Transmitting Trauma: A systematic review of vicarious racism and child health.

Racism is a pervasive stressor. Although most research focuses on direct targets, racism can also have unintended victims. Because children's lives are inevitably linked to the experiences of other individuals, and they are in critical phases of development, they are especially vulnerable to such stressors. Despite the growing body of literature on children's direct exposure to racism, little is known about the relationship between vicarious racism (i.e. secondhand exposure to racism) and child health. To examine the state of this literature, we performed a systematic review and screened 1371 articles drawn from 7 databases, with 30 studies meeting inclusion criteria. For these 30, we reviewed research methodology, including conceptualization and measurement of vicarious exposure, sample characteristics, significant associations with child health outcomes, and mediators and/or moderators of those associations. Most studies were published after 2011 in urban areas in the U.S., employed longitudinal designs, and focused on African American populations. Socioemotional and mental health outcomes were most commonly reported with statistically significant associations with vicarious racism. While all studies examined racism indirectly experienced by children, there was no standard definition of vicarious racism used. We organize the findings in a schematic diagram illustrating indirectly-experienced racism and child health outcomes to identify current gaps in the literature and ways in which to bridge those gaps. To further the field, vicarious racism should be uniformly defined and directly measured using psychometrically validated tools. Future studies should consider using children as the informants and follow children into early adulthood to better understand causal mechanisms. Given the recent national exposure to racially-charged events, a deeper understanding of the association between vicarious racism and child health is crucial in fueling research-informed social action to help children, families, and communities exposed to racism. PROSPERO registration number: CRD42016039608.