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

Felesia R. Bowen; Linda A. Lewandowski; Julia A. Snethen; Gwendolyn Childs; Freida H. Outlaw; Cindy Smith Greenberg; Pamela J. Burke; Elizabeth Sloand; Faye Gary; Janiece DeSocio

doi:10.1016/j.pedhc.2021.08.005

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

Felesia R. Bowen, Linda A. Lewandowski, Julia A. Snethen, Gwendolyn Childs, Freida H. Outlaw, Cindy Smith Greenberg, Pamela J. Burke, Elizabeth Sloand, Faye Gary, Janiece DeSocio

School of Nursing

Research output: Contribution to journal › Article › peer-review

Abstract

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

Original language	English (US)
Pages (from-to)	79-89
Number of pages	11
Journal	Journal of Pediatric Health Care
Volume	36
Issue number	2
DOIs	https://doi.org/10.1016/j.pedhc.2021.08.005
State	Published - Mar 1 2022

Keywords

Toxic stress
adverse childhood experiences
racism

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

Access to Document

10.1016/j.pedhc.2021.08.005

Cite this

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

abstract = "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",

keywords = "Toxic stress, adverse childhood experiences, racism",

author = "Bowen, {Felesia R.} and Lewandowski, {Linda A.} and Snethen, {Julia A.} and Gwendolyn Childs and Outlaw, {Freida H.} and Greenberg, {Cindy Smith} and Burke, {Pamela J.} and Elizabeth Sloand and Faye Gary and Janiece DeSocio",

note = "Funding Information: The authors would like to acknowledge Christine Andresen, MLS, MIT, Assistant Professor, Medical University of South Carolina, for her assistance with creating the visual depiction of the Toxic Stress Model. The authors would also like to thank the authors of the SDOH ICD-10 Crosswalk (Douglas. P. Olsen, Benjamin D. Oldfield, and Sofia Morales, Navarro) for allowing them to use and modify the Social Determinant of Health: ICD-10 Crosswalk. Publisher Copyright: {\textcopyright} 2021 National Association of Pediatric Nurse Practitioners",

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doi = "10.1016/j.pedhc.2021.08.005",

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T1 - A Schema of Toxic Stress Informed by Racism, Transgenerational Stress, and Disadvantage

AU - Bowen, Felesia R.

AU - Lewandowski, Linda A.

AU - Snethen, Julia A.

AU - Childs, Gwendolyn

AU - Outlaw, Freida H.

AU - Greenberg, Cindy Smith

AU - Burke, Pamela J.

AU - Sloand, Elizabeth

AU - Gary, Faye

AU - DeSocio, Janiece

N1 - Funding Information: The authors would like to acknowledge Christine Andresen, MLS, MIT, Assistant Professor, Medical University of South Carolina, for her assistance with creating the visual depiction of the Toxic Stress Model. The authors would also like to thank the authors of the SDOH ICD-10 Crosswalk (Douglas. P. Olsen, Benjamin D. Oldfield, and Sofia Morales, Navarro) for allowing them to use and modify the Social Determinant of Health: ICD-10 Crosswalk. Publisher Copyright: © 2021 National Association of Pediatric Nurse Practitioners

PY - 2022/3/1

Y1 - 2022/3/1

N2 - 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

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

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Keywords

ASJC Scopus subject areas

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