intro: Welcome to Pediatric Voices, Duke Children's podcast about kids healthcare. Now here's our host, Dr. Angelo Milazzo.

Dr Angelo Milazzo (Host): Hello and welcome to Pediatric Voices, a podcast that dives deeply into conversation with the people who make up the team here at Duke Children's Healthcare. Welcome, those of you who are listening to the show for the first time, and welcome back to those of you who've listened to some of our previous episodes.

I'm Dr. Angelo Milazzo, a pediatric cardiologist and a professor of pediatrics here at Duke Children's. I'm one of the hosts of the podcast. I'm here to bring you insights about timely topics in children's health from my expert friends and colleagues. On this episode of Pediatric Voices, let's look at diversity and inclusion through a different lens than we might be used to. I want to look at it from a perspective which is often at best misunderstood and at worst ignored. I want to consider how we might talk to our children about these complex subtle and critical issues around diversity and inclusion.

Like all of our society's institutions, medicine has been reckoning with issues of diversity, inclusion, equity, and justice, especially in the last few years. And in the wake of events and changes in our society that have been front page headlines and familiar to anyone who listens to the news or reads a newspaper, in academic medicine where issues can seem to be or actually be somewhat disconnected from the real world, we've recognized that we need to think differently in the way we see one another, the way we treat one another, particularly when there are differences among us and between us.

So luckily, today, I have the ideal colleague and expert to help us unwind and sort through the subject. Today, I'll be speaking with Dr. Jasmine Willis-Wallace. So, Jasmine is the Vice Chair for Diversity, Equity, and Inclusion, and also an Assistant Professor of Pediatrics here at Duke Health in our Department of Pediatrics. She's the first person to hold the position of Vice Chair for Diversity, Equity, and Inclusion, and we were thrilled as an administrative team when she joined us last year. Jasmine is an accomplished professional. She has a background and training in Diversity, Equity, and Inclusion work, in Higher Education Administration, in Program Management, and in teaching, training, and development.

Jasmine received her Bachelor's of Science degree with a Major in Business Administration from Miami University of Ohio, as well as a Master of Science Degree with an emphasis on College Student Development and Counseling from Northeastern University in Boston. She earned her Doctorate Degree in Education with a focus in Higher Education Administration from Northeastern University as well. She also holds a Diversity, Equity, and Inclusion in the Workplace certificate from University of South Florida.

I have the privilege of working closely with Jasmine because we're both part of the administrative team here in the Department of Pediatrics at Duke Children's and at Duke Health. So, it's my great pleasure to welcome her to the show. Welcome, Jasmine. Like I said, it's fantastic to have you here on the Pediatric Voices podcast.

Dr Jasmine Willis-Wallace: Hello, thank you for having me.

Host: Jasmine, I want to dive right into the subject and I want to start by talking about the why behind this topic. Why do issues of diversity and inclusion matter? And especially, why does it matter when it comes to talking to children about these issues?

Dr Jasmine Willis-Wallace: Well, simple answer, why does it matter, is just because it does. But the really deep answer as to why this work mattered in talking to our children. about diversity and inclusion matters is, I'm going to quote someone who once said, and it was a licensed social worker who wrote an article about how to promote diversity and inclusion in your children's life.

And they mentioned a couple things. So, why we need to do this is because talking about it openly and positively about our differences can really help our children to better understand not just people around them, but can help them better understand themselves. And when we take the time to embrace diversity and inclusion, it empowers children to engage in the world around them and shines confidence and kindness on our children, right? Diversity and inclusion also helps our children to learn to empathize with people who are different from them. And diversity and inclusion, it makes children just better learners and allows them to understand various subject matters from multiple points of view at an early age.

And so, sometimes we think to ourselves, "Oh, children, they're too young to learn about this stuff." And at what point should we start talking to children about this? Aren't they too young? Well, believe it or not, children at the grade school level are very receptive to these conversations. And there's a lot of social workers that do a lot of work around diversity and inclusion when it comes to our children. And another social worker actually out of North Carolina mentioned that embracing diversity and acceptance allows kids or children to absorb their world with curiosity, self-assurance, and kindness. So, it helps children to learn to identify with individuals who are different from them. And that's a great thing. And so, that's why talking to our children and allowing our children to talk to us about diversity and inclusion is very, very important.

Host: So Jasmine, something you said really struck me. You said that children as early as the early grade school level are ready for these conversations. That would not have been my guess. I think it's very interesting. That seems very early in life, like a very tender age, so to speak. So, what are the challenges in terms of talking to kids that young about these issues that some adults can't seem to begin to tackle?

Dr Jasmine Willis-Wallace: So if you actually take a look at some of the curriculum in our school system, a lot of our school systems are rearranging and thinking about their curriculum in a way that is representative, and that represents diversity within the curriculum. And there are different age-appropriate ways to do that.

So even our school system, as early as kindergarten, as early as pre K, actually, are starting to really think about their curriculum, think about the representation of their curriculum, and also think about the honesty of what they're teaching in their curriculum. So, our educators are no longer saying, "Oh, this is not age-appropriate. We shouldn't be talking about different cultures in this way just yet, because children aren't able to grasp it." When in fact, they're switching that in their curriculum and really diving into, particularly in our social studies type curriculum and our science curriculum, on the ways of how do we really talk about diversity and inclusion in different cultures, in our history, of our world, in our country, in a way that is age-appropriate. So while we think that children aren't getting that in schools, they actually in fact are, because of the redesign of a lot of curriculum in which schools are using. So, it's not that children are too young to absorb it, it's how you talk about it. It's what helps children to make sense of it.

And so when I talk about it with my child, I use a lot of books, And when he watches a television show, we try our best to find those shows that are representative of different people. Because when my son sees a show and he goes, "Oh, Spidey Friend looks like me," then we can talk about it like, "Yeah, and how does he look like you? In what ways does Spidey Friends look like you?" And so, we have those conversations because it's fun and he recognized it in the moment. So, that's a key time to just sit and talk about it for a second.

Host: So, Jasmine, you mentioned teachers and the role that they play in initiating these discussions with children, and that makes all the sense in the world. Children are exposed to teachers, you know, for a significant part of those key developmental stages, particularly in the early school age years. And then, you talked about yourself. So obviously, parents are there all the time. They have a huge opportunity to engage in these conversations with kids. What about the other people that come in and out of our children's lives? What about coaches? What about librarians? What about members of the public? What about other family members? Are these people also poised to initiate or to engage in these conversations? Or does it vary depending on the relationship with the child?

Dr Jasmine Willis-Wallace: I wouldn't say that people have to be poised to have this conversation, because sometimes it really stems out of your own lived experiences and where the conversation comes from. And so when we think about, "Well, how do I even approach, what do I need to do for myself to be prepared to think about having a conversation about diversity and inclusion with my child?" I want you to think about it in a few ways.

So starting with yourself, and doing that self-check. So, taking some time to recognize your own biases, because that's important, right? Because how we have conversations with children is also influenced by the biases that we have. Recognize any discomfort that you might have when it comes to talking about these different topics. Because I always like to challenge people and say that sometimes when you're having these conversations, your child is going to say something. I mean, four-year-old, five-year-old, they're just going to say it, and that is okay. And we have to be okay to get a little uncomfortable in our comfortable environment when we talk about these different subjects. And think about the message that you're sending through your words and actions. So, I go back to this idea of it's how. It's not necessarily just talking to our children, but it's how we talk to our children. And I really urge parents and guardians and teachers and pediatricians and everyone that works with children to really think about yourself and doing that self-check so that you have a full understanding of how you're coming into the space to talk to that child about a different topic that they may have brought up.

And then, I also urge adults, parents, guardians, everyone, to really teach the value of diversity. Teach why it is important. Teach why it's a joy to be in a classroom of diverse individuals. So, another professional counselor had mentioned that the lesson that kids need to grasp is that different from does not equal less than. So if we come into the conversation with this idea that different from or learning about a different culture or learning about a different ability, learning about a different language, it's about not saying, "Oh, they're different and it's less than," but saying, "It's different and it's great." And that's how we engage children to be able to look through the lens of greatness when they're thinking about difference, rather than looking through the lens of, "Oh, this person is different. Ugh, this person is different. Is that okay?" It is great. And I think it's about how we approach.

And kids need to understand that while people might look, think, speak, or act differently, it's a positive thing. Imagine us all walking around the world, speaking the same language, looking alike. I mean, that would be kind of boring. And so, we want children to embrace this colorful canvas that is full of different languages, full of different cultures, and full of different races, and genders, and sexual orientations. We want children to embrace that as a positive thing. And when we talk about these different cultures and customs and different abilities and so on, we want to answer these questions that children have. Because guess what? It's okay for children to ask the question. I know sometime when a child might recognize something different and they point it out, a parent or a guardian or a grandparent or whoever is with that child might say, "Oh, shh, shh," no. Let's stop saying, "Shh," and start saying, "Let's talk about it," rather than shushing the child because they've noticed something different. They've noticed someone might have a wheelchair for mobility, or they've noticed someone might have a hearing aid to help them hear better. Let's talk about what that means, rather than saying, "Shh, don't say that." So, I think that's how we have to think about teaching the value of diversity within our country, within our nation.

And I think one more thing that I want to point out is I read this article that I found so interesting weeks ago, months ago, and this author was talking about safety. And when we think about safety, for example, as a parent, I'm constantly going, "Put your helmet on," or "Don't touch that, it's hot," or "Don't pick that up, you might drop it on your foot." And we are constantly reminding our children of different safety tips, right? Because our short-term goal, when we educate our children on safety tips, is that they're going to establish that basic literacy of, "Okay. When I touch the oven, it's going to be hot, so let's not touch the oven." And then, they're going to practice that safe behavior, so they're not going to touch that oven. And then, the long-term effect of teaching them about safety is that the child is going to have the ability to make decisions that result in their safety.

So, let's take that and put it in the lens of talking about diversity, because this person says that we should talk about diversity in the same way that we talk about safety. So, the short-term goal, when we're talking about diversity would be to establish that basic literacy of race, gender, respect, different abilities, empathy, and more. So, establishing that, yes, people come in all different shades of beautiful colors. Establishing that family dynamics are different. So, for example, my four-year-old and I, we went to a community reading center. And they were reading a story, and then we started to see that it was about families. And through that book, my son and I were able to talk about families are different, families have grandparents, families have parents that are mom and mom, families have parents that are dad and dad, or they're grandparents, or an aunt. And we started talking about this concept of how families are different. And then, that medium-term goal is that the child will learn about inclusive behavior. The child will learn to be more respectful of the differences in which people carry. And then, that overall long-term is that they continue to practice that.

So when we're talking to children at an early age about diversity, it is our hope that they continue to build upon and practice those inclusive behaviors of embracing differences in the most positive way. And so, I know I kind of rambled on there, but I thought that that concept of aligning the conversations of diversity just as much as we talk about safety with children, what an interesting concept.

Host: I love that analogy, and it reminds me of a conversation that I had with our colleague, Gary Maslow, previously on the show. Gary is a pediatrician and a psychiatrist, and we were talking about resilience. And Gary said that, in order to acquire resilience, there are developmental steps that you have to achieve in early childhood. And if you miss one of those steps, or if you come to that step late, it may threaten your ability to develop resilience in the long run. It sounds like what you're talking about is that if we engage with children at a young age, at an early developmental stage with these issues, we're actually arming them with information and with a perspective that could actually enhance their resilience. Am I reading too much into this or am I getting it somewhat right?

Dr Jasmine Willis-Wallace: I think that's a good alignment when we think about the resilience to be able to continue to have the conversations as they get older. So, children learn from their lived experiences. Children learn from the education system in which their parent or guardian decides to put them in. Children learn in the different capacities. And so, for me, I think building that resilience, just like we build the resilience for the child to know that if they're going to ride their bike, please put your helmet on, and we continue to practice that all the time, why not continue to have the conversation so that children can begin to build the resilience of understanding that diversity is a positive thing. It's not this negative concept that's sometimes it's tagged to diversity, but rather the diversity of individuals helps you to grow, helps you to learn, and helps you to be that much of a better person than you already are.

And so, I think that's a good alignment when thinking about the resilience of the conversation and building that capacity for our future generations to think of diversity in a totally different way that maybe my generation didn't think about it or your generation didn't think about it. So, I think it's also about that generational knowledge that we can continue to build with our children.

Host: Jasmine, for the parents who are listening, who are intrigued by this and who want to get started having these conversations with their children, what are the quick tips? How can they dive into this work? I mean, clearly, the average parent is not going to have the extensive perspective, the training that you have the exposure to the principles of education and the academic perspective, but how can a mom or a dad or another parent or guardian get started with these conversations and with this work?

Dr Jasmine Willis-Wallace: I want to start by saying don't make it harder than it needs to be. I think our fear of how we're going to talk about it sometimes outweighs the actual ability to just have the conversation. So for us, in our household, we always start with books. We start with the representation of our books. To ensure that when my child picks out a book, there is full representation of different cultures, different people within those books. And that is such a fresh way to think about how we have that conversation. Because I can't tell you how many times when just reading a book, when we're pausing because my son is asking a question, and I will say our authors have done a phenomenal job in the kids' literacy section of really having those books that are representative of many different cultures and also finding ways to have those conversations through the beauty of a book.

I also urge folks to think about what's your child watching. I mean, I know, nowadays, we're a little more cautious of screen time. I'll put it out there, my child watches the screen for a certain amount of time during the day. But we think about what is on that screen. So, for example, we talked about Spidey and his Amazing Friends. I mentioned that I also want to shout out to Sesame Street. I was a huge Sesame Street fan growing up, a huge Mr. Rogers fan growing up. The Sesame Street is like, whoo, if anybody has mastered the idea of talking about diversity and inclusion, kudos to Sesame Street because I feel like they have put in the work. I also love a good Gracie's Corner. I don't know how many parents or guardians out there, or teachers, social workers, educators have heard about Gracie's Corner, but reframing how you do the alphabet, Gracie's Corner has nailed it. And so, there's so many different avenues when we think about our media, and we think about what is our child watching that can contribute to those conversations.

And then, I also want to talk about our community. Our community, and I know that this is a podcast, so think about your community as a whole and think about where are we going on that Saturday afternoon? Checking out that library and the millions of programs that they put on that cater to children. Think about your community partners and where I can join in and go to a community event that is happening in the community, that are most of the time free, that is engaging in showing my child or showing children a different culture or something different. Take a moment to do that. So, I think sometimes, again, we don't have to make it as hard as it needs to be. Through our books, through our media, television, screen time, whatever you want to call it, and through just our own community. People are thinking about this work in many different ways, and the younger our children are, the more our communities and people are thinking about how do we introduce this to children? Because it's important. I mean, they're going to see it on the media, they're going to see it on social media, but how can we as adults put that into a positive conversation? And I know that I talk about children a lot too, but I also want to tap into our young adults as well, our teenagers. Our teenagers are driven by social media.

I will say, you can learn a lot from social media. TikTok, I mean, wow, okay, I never knew. But also thinking about what is your child on TikTok watching. Because some of the times, they're actually learning about something that they might not be getting from the classroom. And so, our teenagers, and I think our young adults are really diving into diversity and inclusion. And I will say that media is different than it was before. There's a lot more representation. So, our teenagers and our young adults are able to see them through different things, whereas that might have not always been the case when I was a teenager opening up a magazine and seeing someone that looks like me and has the body shape that I have, and not being accepted. But more and more, our young adults are able to grasp that, capture that, and that is a part of diversity education amongst our young people who are using social media as the drivers of one of their educational resources.

Host: I love that answer. First, I'll say that, you know, I will date myself, I'm a child of Sesame Street, The Electric Company and ZOOM. So for any of our listeners who know what Zoom is or was, and remember it, just send me an email and carry the show. We'll talk about it because it was a foundational experience as a young person.

The other thing I'll say is, you know, I'm glad you touched on social media. There hasn't been an episode of this series where I have not brought it up with a guest, because it's so prevalent in everything we think about in medicine today. And we think about the development of children as they age into teenagers and then into the young adult years, as you mentioned, that influence of social media just gets compounded over and over again.

. And I love the optimism you bring to it because for so many people today, their first reaction is that social media is not necessarily a force for good. So, what do you say to those people when you're trying to talk to children, teens, and young adults about these issues around diversity, equity, inclusion? They're getting all sorts of messages through social media, some positive, some not so positive. How do you respond to the critics who say that this is not a tool that's helping our young people, but it's actually hindering their ability to grasp these issues. What's your reaction to that?

Dr Jasmine Willis-Wallace: I know social media has its pitfalls. Trust me, I know. I'm not an Instagrammer, I'm not a TikToker, but I know it has its pitfalls. But I also think there's this concept of filtering and being able to educate your child on being able to filter the messages. Because, like I stated before, a lot of this stems from how this is being talked about in our household, within their lived experiences of education. And sometimes, you know, helping a child or a teenager or a young adult to filter, "Okay, what aligns with what we've been having conversation when it relates to the positivity of diversity?" And so, yes, I get it. Social media can be the epic pitfall, but I would push back to say that social media also brings different perspectives.

And so when child is in their education state, or they're having a conversation with a family member during these wonderful seasons that we are about to encounter, and they hear something, and they're like, "Oh, but that's a different perspective and being able to pull from those influencers that they feel have had a positive insight on how they view diversity, equity, and inclusion, I think it's all about perspective. And it's all about allowing young adults to have those different perspectives, but also having the ability to filter out those perspectives when it has that moment of that doesn't make sense. And I push to say that we're fortunately, and unfortunately for those who are not fans of social media, I don't think it's going anywhere. So, we always try to find a way, just like I don't think diversity and inclusion is going anywhere. So instead of pushing back, how do we embrace some of what social media can do for us in the spaces of education, when it comes to diversity, equity, and inclusion? So, it's that whole concept of being able to filter.

I mean, just like we do with everything else. How do we filter through? And how do we have the conversation when your child comes to you, who is a young adult, and says, "I saw this on social media. Let's have that conversation." Instead of saying, "Oh, social media is so terrible. It's not going to go anywhere." So, let's just sit there and have the conversation, "Okay, what did you see? How did that make you feel? Let's talk a little bit about what that means for you." And instead of shutting it down and then having it just filter, and then the person finds another means of getting the answer through social media, let's have the conversation that is brought to our kitchen tables.

Host: Again, I love the lens of optimism and positivity that you bring to this work. I think for many families, for many parents, this seems daunting, but you've broken it down in a way that seems very accessible, very attainable. I want to give you the opportunity to give a summary here. If you had to, give one last piece of advice or one last perspective on this for our listeners, again, people who may be wanting to engage with their children, how would you sum things up for them?

Dr Jasmine Willis-Wallace: My final thoughts would be take a moment to do that self-reflection for yourself and make sure that you understand the lens that you're coming into the conversation with. Utilize your community resources, utilize your book, utilize a little bit of that screen time to think about when your child asks those questions. And on top of that, when your child asks, or a child asks the question, don't shush. Embrace the ability to talk more about it. Because the more that we shush children and young adults around these topics, the more they're going to think it's not appropriate to talk about, when indeed, it is appropriate to talk about.

And the last and final thought, talk about diversity just like you would talk about safety, because it's important. It's not going to go anywhere. Our country, our world is just going to continue to grow in the space of diversity. So, let's just start talking about it. And that's it. And don't let the fears tell you otherwise.

Host: Well, I love that summary. And, you know, as I said at the top of the show, I think we often ignore the impacts of these conversations on children. They can feel too complicated, too fraught, or too adult. But I suspect that if we take your advice, if we're willing to engage, we'll probably come away with a better understanding of our own perspective if we take the time to engage with our children around these complicated issues.

So, Jasmine, thank you for being a guest on the show. Clearly, there's much more work to be done, more for all of us to do, and I think you gave us a great template to get started. I hope you'll be willing to come back and take up this conversation with me again.

Dr Jasmine Willis-Wallace: Absolutely. Thank you for having me.

Host: Pediatric Voices is brought to you by Duke Children's Hospital and the Department of Pediatrics at the Duke University Medical Center here in sunny Durham, North Carolina. The show was created by my friend and colleague, Dr. Richard Chung, and by me, Dr. Angelo Milazzo. Courtney Sparrow keeps us on track and organizes our work. Special thanks to Debbie Taylor, to Dr. Ann Reed, and to the amazing people at Doctor podcasting. You'll find our podcast, and please hit the subscribe button wherever you find your favorite shows. You can connect with us online at our website, which is pediatrics.duke.edu/podcasts. You can also connect with us on all of the usual social media channels and at dukechildrens.org. We'd love to hear from you. So, leave us a review at Apple Podcasts or any of your favorite podcast services. Thanks again for being part of the show. We'll see you next time.