Abstract :
KEY WORDS Toxic stress; racism; adverse childhood experiences 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 * Correspondence: Felesia R. Bowen, PhD, DNP, APRN, FAAN, University of Alabama at Birmingham School of Nursing, 1720 2nd Ave, NB 202A, Birmingham, AL 35294-1200 (footnote) Conflicts of interest: None to report. Byline: Felesia R. Bowen, PhD, DNP, APRN, FAAN [fbowen@uab.edu], Linda A. Lewandowski, PhD, RN, FAAN, Julia A. Snethen, PhD, RN, FAAN, Gwendolyn Childs, PhD, RN, FAAN, Freida H. Outlaw, PhD, RN, APRN, FAAN, Cindy Smith Greenberg, DNSc, RN, CPNP-PC, FAAN, Pamela J. Burke, PhD, RN, CPNP-PC, FSAHM, FAAN, Elizabeth Sloand, PhD, CPNP-PC, FAANP, CNE, FAAN, Faye Gary, EdD, MS, RN, FAAN, Janiece DeSocio, PhD, RN, PMHNP-BC, FAAN