than adults, according to the Urban Child Institute.

Synapses are the nerve system's way of passing information from one neuron to the next. Babies are born with approximately 2,500 synapses per neuron and this number grows to 15,000 by age 3.

The brain, however, does not actually need 15,000 synapses. In fact, this is approximately twice as many synapses as those in adults’ brains. Throughout childhood and adolescence, the brain will prune, or get rid of, synapses that are not used frequently.

In the meantime, children are considered to have an excess of synapses, which allows the brain to “capture” and process events and environments toddlers experience a lot quicker than it could later in life.

The heightened malleability of the brain during this time increases the consequences of nutrient deficiencies for children, according to a 2001 study by professors Vonnie McLoyd and Betsy Lozoff at the University of Michigan.

Their study found that 5% of poor Black toddlers have iron deficiencies, which is a percent twice that of poor whites.

Iron deficiencies experienced during this time limit brain development, leading to poorer test scores and behavioral issues (such as constantly being disciplined at school), stated the study. Research has yet to find evidence that these cognitive and behavioral problems can be reversed.

Black children are also more likely to have elevated levels of lead in their blood, found the study. McLoyd and Lozoff state that 22% of poor Black children have elevated levels of lead in their system compared to only 2% of non-poor white children.

Even minimal traces of lead in the bloodstream can damage brain cells, especially in pre-school-aged children. Elevated levels lead to permanent neurological damage that causes cognitive and behavioral delays, note McLoyd and Lozoff.

Deniz Dersim Yeter, an independent academic in Kansas, controlled for socioeconomic status and other factors and concluded that Black children were still at an increased risk of lead poisoning.

Discriminatory government policies are at the heart of why Black children have a higher risk of lead poisoning.

David Rosner, co-author of "Lead Wars", states that Black Americans are more likely to live in homes with elevated levels of lead because of government policies that pose barriers to Black homeownership and push Black Americans to live in older houses.

Today, Black children living in homes built between 1950 and 1977, before lead paint was regulated, are six times more likely to have elevated levels of lead in their blood when compared to white children living in buildings built in the same time period.

The harm done to Black children’s developing brains during this crucial stage of life will have lasting, irreversible side effects that set toddlers behind as they enter pre-k and kindergarten.

Ages 4 to 5

As children enter pre-K and kindergarten, at ages 4 and 5 respectively, they begin to build friendships. While these relationships are vital to their overall development, they also create the space for Black children to begin to experience race-based judgment from their white peers, which can have negative impacts on their sense of self and mental health.

From ages 4 to 5, children are able to develop their own racial biases. According to Erin Winkler, a professor of African and African Diaspora Studies at the University of Wisconsin-Milwaukee, children at this age categorize those around them based on various characteristics, including racial appearance, to better understand their environment.

These biases are developed because of toddlers’ immature cognitive structures, which make them especially vulnerable to stereotyping, said Winkler. She also notes that young children have an inclination to categorize the people around them, but they are usually unable to consider more than one factor (e.g. race and height).

Children choose to categorize people by race because it is a highly visible attribute that is given significance from an early age (e.g. a parent using another child’s skin tone to describe them). As children begin to see the significance of race, they also attach their own meaning to racial categories, states Winkler.

At this age, children form racial biases because they are dependent on transductive reasoning to process new information, according to Winkler. Transductive reasoningpushes children to develop connections between instances that occur around them.

For example, if a dog barks and a mirror breaks at the same time, the child may assume that the dog’s bark caused the mirror to break. Similarly, if a child believes they are smart, they may assume that only children that look like them are also smart.

Winkler notes that the conclusions children reach do not have to be logical- and they often aren’t. However, these conclusions still affect how children understand the world around them.

Experiencing racial biases during ages 4 and 5 impacts children in two ways, said Winkler. First, if they are in environments where few people look like them, they begin to internalize negative stereotypes about themselves. Winkler gives the example of a Black child only seeing white children portrayed in books or movies and internalizing the message that white children are better playmates.

Second, since their peers are developing racial biases during this time, Black children are vulnerable to experiencing judgment and racism. Winkler gives the example of a white child being surrounded by white family members and white friends. Though no one may ever state that people of different races cannot be friends, the child may still come to that conclusion if the only people they regularly interact with are white.

Experiencing racial biases and judgment at a young age can negatively impact children for the rest of their lives, particularly their mental health and self-esteem.

Commissioner Thornton recalled her experiences with both these phenomena. She explained growing up and only seeing light-skinned people of color on television. As a result, she said, many children around her began to think that only light-skinned people of color could be successful.

Thornton also spoke of the second implication Winkler identified. She described witnessing children experience covert racism from their peers and often not knowing how to deal with such judgment at a young age.

As children grow older, they may eventually learn how to handle such judgment, but the negative effects it has on their self-esteem and mental health remain.

Ages 6 to 8

From ages 6 to 8, Black children’s mental health can be further undermined by their parents’ experiences with racism.

A 2015 study published in the Journal of Black Psychology identified a correlation between Black parents' experiences with discrimination and their children’s behavioral and emotional wellbeing at age 7.

The study found that the more discrimination parents faced, the higher levels of depressive symptoms they exhibited and the less effective parenting practices they utilized. This effect on parenting practices, the authors speculate, is associated with greater behavioral issues in children.

The article notes that while all families are susceptible to experiencing discrimination, ethnic-minority families face historical and systemic factors that increase their probability of facing interpersonal discrimination.

While the number of parents and children included in the 2015 study was relatively small, the study’s insights point to a conclusion other research has also reached.

A 2020 study conducted by the University of Georgia and the University of Texas at Dallas examined the effect of Black parents’ experiences with racism on their children. Researchers conducted two rounds of interviews with each family and interviewed a total of 132 families.

The study found that Black parents who experienced racism felt the need to prepare their children for similar experiences. This preparation was associated with higher levels of anxiety and sadness in children.

During the ages of 6 and 8, Black children can also experience increased levels of internalized racism that leads to chronic stress, which has negative impacts on long-term health outcomes.

Chronic stress increases the likelihood of suffering from inflammation, which can cause heart disease, diabetes, cancer and arthritis, according to a study conducted by Harvard and Columbia.

In this study, chronic stress was assessed by the level of cumulative adversity a child faced between ages 0 and 8.

According to the study’s findings, the more cumulative adversity faced early on in life, the more chronic stress a child experienced. The higher the level of chronic stress a child experiences, the more likely they are to have proteins in their bloodstream that indicate they will develop inflammation later in life.

Though this study did not focus exclusively on Black children, other research makes clear that Black children experience adversity at a higher level than other children.

As a recent study from the American Public Health Association notes, Black children are especially likely to face adversity early on in life including stressors from "high unemployment, failing schools, community violence, racism, and discrimination.”

Therefore, interpersonal racism motivates parents to prepare their school-aged children for the potential of facing such discrimination. This preparation may increase levels of anxiety in children.

At the same time, structural racism increases the likelihood that school-aged children face adversities early in life which are associated with inflammation-related diseases.

As children transition into their pre-adolescent phase, these experiences of interpersonal and structural racism only continue.

Ages 9 to 12

During the ages of 9 to 12, adolescents begin to develop a stronger sense of identity. Experiences of racism during this time can be damaging to adolescents’ self-esteem and their long-term physical health.

As children navigate physiological changes and increasing cognitive maturity, they also attempt to identify their strengths and label themselves, according to Jacquelynne Eccles, a professor of psychology and education at the University of Michigan in Ann Arbor. Eccles also notes that social acceptance is vital during this period, and a lack of acceptance can negatively impact a child’s sense of self.

In this stage, children also have the capacity to incorporate historical and social understanding in their conception of racism, according to a paper authored by Louise Derman-Sparks at Pacific Oaks College and Carol Higa and Bill Sparks from the Los Angeles school system. As a result, they may be able to recognize racism more readily, which can increase the level of stress they experience.

A study by the Society for Research in Child Development looked at 350 adolescents’, aged 9 to 14, perceptions of their stress level and racial identity. It concluded that greater levels of perceived racial discrimination were associated with increases in emotional and behavioral problems. The study also noted that the more discrimination a youth experienced, the lower their self-esteem.

The coping strategies that Black adolescents adopt in response to discrimination can also be damaging. Commissioner Thornton has witnessed this phenomenon first-hand.

Thornton noted that on an emotional and psychological level, overt and covert racism causes Black children to feel that they do not belong. This may lead them to shield themselves by disengaging. These practices, she said, are damaging to their mental health.

The impacts of racism and discrimination are not limited to mental health, however. Black Americans’ physical health is also harmed.

Regularly experiencing discrimination or anticipating it is illustrative of the "weathering effect" that many use to explain the link between racism and physical health.

Arline Geronimus, a professor in the Health Behavior and Health Education at the University of Michigan, coined the term in 1992.

She likens the weathering effect to a game of Jenga. Each experience of racism and disparity in access to resources takes away one block, ultimately leading to the collapse of the entire structure. Rather than a stack of wooden bricks falling down, it is Black individuals' health.

There are numerous manifestations of this failing health. For example, when the body is stressed it releases numerous hormones and neurotransmitters, including norepinephrine, epinephrine and cortisol. While this process is natural, in excess, it is detrimental to health.

An excess of these hormones and neurotransmitters is linked with high blood pressure, high cholesterol and high glycated hemoglobin, all of which can negatively impact children's physical development.

Overall, racism and discrimination experienced during this time lowers adolescents' self-esteem and slowly chips away at their physical health.

Ages 13 to 18

Racial discrimination faced by families also increases the likelihood that children experience depression in their adolescent years as it can lead to conflict within the family.

One study from the University of Georgia (UGA) found that when families experience stress, an increase in caregiver-youth conflict occurs, which in turn decreases adolescents’ self-control.

The study defined self-control as an individual’s ability to prevent themselves from conducting socially unacceptable behaviors or exhibiting emotions or thoughts deemed inappropriate. Self-control is used as a way to predict an adolescent’s likelihood of experiencing depression, according to the study.

The study concluded that chronic family stress results in “significant” increases in the probability that teens suffer from depression.

"If you are a parent who is coming home and trying to take care of your kids, but you are also having to work multiple jobs and you are experiencing discrimination in the workplace, [your experiences with discrimination] exacerbate the normal stressors of parenting and the normal stressors of taking care of adolescence," said Ava Reck, Ph.D. candidate at UGA and co-author of the paper.

Black youth are likely to experience this stress because they are "more likely to live in families that have limited access to resources," said Reck. "We know that limited access to resources can impact a whole host of outcomes: academic outcomes, emotional outcomes and physical health. This isn't caused by race, but by the disparities in experiences in the U.S.”

When trying to understand the experiences of Black youth, Reck points to the need to "contextualize the stress faced by families in terms of the historical adversity and racism-based exclusion from health and educational resources."

Among the resources that Black families are excluded from are those that "promote cohesion and mental health within families," Reck noted.

She cited intervention programs like the Strong African American Families Teen Program run in South Georgia that helps teens and parents talk through their individual experiences and understand each other better. This program was developed because Black families did not previously have access to initiatives dedicated to educating parents.

Reck points to two main implications of her paper.

"The first is that the U.S. needs to seriously consider redistribution of power at the larger macro level and the more individual micro level to address the racist systems that have resulted in disproportionate access to resources which are right now impacting youth wellbeing,” she said. “The second, more manageable implication, is that we need to better understand the processes and mechanisms through which stress is affecting young people's lives."

These implications point towards the need to start thinking about how the barriers to Black children's development can be addressed.