Each year, Connecticut Children’s Office for Community Child Health (OCCH) has the privilege of inviting a speaker to deliver one of the University of Connecticut Department of Pediatrics’ weekly Grand Rounds lectures. The audience for this event includes both institutionally- and community-based pediatricians, Connecticut Children’s team members, and an array of community partners. Even prior to the COVID-19 pandemic and the changeover to virtual sessions, the lectures were available via the internet and broadcast to a widespread audience.
In preparing for our annual OCCH lecture, we strive to identify a topic that reflects a critical contemporary issue that demands our collective attention and is often the focus of our community-oriented work. We often invite OCCH leaders to share the work of their programs to encourage interest and strengthen impact. However, this year, our OCCH staff uniformly called for a speaker to address the widespread, amplified demands for equity, racial and social justice as a consequence of the disproportionate impact of COVID-19 on people of color and the rise of the Black Lives Matter movement in response to the unconscionable killings of Ahmaud Arbery, George Floyd and Breonna Taylor.
The selection of this topic was consistent with the commitments made by Connecticut Children’s and OCCH to advance diversity, equity and inclusion. Our OCCH staff has developed and launched “Pathways to Action” to ensure that our workplace culture is welcoming and inclusive and that we view all of our work through the lens of racial and social justice. While these efforts are clearly driven by passion, commitment, and good intentions, we also recognize the importance of their being informed by research and science. We, therefore, sought a speaker who could share this knowledge to guide our initiatives. While virtual technology affords us the opportunity to draw upon experts from across the nation and even around the world, the expertise that we sought resided literally across the street from our offices in Wizdom Powell, PhD, director of the UConn Health Disparities Institute.
Dr. Powell is a renowned population health disparities research scientist, clinical psychologist, and program evaluation specialist who is an expert on the role played by psychosocial determinants in health disparities and inequities with a particular focus on racism and masculinities, as well as inequities within Black adolescent and adult male populations. She has led the UConn Health Disparities Institute for the past three years, having been recruited from the University of North Carolina at Chapel Hill Gillings School of Global Public Health and its Department of Health Behavior where she was a tenured associate professor. She previously served as White House fellow and special advisor on military mental health policies to Defense Secretary Leon Panetta and the Obama Administration. I had the good fortune to meet Dr. Powell through my service on the City of Hartford’s Public Health Working Group on COVID-19 Response and Recovery which she expertly chaired. Her academic credentials include both an MS and PhD in clinical psychology from the University of Michigan, as well as an MPH from the same university’s School of Public Health.
The title of Dr. Powell’s talk was, “Speak to the Wounds: What We Need to Know about Racial Trauma and Radical Healing During Uncertain Times.” While I cannot possibly do justice to her rich, comprehensive, insightful, and compelling content, I am pleased to reflect on a few of the concepts that offer such meaningful implications for our work. Please note that this summary reflects my interpretations of Dr. Powell’s comments and I apologize, in advance, for any misperceptions.
Dr. Powell spoke eloquently of the “invisible wounds” inflicted by the trauma of the pandemic and the profound consequences of the “syndemic” of Covid-19 and racism, with the latter rampant at both the systemic and “everyday” levels, as evidenced by cumulative microaggressions and the systemic assault on the role identity of parents, particularly the threat to the role of Black men as fathers and providers. She urged reflection on the powerful question, “How are the children?” noting the alarming increase in suicide rates among Black boys. She spoke to the irony of the mismatch between perceptions of Black fathers as uninvolved and research findings that demonstrate their greater engagement than their white counterparts. The harmful and even fatal consequences of persistent racism are far too evident, with Black men at higher risk than whites of being killed by police, Black children being more likely to experience academic failure and the many bearing witness to injustice experiencing trauma symptomatology.
Dr. Powell shared compelling research findings on the impact of trauma on children, such as the correlation between gender and the trauma response, with Black boys expected to “be a man about it” and Black girls’ proclivity to “tend and befriend,” implying a “superwoman” schema. The impact of such behaviors include Black boys and girls being viewed as more “adult-like” than their white counterparts, with horrifying consequences of these “adultification biases” for their treatment by such sectors as the criminal justice system.
Dr. Powell derived implications of these critical research findings. Perhaps most importantly, racism must be viewed and addressed as the public health problem that it is. We must measure the injury caused by the trauma of racism, develop interventions to buffer the impact of racism on children, undertake the “radical healing” necessary to enhance children’s social-emotional competence and self-regulation, address social determinants of health, and ensure alignment of systems, policies, and practices to achieve equity. “Speaking to the wounds” must go beyond trauma-informed care to healing-centered mentoring and pedagogy. Such healing must include radical empathy and hope.
I cannot recall a Grand Rounds that encouraged more powerful introspection and yielded more profound implications for our work to strengthen families to promote children’s optimal health, development and well-being. While I suspect that most, if not all, of the large audience of nearly 300 derived their own take-away messages and thoughts for action steps, I am pleased to share a few of mine:
- Dr. Powell’s summary of rich and powerful research findings reinforces the importance of ensuring that our efforts through such efforts as Connecticut Children’s Diversity, Equity, and Inclusion initiative and OCCH’s Pathways to Action are driven by science, as well as our intuition, passion and best of intentions. Our work must be research informed and research driven.
- The discussion validated many of the critical concepts and principles that drive our work. Achieving equity and justice demands a comprehensive systems approach invoking, as we so often state, “all systems in” and “cross-sector collaboration.” All sectors offering support to children and their families are critical, as Dr. Powell’s example of the role of the arts so effectively illustrated. We must continue to focus on strengthening families’ protective factors, given the importance of enhancing family resiliency and advancing children’s social-emotional well-being.
- We must be more explicit in calling out racism and its inherent inequities to invoke and advance the radical healing needed to achieve the outcomes that we seek. In our efforts to address the “biology of adversity,” i.e., adverse childhood experiences, toxic stress, and social determinants of health, we cannot be agnostic regarding the impact of racism and its attendant traumas.
I am encouraged by the strong attendance, engagement and reactions to Dr. Powell’s exceptional presentation. While the large size of the audience favorably reflected the perceived importance of her critical topic for discussion, the overwhelmingly favorable evaluations of her talk on racial trauma and radical healing, and the encouraging statements of respondents’ commitment to applying the lessons learned to their practice and behavior inspire the hope that Dr. Powell described as necessary to be impactful and achieve change. Indeed, nothing is more crucial to our future as a society.
Paul H. Dworkin, MD is executive vice president for community child health at Connecticut Children’s, director of Connecticut Children’s Office for Community Child Health and founding director of the Help Me Grow National Center. Dr. Dworkin is also a professor of pediatrics at UConn School of Medicine. Learn more »
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