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A Schema of Toxic Stress Informed by Racism, Transgenerational Stress, and Disadvantage

Published:October 06, 2021DOI:https://doi.org/10.1016/j.pedhc.2021.08.005

      Introduction

      The Toxic Stress Schema (TSS) is an ecological framework with a social justice lens for identifying and alleviating stress and strengthening social determinants of health for children and families of color impacted by the COVID-19 pandemic and the cumulative effects of racism and generational, systemic inequities.

      Method

      Relevant literature is reviewed, and examples were provided to illustrate the differential impacts of the “stress superstorm” of 2020 had on children of color based on their family's position on the advantage–disadvantage continuum.

      Results

      The utility of the TSS framework as a model for advanced nursing practice is demonstrated, and recommendations are formulated for the pediatric nurse practitioner's role in health policy.

      Discussion

      The COVID-19 pandemic elucidated the historical inequities experienced by children and families of color. The TSS framework provides a model for recognizing, organizing, and implementing

      KEY WORDS

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      Biography

      Felesia R. Bowen, Professor and Associate Dean for Diversity, Equity, and Inclusion, The University of Alabama at Birmingham School of Nursing, Birmingham, AL.

      Biography

      Linda A. Lewandowski, Dean and Vice-Provost for Health Affairs, University of Toledo College of Nursing, Toledo, OH.

      Biography

      Julia A. Snethen, Professor and PhD Program Director, University of Wisconsin-Milwaukee, Milwaukee, WI.

      Biography

      Gwendolyn Childs, Associate Professor and Associate Dean for Undergraduate and Prelicensure Education, University of Alabama at Birmingham School of Nursing, Birmingham, AL.

      Biography

      Freida H. Outlaw, Executive Academic Consultant, Substance Abuse and Mental Health Services Administration, Minority Fellowship Program, American Nurses Association, Silver Spring, MD.

      Biography

      Cindy S. Greenberg, Dean, College of Health and Human Development, California State University, Fullerton, CA.

      Biography

      Pamela J. Burke, LEAH Program Faculty/Senior Advisor for Nursing, Boston Children's Hospital, Division of Adolescent & Young Adult Medicine, Boston, MA.

      Biography

      Elizabeth Sloand, Professor, Johns Hopkins University School of Nursing, Baltimore, ML.

      Biography

      Faye Gary, Medical Mutual of Ohio & Kent W. Clapp Chair and Professor of Nursing, Cleveland, OH.

      Biography

      Janiece DeSocio, Professor of Nursing, Seattle University College of Nursing, Seattle, WA.