"We didn't previously know whether perceptions that discrimination
is increasing in the larger society is a significant source of
stress that is associated with risk of behavioral health problems,"
said lead author Adam Leventhal, director of the Health, Emotion, &
Addiction Laboratory at the University of Southern California in Los
Angeles.
"This is a timely question given that the sociopolitical climate has
recently intensified in the U.S. due to social policies perceived by
many to be discriminatory, including proposals to construct a
US-Mexico border wall to deter undocumented immigration, attempts to
repeal the Affordable Care Act that provides health insurance to
millions of low-income Americans, and travel bans to prohibit entry
into the US from several countries with religious minority
populations," Leventhal said by email.
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For the study, published in JAMA Pediatrics, researchers surveyed
2,572 high school students once in eleventh grade and again a year
later to see how often they experienced stress, worry or concern
regarding "increasing hostility and discrimination of people because
of their race, ethnicity, sexual orientation/identity, immigrant
status, religion, or disability status in society."
Researchers scored students' reported level of stress, worry, and
concern on a scale from 0 for "none at all" to 4 for "extremely."
Overall, students' average composite scores for all three feelings
about discrimination increased from 1.56 in 2016, when they were in
eleventh grade, to 1.71 the following year.
As kids' scores rose higher above the average, the greater their
odds of risky behavior a year later. Each one-unit standard
deviation increase above the average scores in 2016 was associated
with 77 percent higher odds that students used cigarettes in 2017,
13 percent higher likelihood that they used marijuana, and 11
percent greater odds that they used alcohol.
In addition, each one-unit increase above average scores in 2016 was
associated with 11 percent higher odds that students would report
symptoms of depression in 2017 and 12 percent greater likelihood
that they would experience symptoms of attention deficit
hyperactivity disorder (ADHD).
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These associations weren't necessarily related to whether teens
directly experienced discrimination. The study asked about their
feelings related to their perception of how much discrimination
exists in society.
But the effects did appear more pronounced for students of color at
the 10 Los Angeles high schools where the surveys were conducted.
For example, each one-unit increase in composite scores for concern
about discrimination was associated with almost tripled odds that
African-American students would smoke, and 30 percent greater
likelihood that Hispanic teens would smoke. White students were 23
percent more likely to smoke, but this difference wasn't
statistically meaningful and might have been due to chance.
The proportion of students reporting feeling "very or extremely
concerned" about discrimination also increased from 42 percent in
the first survey in 2016 to 45 percent the following year.
The study wasn't a controlled experiment designed to prove whether
or how perceptions of discrimination might directly impact teens'
behavioral health. It's also possible that teens' experiences in Los
Angeles might not reflect what would happen elsewhere in the U.S.
But the results still suggest that parents need to talk about
discrimination with their kids, said Dr. Nia Heard-Garris of the Ann
& Robert H. Lurie Children's Hospital of Chicago.
"Even if parents think discrimination is not applicable to their
teens or families, having a conversation about discrimination, even
about the experiences of others, might be a way to start the
conversation and then discuss ways to address discrimination
personally or societally," Heard-Garris, author of an accompanying
editorial, said by email.
"Also, there may be a role for the pediatrician to help these
families start these conversations, as some of the recent exposure
to discrimination on national scale has been unavoidable for many
teens," Heard-Garris added.
SOURCE: http://bit.ly/2NoJ72J and http://bit.ly/2NgEXtV JAMA
Pediatrics, online August 20, 2018.
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