Kids & Teens Health

Pediatric health disparities for Black children begin before birth and compound across childhood. Black infants die at twice the rate of white infants in the United States — a disparity the CDC identifies as one of the most persistent in all of public health. Black children are five times more likely to be hospitalized for asthma. They are more likely to experience exposure to environmental toxins including lead and air pollution that affect cognitive development and respiratory health. Black adolescents face mental health challenges compounded by racism, social media, academic pressure, and limited access to therapists who understand their experience.

None of this reflects anything inherent about Black children's biology or their families' choices. It reflects the downstream consequences of living in a society that has historically underinvested in Black communities' health infrastructure and that continues to provide inequitable pediatric care. This hub provides practical information to help Black families navigate, advocate within, and get the most from pediatric health systems.

Asthma affects Black children at nearly twice the rate of white children, and Black children are five times more likely to be hospitalized for asthma and ten times more likely to die from it. The disparity is driven substantially by environmental factors: Black children are more likely to live in neighborhoods with poor air quality, cockroach allergen exposure, and limited access to green space. Trigger identification and avoidance — cockroaches, dust mites, tobacco smoke, outdoor air pollution — is foundational asthma management. Every child with asthma should have a written Asthma Action Plan developed with their provider. Poorly controlled asthma in childhood has long-term consequences including reduced lung capacity in adulthood.

Sickle cell disease (SCD) is the most common inherited blood disorder in the United States, affecting approximately 100,000 Americans — more than 90 percent of whom are Black. It is detected through newborn screening, which is mandatory in all 50 states. Early identification allows prophylactic penicillin to begin by 3 months of age, significantly reducing the risk of bacterial infections that can be life-threatening for young children with SCD. Hydroxyurea, the primary disease-modifying therapy, reduces pain crises and hospitalizations and is underused — partly due to provider unfamiliarity. Two gene therapies (Casgevy and Lyfgenia) were FDA-approved in late 2023, offering the possibility of functional cure for eligible patients, though access remains limited by cost and specialized center availability. Comprehensive care in a sickle cell center of excellence is associated with significantly better outcomes.

Suicide rates among Black youth aged 10-19 have risen significantly over the past decade, with Black boys aged 5-12 now having higher suicide rates than their white peers — a reversal of historical patterns. Black adolescents face compounding stressors including racism-related stress, academic pressure, social media, and, for many, community violence exposure. The mental health workforce serving Black youth is profoundly inadequate: fewer than 5 percent of child and adolescent psychiatrists identify as Black or African American. School-based mental health services, peer support programs, and teletherapy platforms have helped expand access. Warning signs in adolescents include sleep disruption, withdrawal from friends and activities, increased irritability, and changes in academic performance — not only the stereotypical signs of depression such as tearfulness.

Black children are diagnosed with autism spectrum disorder (ASD) on average 1.5 to 3 years later than white children, according to CDC ADDM Network data. This delay in diagnosis translates directly to delays in intervention: early behavioral therapies (ABA, speech-language therapy, occupational therapy) have the strongest evidence for improving outcomes when initiated before age 5. Research suggests Black children with ASD are more likely to be initially diagnosed with conduct disorder or intellectual disability — potentially reflecting provider bias in symptom attribution. The M-CHAT-R screening tool should be administered at 18 and 24-month well-child visits; if your pediatrician is not administering it routinely, you can request it. Any parental concern about development should prompt an evaluation regardless of screening results.

Childhood immunization rates for Black children have historically been comparable to or higher than national averages, but COVID-19 vaccine hesitancy revealed real concerns about pharmaceutical industry trustworthiness and government health messaging in Black communities — concerns with documented historical justifications. Building vaccine confidence requires honest acknowledgment of this history alongside transparent presentation of vaccine safety and efficacy data. The childhood immunization schedule — DTaP, MMR, IPV, varicella, Hib, hepatitis B, PCV15, and others — is one of the most effective public health tools in history and is consistently shown to be safe across all populations. Questions about the schedule should be directed to your child's pediatrician using verified sources (CDC, AAP) rather than social media.

Finding a pediatrician who understands Black families' experiences and communicates without implicit bias makes a real difference in whether children receive complete, preventive care. Our provider directory includes Black pediatricians, child psychiatrists, and developmental specialists. Community health centers are an important resource for families without insurance or with high-deductible plans — they offer sliding-scale fees and comprehensive pediatric care.

Questions for a new pediatrician: How do you approach developmental screening? What is your policy on antibiotic prescribing? How do you handle mental health concerns in adolescents? At what age do you start having one-on-one conversations with adolescent patients? Red flags include dismissing parental developmental concerns, defaulting quickly to ADHD diagnoses before thorough evaluation, or showing discomfort with questions about sickle cell trait or disease management.

For adolescents in mental health crisis: text or call 988 (Suicide and Crisis Lifeline). Crisis Text Line: text HOME to 741741. For sickle cell pain crises, go to the emergency room or urgent care — do not wait for pain to become severe before seeking care. See our full crisis resources page.