Perceived racism and demographic, mental health, and behavioral characteristics among high school students during the COVID-19 pandemic—Adolescent Behaviors and Experiences Survey, United States, January-June 2021

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introduction

Racism, defined as “a system of structuring opportunities and assigning value based on the social interpretation of appearance (i.e. race) that unfairly disadvantages certain individuals and communities, unfairly advantages others. other individuals and communities and undermines the strength of the whole society. by the waste of human resources” (1) is a critical social determinant of health and a key driver of systemic inequalities in health outcomes (1,2). Racism influences the health and well-being of racial and ethnic minority individuals and families across the lifespan and contributes to racial and ethnic disparities in health (2,3). Self-reported or perceived racial discrimination in adults is associated with poor mental health, high-risk behaviors (eg, substance use and abuse), physical health problems (eg.3). Although less is known about perceptions of racial discrimination among children and adolescents (4,5), a growing body of research describes associations between racial discrimination and youth health outcomes. Experiences of racial discrimination are associated with poor mental health (eg, anxiety, depression, and low self-esteem), health risk behaviors, reduced social and adaptive functioning, and delinquent behaviors in young people (6,7). Racial discrimination in educational settings contributes to racial disparities in academic achievement and educational attainment, which are important markers of long-term health outcomes (7).

Understanding adolescent experiences of racism and racial discrimination and how these experiences influence health is important to promoting equitable health outcomes for racial and ethnic minority youth. To understand the health effects of racism, well-defined and consistent definitions and reliable measures of racial discrimination are essential (6). To date, few measures have been designed to assess perceived racial discrimination among child and adolescent populations (5).

Throughout the COVID-19 pandemic, communities of color have been disproportionately impacted by the severe consequences of COVID-19 (for example, hospitalizations, intensive care admissions, or in-hospital deaths) and limited access to quality health care (8). Structural racism, a central pathway through which racism influences health (3), is associated with inequalities in COVID-19 morbidity, hospitalization and mortality (8). There is less understanding of teens’ perceptions of racism and its consequences during the COVID-19 pandemic. Perceived racism in school is an important but understudied determinant of adolescent health and well-being, and knowing how perceived racism influences adolescent health can help reduce health inequalities. In the spring of 2021, the CDC implemented the Adolescent Behaviors and Experiences Survey (ABES) to assess student behaviors during the pandemic. The ABES, a nationally representative sample of high school students, included a single-item measure of perceived racism. Using data from the ABES, this report examines perceived racism and the extent to which perceptions of racism are associated with behavioral health outcomes in adolescents. The findings of this report can help inform the development of school staff training and interventions to support the health and well-being of all students.

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