>>WELCOME TO THE NHLBI DIVERSITY, EQUITY, INCLUSION AND ACCESSIBILITY CHAMPIONS SPEAKER SERIES. THE TOPIC IS IMPLICIT GENDERED RACIAL BIAS, ADULT OCCASION IN BIAS AND BLACK GIRLS. THIS IS THE FIFTH PRESENTATION IN THE CHAMPIONS SPEAKER SERIES AND ON BEHALF OF THE HEAD OF THE DIVISION, NHLBI OFFICERS, Dr. GEORGE, DEIA CHAMPION SPEAKER TEAM, THANK YOU FOR COMING. MY NAME IS CAROL BROOK. I AM BOTH THE CHAIR AND EVENT LEAD. TITLE OF OUR PRESENTATION TODAY, IMPLICIT GENDERED RACIAL BIAS, ADULTIFICATION BIAS AND BLACK GIRLS. MEMBERS OF THE COMMITTEE ARE LISTED BELOW. IF YOU ARE INTERESTED IN THIS EFFORT AND WOULD LIKE TO JOIN THE COMMITTEE, MORE INFORMATION ON HOW TO DO SO WILL BE PROVIDED AT THE CONCLUSION OF THE PRESENTATION. I HAVE THE DISTINCT HONOR OF INTRODUCING Dr. MILLER IN THIS ROLE SHE PROVIDES THE INSTITUTE EMPLOYEE TRAINING, WORKFORCE PROGRAMS AND INITIATIVE TO SUPPORT THE NHLBI MISSION. PRIOR TO JOINING NHLBI, Dr. MILLER SPENT MORE THAN NINE YEARS IN AS DIRECTOR OF NIBH WHERE SHE SERVED AS HEALTH SCIENCE ADMINISTRATOR AND MORE RECENTLY SERVED AS CHIEF WORKPLACE PROGRAM AND OPERATIONA L GRANT EXECUTIVE OFFICE. IN THIS ROLE SHE LED WORKFORCE, EMPLOYEE ENGAGEMENT, EQUITY, INCLUSION AND DIVERSITY AND HE IS A ACCESSIBILITY EFFORTS. NHLBI COLLEAGUES AND GUESTS, IT IS MY PLEASURE TO INTRODUCE TO YOU LEAM MILLER. >>THANK YOU FOR THAT WARM INTRODUCTION. NHLBI IS CURRENTLY DISCUSSING SEM NATION OF SUCCESS OF NHLBI, PLANNING, DEIA EFFORTS AND INITIATIVES. AT THE CONCLUSION OF THE PRESENTATION, I WILL ASK DOCTOR BLAKE THE FOLLOWING QUESTIONS. BASED ON YOUR EXPERTISE, WHAT RECOMMENDATIONS WOULD YOU PROVIDE TO US, NHLBI IN PURSUING OUR GOALS AND WHAT ADVICE WOULD YOU OFFER TO HELP US AVOID PITFALLS? A LITTLE BIT MORE ABOUT DOCTOR BLAKE. DOCTOR BLAKE WHO IS PRESENTATION TOPIC ON -- [INDISCERNIBLE] IS A LICENSED PSYCHOLOGIST DIRECT TORE OF BEHAVIORAL HEALTH AT THE SCHOOL OF PUBLIC HEALTH AT TEXAS A & M UNIVERSITY. THE TALK WILL FOLLOW THREE THEMES WITH HEALTH EQUITY AT THE CENTER OF THOSE AREAS. PEER DIRECTED AGGRESSION, BULLYING AND VICTIMIZATION OF SOCIALLY MANUALALLIZED YOUTH, THE APPARENT IMPACT OF SCHOOL DISCIPLINE ON BLACK FEMALES AND THE IMPACT OF SCHOOL HEALTH INTERVENTIONS ON YOUTH'S PHYSICAL AND MENTAL HEALTH AND EDUCATIONAL OUTCOMES. Dr. BLAKE RECEIVED HER PH.D. FROM THE UNIVERSITY OF GEORGIA AND HOLDS A HOST OF PROFESSIONAL CERTIFICATIONS. Dr. BLAKE'S TEACHING INTERESTS INCLUDE COMMUNITY HEALTH, PEER HEALTH EDUCATION, SCIENCE AND PRACTICE OF HEALTH AND WELL-BEING AND PREVENTIVE SCIENCE. Dr. BLAKE IS A PRESIDENTIAL IMPACT FELLOW, TEXAS A & M, FROM 2018 TO 2021 AND SHE WAS A RECIPIENT OF THE CAREER DEVELOPMENT AWARD, LOAN REPAYMENT PROGRAM AND NATIONAL INSTITUTE OF HEALTH'S NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES IN 2010 TO 2013. I WILL NOW HAND IT OVER TO OUR PRESENTER, Dr. BLAKE. >>THANK YOU SO MUCH FOR THAT EXCELLENT INTRODUCTION AND FOR THE INVITATION TO SPEAK TODAY. I AM GOING TO TALK TODAY ABOUT ADULTIFICATION BIAS, PARTICULARLY ADULTIFICATION BIAS IN THE FORM OF GENDERED RACIAL BIAS AND HOW THAT IMPACTS BLACK GIRLS. BEFORE I GET STARTED, I WOULD LIKE TO BEGIN WITH A QUOTE FROM ACTUALLY A TEXTBOOK THAT I BELIEVE REALLY CAPTURES THE ESSENCE OF MY WORK. THIS IS NOT MY QUOTE BUT I BELIEVE IT IS REALLY POWERFUL AND ESSENTIALLY QUOTES BLACK GIRLS ARE ONE OF THE MOST VULNERABLE, VICTIMIZED AND DISENFRANCHISED GROUPS IN THE NATION. AND THIS IS A PARTICULARLY POWERFUL QUOTE THAT I DIDN'T HAVE WHEN STARTING MY RESEARCH ON BLACK GIRLS BUT I DO THINK IT CAPTURES THE ESSENCE OF THE TYPE OF WORK I DO AND UNDERSTANDING THE IMPORTANCE OF LOOKING AT THE EXPERIENCES OF BLACK GIRLS. BUT WE DON'T ONLY HAVE TO TURN TO QUOTES, WE CAN LOOK IN THE MEDIA AND ALTHOUGH SOME OF THESE HEADLINES ARE DATED, WHAT WE CONSTANTLY SEE IS UNFORTUNATELY BLACK GIRLS ARE SUBJECT TO VIOLENCE, OVERPOLICING, AND SIGNIFICANT HEALTH DISPARITIES. WHEN I STARTED MY CAREER DOING RESEARCH ON BLACK GIRLS, I ACTUALLY STARTED STUDYING PEER-LED AGGRESSION BUT IT LED TO LOOKING AT OTHER DISPARITIES IN PART BECAUSE IT DIDN'T ALIGN WITH WHAT I WAS SEEING AND WHAT I SAW IN MY OWN EXPERIENCE AND THERE WASN'T A LOT OF RESEARCH EXPLORING THE WHY. WHY ARE THESE THINGS HAPPENING TO BLACK GIRLS, WHY ARE THERE SUCH NEGATIVES WITH LAW ENFORCEMENT, AND I SHOULD BE ABLE TO UNDERSTAND THE HISTORY OF WHY AND WHAT LED ME TO EXPLORE THIS WORK IN ORDER TO GRASP THE CONCEPT. SO AS MENTIONED, SOME OF OUR WORK HAS RECEIVED SIGNIFICANT MEDIA ATTENTION WHICH IS BOTH FLATTERING AND A LITTLE BIT EMBARRASSING BUT EQUALLY FLATTERING AND SO I WOULD LIKE TO SHOW YOU A CLIP FROM THE BLACK AF THAT PROVIDES A BIT OF A SNAPSHOT OF WHAT ADULTIFICATION BIAS IS AND THEN LEAD YOU THROUGH THE RESEARCH WITH THE ADULTIFICATION IN THE CONSTRUCT. SO I APOLOGIZE IF THE PRESENTATION IS A LIT -- BIT CLUNKY, IT MIGHT JUST BE THAT. [ FAINT AUDIO ] >>HOW NOTHING IS MORE CONVENIENT THAN CREATING A NARRATIVE THAT LITTLE BLACK GIRLS ACT AND LOOK OLDER THAN THEIR AGE TO JUSTIFY ALL THE HORRIBLE STUFF THAT COMES BACK TO US AND NOW 400 YEARS LATER, THERE IS FINALLY A NAME FOR IT -- ADULTIFICATION. THERE ARE STUDIES ON ADULTIFICATION LIKE THE ONE FROM GEORGETOWN LAW, THAT THE STUDIES PERCEIVE BACK WHAT GIRLS BEEN MORE MATURE THAN WHITE GIRLS THEIR AGE AND THIS IS IN EVERY ASPECT OF OUR LIVES, IN SCHOOL WHERE BLACK GIRLS ARE THREE TIMES MORE LIKELY TO BE DISCIPLINED THAN WHITE GIRLS. OR IN THE HEALTHCARE SYSTEM. WHERE BLACK GIRLS ARE TWO TIMES MORE LIKELY -- >>I WILL STOP IT HERE. THIS PROVIDES THE QUANTIFICATION OF ADULTIFICATION BIAS AND ACCURATELY SHOWS THE HISTORICAL SIGNIFICANCE ON WHERE IT EMERGED. WHAT I WOULD LIKE TO DO IS TALK A LITTLE MORE ON WHY AND WHERE DID THIS COME FROM. THE ORIGINAL WORK I WAS DOING ON BLACK GIRLS ORIGINALLY FOCUSED ON THE SCHOOL SYSTEM AND I AM SURE YOU ARE ASKING YOURSELF WHY. BECAUSE MY WORK POSES ON GIRLS WHO A ADOLESCENTS AND BLACKS WHO SPEND A SIGNIFICANT AMOUNT OF TIME FROM THE EDUCATION SYSTEM. AND WHAT CONTRADICTED MY OWN EXPERIENCE AND WHAT WAS IN THE RESEARCH WERE BLACK GIRLS WERE OVERDISCIPLINED SO THEY WERE BEING SUSPENDED AT SIGNIFICANTLY HIGHER RATES THAN OTHER GIRLS IN THEIR SAME AGE PEERS AND BEING SUSPENDED AT HIGHER RATES EVEN THAT HAPPEN WHITE MALES. AND THIS REALLY CONTRADICTED THE IDEA OF HOW WE THINK ABOUT BLACK GIRLS HAVING BLACK WOMEN, ESPECIALLY IN MY OWN EXPERIENCE. THE PERCEPTION HAS ALWAYS BEEN THAT PLAQUE GIRLS ARE DOING WELL, SUCCEEDING ACADEMICALLY, GOING TO HIGH SCHOOL, GOING TO COLLEGE, SO I WAS REALLY CONFUSED WHEN HOW CAN WE HAVE THIS TRAJECTORY OF BLACK GIRLS EXCELLING CAN ACADEMICALLY, EDUCATIONALLY, NEVER IN THE CRIMINAL JUSTICE SYSTEM BUT AT THE SAME TIME HEARING THEY ARE OVERSUSPENDED. SO WHAT WE KNOW IS WHEN CHILDREN ARE OVERSUSPENDED, PARTICULARLY CHILDREN OF COLOR, THEY LOSE SIGNIFICANT AMOUNT OF TIME THAT CAN IMPACT THEIR ACADEMIC SUCCESS. AND WHAT WE ALSO KNOW IS AS CHILDREN HAVE GREATER CONTACT WITH SCHOOL DISCIPLINES, IT INCREASES THE LIKELIHOOD THEY ARE HAVING CONTACT WITH THE CRIMINAL JUSTICE SYSTEM. SO WE HAVE THIS ESTABLISHED RESEARCH WHICH I WILL ALLUDE TO LATER BUT WE NOTE THERE IS A LINK BETWEEN THE SCHOOL SYSTEM AND CRIMINAL JUSTICE. BUT WHAT WE DON'T KNOW IS THAT BLACK GIRLS WERE INVOLVED IN THAT. AND WHAT MY WORK WAS STARTING TO UNCOVER WHEN BLACK GIRLS ARE NOT DOING OKAY, THAT THEY ARE SUBJECT TO THE SAME LEVEL OF DISCIPLINE DISPARITIES AS WERE BLACK MALES. AND WHEN WE START LOOKING AT THE CRIMINAL JUSTICE SYSTEM, WHAT WE FIND IS THERE WERE RACIAL DISPARITIES EVEN WITHIN THAT SYSTEM FOR BLACK GIRLS. SO EVEN THOUGH THE RATES IN GENERAL OF GIRLS HAVING CONTACT WITH THE CRIMINAL JUSTICE BY WAY OF JUVENILE SERVICES, WE FIND BLACK GIRLS VERSUS WHITE GIRLS ARE MORE LIKELY TO HAVE AN INCREASE IN THEIR JUVENILE DELINQUENCY CASES. SO WE'RE SEEING THIS RACIAL DISPARITY EXIST NOT ONLY IN THE EDUCATION SYSTEM BUT CROSSING OVER IN THE JUVENILE JUSTICE CITY'S AND WHEN THIS HAPPENS, -- SYSTEM AND WE FIND BLACK GIRLS ARE THREE TIMES MORE LIKELY TO BE REFERRED TO JUVENILE COURSE THAN CASES INVOLVING WHITE PEERS. SO WE'RE SEEING EXTENSIONS OF CONTACT WITH JUVENILE JUSTICE SYSTEM, MORE SEVERE SANCTIONS FOR BLACK GIRLS, FROM HAVING THEIR CASES REFERRED TO THE COURT AND BEING DETAINED, SO WE'RE SEEING THIS PATTERN, RIGHT, A PATTERN THAT I HISTORICALLY AND PERSONALLY HAD NOT BEEN AWARE OF. I HAD ALWAYS THOUGHT YES, THIS IS HAPPENING TO BLACK MALES, BLACK BOYS, BUT DID NOT REALIZE IT WAS ALSO HAPPENING TO BLACK GIRLS SO I STARTED TO REALLY JUST AGGREGATE THE RESEARCH, THE DATA BY BOTH GENDER AND RACE. AND SO THE PROCESS THAT I JUST DESCRIBED WHICH WE ALL NOW KNOW IS IN THE PIPELINE, BUT I HAVE BEEN DOING THIS WORK OVER 15 YEARS. IN THE SCHOOL TO PRISON PIPELINE, IT REALLY STARTED OUT AS A CONCEPTUAL ARGUMENT BUT NOW WHAT WE'RE SEEING IS THERE IS ACTUALLY EMPIRICAL DATA TO HAVE THIS. SO AS MENTIONED, MY WORK HAS PRIMARILY FOCUSED IN THE EDUCATION SYSTEM WHERE CHILDREN SPEND THE BULK OF THEIR TIME. SO EVEN THOUGH WE HAD THESE CONVERSATIONS ABOUT THE SCHOOL TO PRISON PIPELINE AND THAT THIS IS HAPPENING, IN THIS DIAGRAM I EXPLAIN HOW THE EDUCATIONA L SYSTEM HAS EXPLAINED THESE DISPARITIES. AND SO EVEN THOUGH THEY RECOGNIZE THERE ARE RACIAL ETHNIC DISPARENTS -- DISPARITIES IN SUSPENSION AND AGGREGATE WITH STRAINED RELATIONSHIPS, AGGRESSION, ET CETERA, THEY ALWAYS ASSUMED THIS WAS SOCIONOMIC BASED, RIGHT, LIKE POVERTY. SO THE BLACK BOX PUSHING THIS FORWARD WAS THE SOCIAL ECONOMIC STUDY. SO FOR A SIGNIFICANT PART OF TIME, THE EDUCATIONAL SYSTEM REALLY TOOK AN EQUITY IMPLICIT PERSPECTIVE, BUT WHEN I REALLY STARTED DOING THIS JOB, I WANTED TO LAYER ON THE ROLE OF GENDER AND WHAT WERE THE EXPERIENCES OF BLACK GIRLS, RIGHT? LIKE WHY WERE THEY EXPERIENCING DISCIPLINE DISPARITIES AND WHY WEREN'T WE TALKING ABOUT IT, BOTH EMPIRICALLY AND PUBLICLY? AND I AM HAPPY TO SHARE THAT I AM THE MOTHER OF TWO TEENAGE GIRLS AND SO REALLY KIND OF AT THE TIME THEY WERE CHILDREN, REALLY AT THE TIME I WAS THINKING ABOUT WHAT'S HAPPENING, THESE BLACK GIRLS ARE NOT EXCELLING ACADEMICALLY, WHY ARE THEY HAVING ACADEMIC PROBLEMS, WHY ARE THEY BEING SUSPENDED AND THAT HAD ME LOOKING AT ADULTS. WHEN YOU LOOK AT BLACK GIRLS, WHAT DO YOU SEE IN WHAT COMES TO MIND, WHAT IS IT THAT IS BEHIND THEIR ACTIONS? AND WHEN WE START TO DIG DEEPER, WHAT WE FIND IS EDUCATORS AS WELL AS MANY ADULTS SEE BLACK GIRLS AS AGGRESSIVE, DEFIANT AND PROMISCUOUS. SO WHEN WE LOOK TO THE REASONS WHY THEY ARE BEING DISCIPLINED IT OFTENTIMES HAS TO DO WITH THEIR BEING DEFINED DEFIANT. OFTEN THEY WERE SURVEILLED IN SCHOOL BECAUSE THEY WERE THOUGHT OF AS PROMISCUOUS, THAT THE WAY THEY SPOKE WITH OTHER TEENS WAS AGGRESSIVE. AND AGAIN THIS MADE ME WANT TO LOOK AT THIS WIDER THAT MAYBE BLACK GIRLS ARE NOT SEEN AS CHILDREN BUT BLACK WOMEN? SO MAYBE ADULTS INTERACTING WITH BLACK GIRLS, THEY DON'T SEE THIS 5 OR 7-YEAR-OLD AT AN AGE APPROPRIATE, MAYBE WHAT THEY SEE IS BLACK WOMEN. AND MY BASIS FOR THAT IS BECAUSE OF THE BEHAVIORS THAT BLACK WOMEN EXPERIENCE IS REALLY ALIGNED WITH THE STEREOTYPES THAT EXIST FOR BLACK WOMEN. SO WHEN WE UNPACK THOSE STEREOTYPES, THERE ARE STEREOTYPES THAT SAY BLACK WOMEN ARE AGGRESSIVE, HOSTILE, OFTEN PROMISCOUS, AND DEFINES ALSO RELATES TO THAT LEVEL OF AGGRESSIVENESS. SO PERHAPS IT IS NOT THAT THESE BLACK GIRLS ARE BEHAVING DIFFERENTLY THAN EXPECTED, IT IS THE WAY IN WHICH EDUCATORS AND ADULTS SEE BLACK GIRLS. SO REALLY TO ADDRESS THIS, I WAS VERY MUCH INFLUENCED BY THE WORK -- AND LIKE TO GIVE EVERYONE THEIR FLOURS, THE SOCIOLOGY STUDY OF LINDA BECKERMAN AND SHE WAS ONE OF THE ONES WHO USED ADULTIFICATION. SHE WAS LOOKING AT ADULTIFICATION IN TERMS OF LOW INCOME, RURAL COMMUNITIES AND THE EXTENT TO WHICH CHILDREN WERE SOCIALIZED TO TAKE ON ADULT ROLES. WHEN I TALK ABOUT ADULTIFICATION, I AM NOT TALKING ABOUT IT AS A SYSTEM BUT THE ASSOCIATION OF BLACK GIRLS WITHOUT KNOWING ANYTHING INDIVIDUALLY ABOUT THAT BLACK GIRL. SO IN ORDER TO DESIGN THE STUDY, AND I WAS THE LEAD RESEARCHER ON THE GEORGETOWN REPORT, WE WERE INTERESTING IN ASKING QUESTIONS ABOUT WHAT IS DEVELOPMENTALLY APPROPRIATE, WHAT WOULD WE EXPECT BLACK GIRLS TO BE OR HOW THEY SEE THEM AND THEN WHAT WOULD ASSOCIATE THEM WITH BEING MORE INDEPENDENT AND ADULT-LIKE. AND THESE QUESTIONS ARE BASED, AGAIN, ON WHAT IS DEVELOPMENTALLY APPROPRIATE OR INAPPROPRIATE AND WHAT IS ASSOCIATED WITH THE RACIAL STEREOTYPES OF BLACK WOMEN. SO WE ASKED ADULTS HOW MUCH DO BLACK OR WHITE FEMALES NEED TO BE SUPPORTED. AND WE WOULD EXPECT ALL CHILDREN TO BE SUPPORTED. WE ASKED HOW DO BLACK OR WHITE FEMALES NEED TO BE COMFORTED, BECAUSE CHILDREN NEED TO BE COMFORTED. AND THEN HOW KNOWLEDGEABLE ARE BLACK OR WHITE FEMALES ABOUT SEX. SO THESE ARE JUST A FEW OF THE QUESTIONS REALLY TAPPING INTO WHAT EXTENT ARE ADULTS PERCEIVING BLACK GIRLS AS CHILDREN AND EXHIBITING THOSE QUALITIES. AND SO WHAT WE DID WAS WE GAUGED THIS SURVEY TO A SAMPLE OF ADULTS IN THE COMMUNITY, NOT ALL WERE EDUCATORS, AND WE HAD THEM COMPLETE THE QUESTIONS AS IT RELATED TO BLACK GIRLS AND WHITE GIRLS AT DIFFERENT DEVELOPMENTAL AGES. AND SO THIS IS A GRAPH. WE ACTUALLY DID A LENGTHY ANALYSIS AND THE ACTUAL NUMBERS ARE NOT SIGNIFICANT BUT WHAT IS SIGNIFICANT IS THE MAGNITUDE OF DIFFERENCE BETWEEN THESE DATA POINTS. AND SO WE ASKED THESE QUESTIONS FOR GIRLS FROM 0 TO 4 BLACK AND WHITE GIRLS, BLACK AND WHITE GIRLS FROM 5-9, 10 TO 14 AND 15 TO 19. SO WHAT I REALLY THOUGHT IS OH, YOU ARE GOING TO SEE SIGNIFICANT DISEQUITY IN THE 14-19 YEARS OF AGE RANGE. AND I THOUGHT OBVIOUSLY NO ONE IS GOING TO SEE A DIFFERENCE IN THE YOUNGER AGES, THERE IS NOT GOING TO BE A DIFFERENCE. BUT WHAT WE FOUND IS THERE WAS A SLIGHT RACIAL DIFFERENCE IN THAT ADULTS SAW BLACK GIRLS AS YOUNG AS 5 YEARS OLD AS BEING MORE INDEPENDENT, AS NOT NEEDING TO BE SUPPORTED, BEING KNOWLEDGEABLE ABOUT SEX COMPARED TO WHITE GIRLS. AND WE FOUND THIS FROM AGE 5 ALL THE WAY UP TO AGE 15. AND I WILL BE HONEST, I WAS COMPLETELY SURPRISED THAT, ONE, PEOPLE ARE THIS FORTHCOMING BUT THE EXTENT TO WHICH THIS ADULTIFICATIION BIAS APPLIED TO BLACK GIRLS. SO THIS IS A PICTURE OF MY DAUGHTER. SHE IS OLDER NOW AND WOULD NOT LIKE ME SHARING THIS NOW BUT AT THE TIME SHE WAS YOUNG AND I THOUGHT HOW COULD SOMEONE SEE THIS, RIGHT? WHERE IS THIS COMING FROM? IF THOSE ADULTIFICATION BIASES OPERATE, IT CAN INTERPRET OR INFLUENCE THE GIRL BEHAVIOR, HOW WE INTERACT WITH THEM AND SEE IT AS BEING VOLITIONAL AND NOT AGE APPROPRIATE. IF WE'RE SEEING BLACK GIRLS NOT AS CHILDREN BUT AS BLACK WOMEN, WE'RE NOT GOING TO RESPOND TO THEM IN DEVELOPMENTALLY APPROPRIATE WAYS AND CONSISTENT WITH THEIR AGE AND BEHAVIOR. SO THIS IS A BIAS WHICH IS THE LENS THAT SHAPES HOW WE SUBSEQUENTLY INTERACT WITH BLACK GIRLS AND THIS LENS IS NOT JUST IN THE EDUCATION SYSTEM. WE SEE THIS IN HEALTHCARE SETTINGS. WE SEE THIS WITH FAMILY SERVICES. WE SEE THIS IN THE CRIMINAL JUSTICE SYSTEM. SO RETHINKING THE WAY THAT WE IDENTIFY WHY WE SEE PARTICULARLY DISPARITIES IN THE EDUCATION SYSTEM, I PROPOSED A MORE EXPANDED MODEL, RIGHT WHERE, WE RECOGNIZE THE RACIAL DISPARITY WE'RE SEEING IS OBJECTION YOULY RACISM, DISCRIMINATION AND THE INTERACTION OF SOCIOECONOMYING STATUS OF RACE OR ETHNICITY BUT THE BLACK BOX WE'RE MISSING IS THE IMPLICIT RACIAL BIAS. AND THERE HAVE BEEN OTHERS WHO HAVE TALKED ABOUT THIS BUT I WANT TO DIG DEEPER. IMPLICIT RACIAL BIAS IS A -- WHERE WE STIPULATE ASPECTS OF CERTAIN QUALITIES OF CHILDHOOD, WHERE WE SEE THINGS THAT APPEAR TO BE APPROPRIATE, ABOUT MAKING MISTAKES, ABOUT KNOWING BETTER, WHEN WE TAKE THAT AWAY FROM BLACK GIRLS, IN THE FORM OF ADULTIFICATION, IT TAKES AWAY THE LENS WHAT HAVE IT MEANS TO BE A CHILD FROM BLACK GIRLS. SO MY WORK REALLY TALKED ABOUT HOW DOES THIS BIAS MANIFEST ITSELF WITH BLACK GIRLS WITH VARIOUS SYSTEMS. MY WORK IN IMPLICIT RACIAL BIAS IN THE SYSTEM AND WHAT CAN WE DO ABOUT IT. SO WHY ARE WE HERE? THIS SEEMS SIMPLE BUT SIMPLE STATEMENTS CAN BE VERY POWERFUL. BECAUSE BLACK GIRLS BECOME BLACK WOMEN. MY GIRLS ARE NOW IN HIGH SCHOOL AND COLLEGE AND THE INTERACTIONS THEY HAD WITH THE BEGINNINGS OF THE EDUCATION SYSTEM HAS IMPLICATIONS AND SHAPED THEIR INTERACTIONS AS THEY CONTINUE TO MATURE AND DEVELOP. SO IDENTIFYING THE ADULTIFICATION BIAS AND NAMING IT AND THEIR EXPERIENCE WITH IT HAS IMPLICATIONS FOR THE LATER TYPE OF BIASES THAT BLACK WOMEN EXPERIENCE AS THEY MOVE THROUGH THEIR EDUCATION, THEIR CAREER AND CONTINUE TO ADDRESS SERVICES. SO WHAT THIS MEANS IS THAT WE ARE DEPENDING ON HOW YOU VIEW THIS, AS SOCIETY RECOGNIZING THAT WE NEED TO STEP BACK AND LOOK AT THE LENS BY WHICH WE IDENTIFY STRUCTURAL RACISM AND THERE ARE CERTAIN WAYS TO LOOK AT THIS AND HOW WE DISMANTLE THIS BUT WE ALSO NEED TO UNDERSTAND HOW EARLY CONTACT WITH THESE SYSTEMS AND STRUCTURAL RACISM THEN SHAPE AND INTERACT IN VERY NUANCED WAYS WITH WHO BLACK GIRLS BECOME AS ADULT, RIGHT? SO THESE THINGS ARE ALL CONNECTED, RIGHT? SO IT IS NOT JUST LOOKING AT CHILDHOOD AND LEAVING IT THERE, BUT REALLY TAKING THIS LONGITUDINAL LENS AND SEEING HOW, AS THE VIDEO ALLUDED TO, IT IMPACTS THE HEALTHCARE SYSTEM, THE TYPE OF HEALTHCARE THAT BLACK AND BLACK ADOLESCENT GIRLS AND THEN LATER BLACK WOMEN DID. HOW ARE THESE THINGS RELATED? HOW ARE THE CHILD WELFARE SYSTEMS AND THE WAY BLACK GIRLS ARE VIEWED IN THAT SYSTEM IMPACT THE WAY BLACK MOTHERS ARE VIEWED IN THE SYSTEM? ALL OF THESE ARE VERY IMPORTANT FOR US TO UNDERSTAND, RIGHT? SO BROADENING BEYOND THE EDUCATIONAL SYSTEM, TAKING THE SAME LENSE, RIGHT, AND APPLY IT TO HEALTHCARE, EMPLOYMENT, THE CRIMINAL JUSTICE, YOU KNOW, THE EDUCATIONAL SYSTEM, LOOKING AT INCOME DISPARITIES, ALL THESE THINGS ARE CONNECTED AND THEY CERTAINLY BEGIN IN CHILDHOOD AND HAVE A IMPACT IN CHILDHOOD AND CONTINUE TO HAVE IMPACT AS BLACK GIRLS MATURE. SO WHERE DO WE GO FROM HERE? THERE HAS ALREADY BEEN WORK THAT HAS SHOWN THE PHYSICAL IMPLICATIONS OF RACISM AND THERE WAS ACTUALLY AN AMAZING STUDY FUNDED PARTLY FROM NHLBI THAT LOOKED AT STRUCTURAL RACISM AND INDIVIDUAL RACISM AT AGES 10 IN BLACK YOUTH AND THE IMPACTS ON INFORMATION. SO WE ARE TAKING STEPS TOWARDS THIS PROCESS BUT REALLY NEED TO UNDERSTAND WHAT ARE YOU PHYSICAL HEALTH IMPLICATIONS OF IMPLICIT GENDERED BIAS? SO RACIAL TRAUMA, RACIAL STRESS, RACIAL COPING, RIGHT, THAT IS THE MANIFESTITATION OF IMPLICIT RACIAL BIAS AND EVENIMPLIED RACIAL BIAS. THERE IS THE JOHN HENRYISM AND SUPER WOMAN THEMES BUT THE IDEA THAT THE BLACK WOMAN IS TAKING CARE OF EVERYTHING AND EVERYONE AND WHERE WOULD THAT COME FROM? WELL, IF YOU HAVE STRUCTURAL RACISM AND ARE EXPECTING THE BLACK GIRL TO BE MOOT MATURE, YOU MAY INTERNALIZE THOSE BELIEFS AND SAY YES, THIS IS WHAT THEY ARE SUPPOSED TO BE DOING BUT WHAT ARE THE PHYSICAL HEALTH THINGS, THE PHYSICAL STRESS, WHAT HAPPENS TO YOUR BODY WHEN YOU CONSTANTLY TAKING ON THE BURDENS OF TAKING CARE OF EVERYONE ELSE? AND ONE OF THE INITIATIVES OF NHLBI WHICH IS GREAT IS HOW DO WE ADDRESS THE EQUITY IMPLICIT TRAINING AND THE HEALTH BIAS AND THIS IS A VERY IMPORTANT TASK. SO WHAT DOES THIS MEAN IN TERMS OF HEALTH POP POLICY CHANGE, IN TERMS OF CARE, INSURANCE, HOW DO WE DISMANTLE THIS STRUCTURAL RACISM THAT IS SO EMBEDDED IN OUR SYSTEM? THE OTHER PART OF THE STORY IS HELPING HEALTHCARE PROVIDERS TO RECOGNIZE THE EXTENT TO WHICH THE IMPLICIT GENDERED BIAS MAY IMPACT THEIR HEALTHCARE, THE QUALITY, THE INTERACTION, AND THE VARIOUS NUANCES, THINGS THAT HAVE HAPPENED, HOW DOES OUR PROCESS WORK TO ADDRESS THAT? WHILE I HAVEN'T WORKED WITH HEALTHCARE PROVIDERS CURRENTLY, IN THE FUTURE I PLAN TO. BUT I CURRENTLY HAVE A TRAINING PROGRAM FOR HEALTHCARE MEMBERS INTERACTING WITH BLACK CHILDREN AND BLACK GIRLS. SO HELPING THEM UNDERSTAND THE WHEN REALLY MATTERS BECAUSE WE ALL EXPERIENCE BIAS, RIGHT? THE QUESTION IS HOW DO WE NOT ALLOW THOSE BIASES BECOME TRADITION. SO SOME OF IT IS TRAINING. NOT ONLY WITH TERMINOLOGY BECAUSE YOU HAVE TO EDUCATE PEOPLE WHAT THEY NEED, BUT WHEN TALKING ABOUT STRUCTURAL RACISM AND ADULTIFICATION OF GENDERED BIAS, WE NEED VARIOUS STAKEHOLDERS IN THE SAME ROOM HEARING THE SAME CONTENT AND OF COURSE WE CAN ALTER THAT BASED ON OUR DISCIPLINE AND EXPERTISE, BUT WE NEED TO HAVE MORE INTERDISCIPLINARY TRAINING BECAUSE IT IS A COMPLEX SOLUTION AND CANNOT BE DONE IN SILO AS WE ALL KNOW. THE OTHER IS IMPLICIT HEALTHCARE TRAINING, PARTICULARLY BECAUSE WE HAVE NOT REALLY NAMED RACE AND GENDER AT THE FOREFRONT AND WE NEED TO TALK ABOUT THAT NOT FROM A GUILTY PERSPECTIVE BUT FROM A ACTIONABLE, LIKE THIS IS WHAT IT IS AND THIS IS WHAT WE NEED TO DO TO ADDRESS THAT, RECOGNIZING THAT WE'RE GOING TO STUMBLE AND MAKE SOME MISTAKES, AND THIS IS THE FIRST TIME WE HAVE EVER HAD THE OPPORTUNITY TO DO THAT AT A CONCERTED LEVEL. AND LASTLY, WE NEED A CENTER FOR THE VOICES OF BLACK GIRLS AND WOMEN. SO THINKING ABOUT OUR SCIENCE AND RESEARCH BEING QUALITATIVE LEAVE ORIENTED BUT I BELIEVE THE COMMUNITY RESEARCH IS VERY VITAL AND IMPORTANT. I ALWAYS TELL PEOPLE WHO BETTER TO TELL THE STORY OF THE EXPERIENCE THAN THE POPULATIONS THAT ARE IMPACTING IT. AND SO WHEN I REALLY DIDN'T RECOGNIZE THE IMPACT THAT MY WORK COULD HAVE WAS AFTER TILL THE REPORT AT GEORGETOWN WAS RELEASED, HUNDREDS OF BLACK WOMEN AND GIRLS SAID YOU GAVE A NAME TO WHAT I HAVE BEEN EXPERIENCING AND I COULD NEVER HAVE BEEN ABLE TO NAME IT. AND IT HAPPENED IN THIS SITUATION AND THAT SITUATION AND THEY KEPT COMING AND REACHING OUT AND SAYING ARE YOU GOING TO DO THIS AND GOING TO DO THAT? THERE IS SOMETHING POWERFUL ABOUT THE VOICES OF THE POPULATION WE INTEND TO ADDRESS HEALTH EQUITY AND DISPARITIES AND AS SCIENTISTS AND SCHOLARS, WOULD HE REALLY HAVE TO CENTER THEIR VOICES. SO WITH THAT, I WOULD LIKE TO CONCLUDE MY PRESENTATION AND OPEN IT UP FOR CONVERSATION AND I AM GOING TO STOP SHARING MY SCREEN. >>THANK YOU, EXCEPTIONAL PRESENTATION. YOUR EVERYSIS ON THE DISCIPLINARY LENS WITH THE RESULT OF ADULTIFICATION OF BLACK GIRLS REALLY SPREADS A LOT OF LIGHT ON NOT JUST THE EDUCATION SYSTEM BUT ALSO ON PHYSICAL AND MENTAL HEALTH AND THAT PARTLY RESONATED WITH ME. BUT RIGHT NOW I WANT TO OPEN THIS UP FOR QUESTIONS AND WE HAVE QUITE A FEW. FIRST BASED ON YOUR EXPERTISE AND PERSPECTIVE, WHAT RECOMMENDATIONS WOULD YOU ADVICE NHLBI IN PURSUING OUR GOALS AND THE SECOND PART OF THAT IS WHAT ADVICE WOULD YOU LEND TO HELP US AVOID PITFALLS? >>I WILL SAY I AM SO IMPRESSED WITH NHLBI ACROSS THE NATION. I THINK YOU GUYS ARE DOING EXCELLENT THINGS. I THINK SO REALLY IT IS ABOUT -- AND OBVIOUSLY, YOU KNOW, THERE ARE DIFFERENT TYPES OF RESEARCH AND REASONS WHY WE HAVE BIAS, ET CETERA, BUT I REALLY THINK IT IS ABOUT EDUCATION, CONTINUING TO HAVE THE CONVERSATIONS, CONTINUING TO HAVE THESE SPEAKER HEARINGS AND BRINGING IN DIFFERENT VOICES FROM SCHOLARS WHO HAVE DIFFERENT EXPERTISE BOTH THE NATIONAL HEART LUNG AND BLOOD RELATED DISEASES BUT ALSO THOSE WHO DON'T HAVE THE EXPERTISE BUT HAVE A DEEPER LENS IN STRUCTURAL, SO THINKING ABOUT SOCIOLOGISTS, ORGANIZATIONAL PSYCHOLOGISTS, PEOPLE OUTSIDE OUR NORMAL WORK WHO HAVE EXPERTISE AND ARE DOING EQUITY WORK. AND I BELIEVE YOU ARE ALREADY DOING THAT SO THAT IS EXCELLENT. AGAIN, CENTERING THE VOICES OF THE POPULATIONS WE WANT TO IMPACT. THAT IS SO IMPORTANT. AND THIS IS A BIT CONTROVERSIAL, BUT MAKING SURE THAT THE FUNDING APPLICATIONS THAT WE'RE ENTERING THOSE VOICES, THEY ARE ACTUALLY ON THOSE WHO HAVE THE EXPERTISE OF EQUITY. THERE ARE SCHOLARS WHO ARE LEADING THESE PROPOSALS THAT HAVE THE EXPERTISE IN EQUITY, RIGHT, ENSURING THAT -- OFTENTIMES WHAT HAPPENS IS WE GET SCHOLARS WHO HAVE TO JUMP ON A TOPIC AND COULD BE REALLY EXCITING AND IT IS INTERESTING AND THERE IS A LOT OF DOLLARS BUT THE PROBLEM IS WHEN PEOPLE KIND OF FOLLOW THAT, IT IS SHORT TERM. IT DOESN'T HAVE SUSTAINABILITY. SO MAKING SURE THAT THE TEAMS ARE REALLY COMPOSED OF PEOPLE WHO ACTUALLY HAVE THAT EXPERTISE AND THAT WE'RE CONSIDERING RESEARCH DESIGN, METHODOLOGIES, ADVISORY COMMITTEES THAT REALLY CENTER THE WEIGHT OF THE POPULATIONS THEY WORK WITH. AND I HAVE SOME COLLEAGUES WHO ARE GOING O TO SAY JAMILIA HAS COMPLETELY CHANGED. BECAUSE THERE WAS A TIME IN MY CAREER WHEN IT WAS ALL FAST-PACED, ALL ABOUT ME AND NOW I HAVE REALLY GROWN A LOT AND RELEASING THIS WORK HAS HELPED ME REALIZE THE POWER OF TRANSLATIONAL WORK. BUT WE HAVE A LOT OF GREAT SCIENCE WORK, A LOT OF GREAT STUDIES BUT IT DOESN'T REACH THE POPULATION THAT NEEDS TO HEAR IT AND BENEFIT FROM IT. SO WE HAVE TO -- I THINK THIS IS MORE BROADLY AT NIH, TO THINK ABOUT THIS. PEER REVIEW PUBLICATIONS ARE WONDERFUL BUT WHAT ARE THE MECHANISMS THAT GET THIS INTO THE HANDS OF THE PEOPLE WE WANT TO EMPOWER? RELEASING THIS REPORT IN A WAY THAT PEOPLE CAN DIGEST AND UNDERSTAND THE CONCEPT REALLY CHANGED THE GAME FOR ME, RIGHT? IT REALLY MADE IT SO PEOPLE WHO WERE FOCUSING ON BLACKS, THERM EMPOWERED AND THEY WENT OFF AND FOCUSED ON PROGRAMS IN THE COMMUNITY AND SO REALLY TO THINK ABOUT THE DISSEMINATION OF SCIENCE AND HOW TO DO THAT AND MOVING OUT OF THE TRADITIONAL LIKE -- THAT'S GREAT, WE SHOULD STILL DO THAT BUT LET'S TAKE IT TO ANOTHER LEVEL SO WE'RE ENGAGING AT THE LEVEL WE WANT TO IMPACT AND THEN THE METHOD, HOW DO WE GET THIS INFORMATION TO THEM, HOW DO WE CENTRALIZE AND EMPOWER THEIR VOICES AND MAKE SURE THEY ALIGN WITH THEIR EXPERIENCE. I DON'T KNOW IF THAT ANSWERS THE QUESTION BUT THAT IS WHAT I WOULD SAY. >>THANK YOU FOR THOSE RECOMMENDATIONS. I HAVE A FEW OTHER QUESTIONS. THE NEXT ONE IS SIMPLE. WHAT DO YOU THINK THE HEART LUNG BLOOD AND SLEEP IMPLICATIONS MIGHT BE FOR BLACK GIRLS AND WOMEN IN PARTICULAR, AND ALSO OTHER MARGINALIZED POPULATIONS IN GENERAL FOR THE UNCORRECTED ADULTIFICATION BIAS -- >>I AM SO SORRY, CAN YOU REPEAT THAT QUESTION? MY INTERNET WENT OUT A LITTLE BIT. >>YES, OF COURSE. WHAT DO YOU THINK THE HEART LUNG BLOOD AND SLEEP IMPLICATIONS MIGHT BE FOR BLACK GIRLS AND WOMEN IN PARTICULAR FOR UNCORRECTED ADULTIFICATION BIAS IN THE COURSE OF A YEAR? >>OOH, I DON'T KNOW AND THAT IS WHY WE NEED TO STUDY AND FUND IT. ONE OF THE THINGS I HAD SOMEONE ASK ME, A BLACK MOTHER, AND SHE SAID IT DOESN'T EXIST IF WE DON'T KNOW IT EXISTS, RIGHT? AND WHAT SHE WAS SAYING IS, YOU KNOW, JAMILIA, YOU ARE BRINGING THIS UP BUT SHOULDN'T WE BE TELLING OUR DAUGHTERS THERE IS THIS ADULTIFICATION BIAS SO LET'S GET THIS IN THE HANDS OF THE SOCIAL NATION. ARE WE CREATING MORE HARM BY INFORMING THEM OF THIS BOGEYMAN OR JUST LET CHILDREN BE CHILDREN? SO THE FIRST QUESTION IS ARE BLACK GIRLS AWARE OF THE ADULTIFICATION BIAS. I BELIEVE THEY ARE AND I HAVE SEEN IT ANECDOTALLY AND EVEN IF THEY DON'T HAVE THE LANGUAGE TO CALL IT THAT, THEY ARE AWARE THERE IS SOMETHING THAT IS CHANGED IN THE AWARENESS AND EXPECTATIONS. AND I THINK THAT AWARENESS, EVEN IF WE DON'T HAVE THE VOCABULARY, CAN HAVE SIGNIFICANT IMPLICATIONS ON OUR PHYSICAL HEALTH. SO WE NEED TO EXPLORE, WE NEED TO STUDY IT AND LOOK AT IT AT THE FORMATIVE YEARS. THE ONE STUDY, THERE IS ONE STUDY I CAN THINK OF. THE ONE STUDY, THEY DIDN'T LOOK AT THE IMPLICATION OF RACISM AND INFLAMMATION DURING CHILDHOOD, THEY WAITED UNTILL TIL THEY WERE YOUNGER ADULTS WHERE THERE WAS THIS CUMULATIVE EFFECT. BUT THAT IS AN IMPORTANT QUESTION, WITH THIS IMPLICATION OF BIAS AND INFLAMMATION, I DON'T THINK WE KNOW YET. >>AND THE SECOND PART OF THAT WHICH YOU STARTED TO HINT AT EARLIER, DOES THE RESEARCH HINT AT HEALTH IMPLICATIONS FOR GIRLS OF COLOR, CAN YOU TALK ABOUT THAT? >>SO THAT IS THE NEXT PHASE OF MY RESEARCH, IS REALLY WHAT ARE THE PHYSICAL HEALTH IMPLICATIONS, RIGHT? LIKE ARE -- HERE IS WHAT I CAN SAY. IT IS KIND OF A DOUBLE EDGED SWORD. IT IS BOTH EMPOWERING AND EXCITING BUT ALSO DISHEARTENING. WHEN I WAS RELEASING THIS RESEARCH, I MENTIONED I HAD RELEASED THIS AND YOUNG GIRLS WERE COMING TO ME AND THEY SAID YES, AND THEY SAW IT AS A SYMBOL OF EMPOWER P.M. AND LEADING THE CHARGE. AND AT FITTER THEY DIDN'T UNDERSTAND THE ADULTIFICATION PROCESS BUT THE MESSAGE WAS YES, I AM RESILIENT, I AM STRONG AND I WOULD HAVE FELT THAT WAY AT 16, 17, 20. NOW I AM A MATURE WOMAN AND AT THAT AGE, I FEEL LIKE THERE ARE PHYSICAL EFFECTS, RIGHT? SO I THINK THAT WE DON'T KNOW, RIGHT? LIKE WE HAVE TO -- WE'RE GOING TO HAVE TO DO MORE RESEARCH THAT EXPLICITLY ADDRESSES THAT. BUT TO DO THAT, WE HAVE TO DO LONGITUDINAL STUDIES. WE CAN'T DO IT FROM ONE PERSPECTIVE BECAUSE IT WILL NOT GIVE US THE ANSWERS WE NEED. >>IS UNIDENTIFIED TRAUMA FROM ADULTIFICATION BEING MISTAKEN BY HEALTHCARE PROFESSIONALS AS SOMETHING ELSE? >>PEOPLE, THESE ARE REALLY GOOD QUESTIONS. YOU KNOW, I DON'T KNOW. I MEAN I THINK THAT WHAT WE'RE FINDING IS THAT YES, THERE ARE A LOT OF RACIALIZED TRAUMAS THAT WE HAVE MISTAKEN IN OUR DYING DIAGNOSTIC SYSTEM, OUR DIAGNOSTIC PROCESS THAT IS BEING SEEN THROUGH A CALLED TACTICAL CULTURAL LENS AND YES, IT IS HAPPENING BUT IT REQUIRES MORE RESEARCH. TO DO THAT, YOU HAVE TO HAVE THE ASPIRATIONAL ASPECT, STUDY THESE THINGS OVER TIME, UNDERSTAND WHAT OTHER TRAUMATIC EXPERIENCES THAT BLACK GIRLS ARE EXPERIENCING BUT I WOULD ARGUE THAT THAT IS A POTENTIAL HYPOTHESIS THAT WE CAN LOOK AT BECAUSE THERE ARE HEALTH PROFESSIONALS, IT IS NOT THAT THEY INTEND TO DO IT, BUT THAT THE AWARENESS THAT IS CREEPING THROUGH IS A LOT OF PROFESSIONALS DON'T HAVE THE CULTURAL COMPETENCY SO IDENTIFY THIS. LIKE I THINK OF CHILD WELFARE, SOCIAL SERVICES, BECAUSE THEY ARE DEALING WITH KIDS DEALING WITH A LOT OF TRAUMA. SO I CAN SEE ADULTIFICATION BIAS BEING IMPACTFUL THERE BECAUSE THEY ARE THINKING ABOUT ALL THESE OTHER TRAUMAS AND NOT CONSIDER THE IMPACT OF THE BLACK GIRL AND HOW THAT FURTHER TRAUMATIZES THEM AND AFFECTS THEIR MENTAL HEALTH AND WELL-BEING SO THOSE ARE THINGS WE HAVE TO EXPLORE. >>AS A YOUNG WHITE MENTOR, HOW DO I HELP YOUNG BLACK GIRLS WITHOUT THIS BIAS? >>WELL, THAT IS INTERESTING. I THINK THE ONE THING IS TO DISCERN ARE WE TALKING ABOUT THE ADULTIFICATION PROCESS OR ADULTIFICATION BIAS? SO I WILL SHARE IN FULL TRANSPARENCY, I ENGAGE IN THAT WITH MY DAUGHTERS. I AM A SINGLE PARENT, WHEN SHE WAS 5, I WAS LIKE OKAY, YOU KNOW YOUR COLORS, WHERE DOES THE REDDING, THE BLUE GO AND IT WAS A GAME BUT SHE WAS SORTING LAUNDRY, RIGHT? SO THERE IS ADULTIFICATION PROCESS NECESSARY FOR A FAMILY TO FUNCTION AND THEN THERE IS THIS ADULTIFICATION BIAS OF YOU REALLY SHOULD KNOW BETTER. SO THAT NUANCE OF GIVING GRABBING GIRLS AND BLACK PARENTS THE NUANCE OF THE LANGUAGE TO TALK ABOUT CERTAIN THINGS, LIKE HEY, THIS CAME TO ME FROM THEIR MENTOR AND THEN SHARE THE STORY BUT HERE IS WHAT I AM THINKING AND DO YOU SEE IT THIS WAY? SEEING IT IN WORDS AND GIVING THEM THE VOCABULARY BUT NOT PUTTING WORDS IN THEIR MOUTH. SO THAT IS SOMETHING I AM REALLY FOCUSED ON WITH YOUTH AND KIND OF LIKE SAYING THIS IS AN EXAMPLE OF THIS, THIS IS AN EXAMPLE OF THIS. WHICH ONE DO YOU THINK ALIGNS WITH YOUR EXPERIENCE? IT COULD BE THAT THEY ARE AT A DEVELOPMENTAL AGE WHERE THEY CAN UNDERSTAND THAT. I WILL SAY VERY YOUNG CHILDREN WILL NOT HAVE THE COGNITIVE PERSPECTIVE ABILITY TO GRASP ADULTIFICATION BIAS BUT AS THEY GET TO BE AN ADOLESCENT, THEY WILL. SO HELPING THEM LABEL IT AND THEN TO BE CAUTIOUS AND SAY THIS IS WHAT I AM THINKING, IS THAT WRONG, RIGHT? AND I WOULD SAY EVEN -- ONE THING I WOULD ENCOURAGE PEOPLE TO UNDERSTAND IS THE ADULTIFICATION BIAS, REGARDLESS OF YOUR RACIAL BACKGROUND YOU COULD EXHIBIT THE BIAS BUT WITH YOU BEING A WHITE MENTOR, IT COULD LIKELY BE THE SAME AS A BLACK MENTOR HAVING THAT EXPERIENCE DEPENDING WHERE THEY GREW UP AND WHAT THEIR EXPERIENCES ARE. SO PART OF THAT IS BEING THE EDUCATIONAL MENTOR BUT I WAS THERE TOO, HELPING CHILDREN AND VERY GENTLY EDUCATING THE PARENTS AS WELL. >>SO ON THAT NOTE, WHAT ADVICE DO YOU GIVE BLACK PARENTS WHEN INSTRUCTING OUR DAUGHTERS TO SPEAK UP WHEN IT COMES TO THE SCHOOL SYSTEM CORRECTION? >>WELL, A CHILD CAN'T GO THERE AS AN ADULT, THERE IS A REASON. SO I WOULD ALWAYS TELL ME CHILDREN I AM THE PARENT. I DON'T WANT THEM HAVE A CONVERSATION WITH AN ADULT AND SAYING YOU ARE ENGAGING IN ADULTIFICATION BIAS. I WANT TO TELL THEM THE CIRCUMSTANCE AND THEN ME AND GO DISCUSS IT WITH THE SCHOOL. SO WHEN THEY WERE YOUNGER IN ELEMENTARY AND MIDDLE SCHOOL, I WAS LIKE YOU LET ME DO THE FIGHT, YOU TELL ME ABOUT IT AND I WILL GO HAVE THE CONVERSATIONS WITH THE ADULTS. SO LISTENING TO YOUR CHILDREN. I THINK THAT IS A BIG PART, AS PARENTS, GETTING THE WHOLE STORY AND IF THEY FEEL THERE IS DISPARITY PREFERENTIAL TREATMENT AND THEY FEEL LIKE THIS IS OCCURRING, THAT IS WHAT THE SYSTEM HAS, THE PARENT IS THE FIRST STEP. AND THEY ARE WELCOME TO SAY HEY, I AM BEING TREATED DIFFERENTLY, I DON'T LIKE THE WAY I AM FEELING BUT I JUST -- THERE ARE SOME WHO MAY DISAGREE WITH ME BUT THERE IS A SIGNIFICANT POWER DIFFERENTIAL BETWEEN STUDENTS AND TEACHERS THAT STUDENTS WILL NEVER FULLY WIN THAT BATTLE AND WE HAVE TO RESHAPE THE WAY THE ADULTS INTERACT WITH STEVENS. SO I WOULD SAY IT IS UP TO THE PARENTS TO REALLY GO IN BUT THAT WOULD BE TO LISTEN TO YOUR CHILDREN. AND THEN THERE MIGHT BE OTHER ADULTS AS WELL, YOU KNOW, THE WHOLE LENS, AND THAT WOULD BE MY RECOMMENDATION. >>THANK YOU. HOW CAN THE SYSTEM BE REFORMED TO ADDRESS THE CORRECT ADULTIFICATION TO HELP BLACK GIRLS AND OTHER MARGINALIZED COMMUNITIES THRIVE NOT ONLY IN EDUCATION BUT HEALTH-WISE AS WELL? >>WHERE DO I BEGIN? LET ME SAY THIS FIRST. WE PUT A LOT OF EMPHASIS ON THE EDUCATION SYSTEM AND INHERENT IN THE COMMUNITY THEY ARE INVESTED IN. SO IF THEY ARE IN A COMMUNITY THAT DOESN'T HAVE A LOT OF PROFESSIONALS, THEY HAVE A LOT OF RESOURCES, THIS COMES INTO THE SCHOOL SYSTEM AND THEY ARE EXPECTED TO COMPENSATE FOR THAT. SO EDUCATIONAL REFORM, ALSO WE KNOW SOMETHING ABOUT THE SILO REFORM. THINGS ABOUT GETTING THIS TROUBLE BUT WE HAVE TO CHANGE THINGS IN THE COMMUNITIES AND I THINK THE FIRST STEP IS REALLY MAKING SURE WE EDUCATE PEOPLE AND GIVE THEM THE SKILLS. I THINK THERE ARE A NUMBER OF TEACHERS WHO MAY EXHIBIT ADULTIFICATION BIAS AND NOT REALIZE IT BECAUSE IT IS SIMPLY AS A NUANCE ESCAPING THEIR AWARENESS. SO EDUCATING THEM ABOUT THE BIAS AND THEN GIVING THEM TOOLS TO MANAGE PARTICULARLY IN BEHAVIORAL SITUATION WHERE THE BIAS IS MORE LIKELY TO BE AGGREGATED. SO GIVING THEM TRAINING THAT WILL ADDRESS NOT JUST ADULTIFICATION BIAS BUT ANY TYPE OF BIAS THAT WILL IMPACT THEIR DECISION MAKIC -- MAKING AND ARE EXPLICIT PROTOCOLS FOR ADULTIFICATION BIAS. WHEN THEY ARE TIRED, WHEN THEY ARE HUNGRY WHEN, DECISION-MAKING IS OBJECTIVE AND IT IS NOT CLEAR WHAT THE CRITERIA IS SO YOU HAVE TO SHAPE AND AND MISINTERPRET THE LENS. SO NOT JUST CREATING IT BUT EDUCATING THEM ON THE BIAS AND TRAINING THEM IN THE SKILLS. BUT IF YOU WANT TO GO A LEVEL FURTHER, BECAUSE SCHOOL IS INHERENT IN THE COMMUNITIES THEY ARE IN, RIGHT, WE HAVE TO START BUILDING UP THESE COMMUNITIES. WE HAVE TO START CHANGING THE SYSTEM, RIGHT? WE HAVE TO START MAKING SURE THERE IS ADEQUATE CARE. I COULD GO ON AND ON. WE NEED MORE TEACHERS IN THE CLASSROOMS, SO MANY LAYERS TO THIS BUT PEOPLE WANT A SOLUTION AND COMPLEX PROBLEMS REQUIRE A COMPLEX SOLUTION SO WE WILL NEED TO TAKE INTO CONSIDERATION THE REGIONAL AND CULTURAL BIAS. [INDISCERNIBLE] >>SO THAT IS ACTUALLY AN INTERESTING QUESTION -- NOT QUESTION BUT THERE IS A LOT OF DEBATE ABOUT WHETHER IMPLICIT BIAS TRAINING IS REALLY EFFECTIVE AND, YOU KNOW, TO GET PEOPLE ON BOTH SIDES AND ALTHOUGH I DON'T THINK THERE IS ONE TRUE AND TRIED METHOD TO DO THIS, AND WE'RE STILL DOING A LOT OF RESEARCH, WHAT I WOULD SAY IS ONE OF THE CHALLENGES OF THIS ADULTIFICATION BIAS WORK IS OFTENTIMES IT IS WHAT IS DEFINED AS BEING EFFECTIVE, RIGHT? AND OFTENTIMES PEOPLE ARE DOING KIND OF ONE-DAY, ONE-AND-DONE, VERY BRIEF TRAINING. AND THAT MAY NOT BE SUFFICIENT ENOUGH TO ALTER COGNITION THAT IN TURN RELATES TO BEHAVIOR, RIGHT? THERE IS ALSO A LOT OF DEBATE ABOUT THE EXTENT TO WHICH -- AND WE HAVE DEBATED THIS IN SOCIAL SCIENCE FOR A LONG TIME, HOW STRONGLY IT IS RELATED TO BEHAVIOR, RIGHT? SO IF YOU CHANGE THE ACTIONS, WE CHANGE THE BEHAVIOR BUT IT IS MORE COMPLICATED THAN THAT. SO AS I SAY IT REQUIRES MORE RESEARCH BUT WE DO NOW KNOW MORE. AND WHAT I THOUGHT WE KNEW IS NOT SUPPORTED BUT THERE ARE A NUMBER OF FACTORS WHERE WE CAN START LOOKING AT THE DURATION OF THE BIAS TRAINING, THE QUALITY, AND HOW IT REALLY KIND OF ADDRESSED THAT ATTITUDE, BEHAVIOR, ASSOCIATION AND MAYBE IT IS NOT ADDRESSING THE ATTITUDE AS MUCH AS -- IF WE CHANGE THE ATTITUDE AND BEHAVIOR, IT WILL NO LONGER BE WHAT WE THINK ABOUT BUT CHANGING THE BIAS DOES NOT OFTEN CHANGE THE BEHAVIOR. >>HOW DOES NHLBI INVOLVE ITSELF IN THE RESEARCH AROUND ADULTIF ICATION OR ARE THERE ANY STRATEGIES THAT CAN BE DEPLOYED AROUND THIS TOPIC? >>I LIKE THIS QUESTION. AND I WOULD ADD FUNDING MECHANISMS. I THINK THEY SUPPORT THAT TO SEE ABOUT MORE DEVELOPMENT PROPOSALS THAT REALLY CALL FOR ADDRESSING, YOU KNOW, RACIAL-ETHNIC DISPARITIES SO LIKE WHAT HAPPENS IN CHILDHOOD ADOLESCENTS AND HOW DO WE DISRUPT THAT? SO I THINK THAT IS ONE WAY THAT A INSTITUTE CAN DO THAT. I THINK PARTNERING WITH OTHER INSTITUTES. I DON'T KNOW, I REALLY FEEL LIKE -- I AM JUST SO IMPRESSED, I JUST HAD NO IDEA ABOUT THE SCOPE OF THINGS YOU ALL ARE DOING AND I LOVE THAT YOU WANT TO GET BETTER BUT I THINK YOU SHOULD APPLAUD YOURSELF BECAUSE YOU ARE DOING SO MUCH MORE THAN OTHER ORGANIZATIONS AT NIH. SO I DON'T HAVE A LOT OF RECOMMENDATIONS. I THINK JUST KEEP DOING THE WORK YOU ARE DOING, KEEP THE PRESSURE ON ON THIS. I THINK IT WILL BE MORE DIFFICULT TO GIVE THIS WORK SO IF YOU CAN CONTINUE TO HAVE THE INFRASTRUCTURE AND THE SUPPORT TO DO THESE TRAININGS, TO THINK ABOUT OUR WAYS THAT WE CAN CONTRIBUTE TO THIS REPORT OF THE ADULTIFICATION BIAS OF BLACK GIRLS, I THINK THAT WILL BE VERY IMPORTANT IN ADDRESSING THE TOPIC. >>THANK YOU AGAIN, Dr. BLAKE. NOT ONLY WAS IT AN EXCELLENT PRESENTATION BUT THE RESPONSES HAVE REALLY GIVEN US A LOT OF THINGS TO THINK ABOUT AND CONSIDER. SO I WOULD LIKE TO THANK YOU ON BEHALF OF Dr. GOODEN AND THE ENTIRE COMMUNITY TO THINK ABOUT THIS SYSTEM AND THE ADULTIFICATION BIAS OF BLACK GIRLS AND ALSO WOULD LIKE TO THANK ALL OF YOU FROM THE NHLBI COMMUNITY FOR ATTENDING TODAY. YOU WILL BE RECEIVING A WEBINAR SURVEY. WE ASK YOU TAKE JUST A FEW MINUTES TO COMPLETE IT BECAUSE WE VALUE YOUR FEEDBACK AND THANK YOU FOR YOUR TIME. AGAIN THANK YOU ALL FOR ATTENDING TODAY AND THIS CONCLUDES OUR WEBINAR. THANKS. AND AS HIGHLIGHTED THIS IS FOR ALL MEMBERS SO YOU WOULD LIKE TO JOIN THE TEAM, SEE THE INFORMATION HERE AND SEND AN E-MAIL TO CAROL AT NIH.GOV. THANK YOU ALL AND HAVE A A WONDERFUL DAY.