Racial discrimination in late adolescence and mental health

Background: 

Racism has negative associations with the mental and physical health of children and adolescents. It is critical in our pursuit of health equity that the relationships between racial discrimination and health are better understood. Unfortunately, research in this field has been limited by mostly cross-sectional studies. Our purpose was to assess whether racial discrimination experienced at ages 18-21 years was associated with increased psychological distress and decreased wellbeing as adolescents transition into adulthood using a national longitudinal dataset collected prospectively.

Methods: 

We performed a secondary analysis of data from the Transition into Adulthood Supplement of the Panel Study of Income Dynamics, a national longitudinal household survey in which data was collected every 2 years. Our primary exposure was racial discrimination experienced at baseline when participants were ages 18-21, measured by the Everyday Discrimination Scale. The Kessler 6 and Mental Health Continuum Short Form assessed the mental health outcomes of psychological distress and wellbeing respectively. Generalized linear mixed effects modeling was used to model outcomes up to 10 years following exposure to racial discrimination. Covariates included baseline psychological distress and wellbeing, gender, race/ethnicity, age, health status, education, closeness to parents, marital status, and local region. 

Results: 

Our sample included 661 participants (62% non-Hispanic Black, 20% non-Hispanic White, 14% Hispanic) who entered the study at ages 18-21 years and participated in at least 2 waves of data collection. At baseline, those who experienced racial discrimination had significantly higher psychological distress (p=< 0.0001) and lower levels of wellbeing (p=< 0.0001) compared to those who did not. Older adolescents who experienced high levels of racial discrimination had increased odds of psychological distress (OR = 6.36, 95% CI: 3.15, 9.58) and decreased wellbeing (OR = 5.50, 95% CI: 2.22, 8.79) within the 10 years that followed compared to those who had not experienced racial discrimination.

Conclusions: 

This prospective study not only reveals the extent to which exposure to racial discrimination in late adolescence is associated with poor mental health outcomes, but also demonstrates that these effects persist years after the initial exposure. This study has important implications for clinical and community-based interventions addressing the need for mental health support that is critical for adolescents who experience racial discrimination.