In a call to action to doctors and other health care professionals, the American Academy of Pediatrics released its first policy statement on the affects of racism on children’s health.

The statement, which was published in the Pediatrics journal in August, is titled “The Impact of Racism on Child and Adolescent Health.” It looks at structural racism, discrimination in education and the impact of racist employment practices on families and children. The pediatricians who wrote the statement also considered racial disparities in birth weight and maternal mortality in the United States and how they are connected to poor prenatal and overall medical care.

“Racism is a significant social determinant of health clearly prevalent in our society now,” co-author Dr. Maria Trent, a professor of pediatrics at Johns Hopkins School of Medicine, told The New York Times.

Per the statement:

The impact of racism has been linked to birth disparities and mental health problems in children and adolescents. The biological mechanism that emerges from chronic stress leads to increased and prolonged levels of exposure to stress hormones and oxidative stress at the cellular level. Prolonged exposure to stress hormones, such as cortisol, leads to inflammatory reactions that predispose individuals to chronic disease. As an example, racial disparities in the infant mortality rate remain, and the complications of low birth weight have been associated with perceived racial discrimination and maternal stress.

Not only does racism impact the health of those who experience it directly, but it also has an impact on those who witness it. Researchers call it a “socially transmitted disease.” Reports The New York Times:

The experiences that shape parents also resonate in their children’s lives, Dr. Trent said; parents and caregivers who reported they had been treated unfairly were more likely to have children with behavioral issues such as attention deficit hyperactivity disorder. In another study, African-American boys from 10 to 15 who had experiences with racism were more likely to have behavior problems like aggression. During childhood, she said, stress can create hypervigilance in children who sense that they are living in a threatening world.

The statement directs doctors to consider their own practices and biases, saying, “By acknowledging the role of racism in child and adolescent health, pediatricians and other pediatric health professionals will be able to proactively engage in strategies to optimize clinical care, workforce development, professional education, systems engagement and research in a manner designed to reduce the health effects of structural, personally mediated and internalized racism and improve the health and well-being of all children, adolescents, emerging adults and their families.”

“It’s not just the academy telling other people what to do, but examining ourselves,” Dr. Trent said.

Changes suggested by the researchers include re-examining internal prejudices and making external changes, including having multicultural dolls in the waiting room, displaying photos of kids of all races and maintaining a roster of physicians that is reflective of the patient pool.

Read the entire statement here.