Specialty : Pediatrics 

Keywords: Institutional discrimination, School engagement, Mental health, Health harming behaviors 

Background:

School environments are a critical period during adolescence that shape an individual’s health trajectory therefore, understanding these relationships is essential for informing interventions and policies that promote equity, resilience, and health among youth from marginalized communities. Discrimination is a pervasive social stressor linked to a range of adverse outcomes in adolescents and young adults. Prior research has established an association between discriminatory experiences with higher violent behaviors and poor mental health in adolescents, disproportionately affecting students of color. While prior studies have assessed the impact of discrimination on a single health domain, to our knowledge, no study has used a validated discrimination measure tailored to adolescents and examined associations across a array of health outcomes. Furthermore, the potential buffering effects of parenting approaches and school disciplinary practices on the harmful impacts of discrimination remain largely unexplored in existing research. Understanding the broader consequences of discrimination is critical for developing interventions that support youth well-being across multiple domains.

Objective:

This study aims to investigate the associations between self-reported experiences of discrimination and key indicators of adolescent well-being, specifically mental health, school engagement, perceived stress, and health-harming behaviors. In addition we aim to test whether parenting style and school disciplinary styles  mitigate or exacerbate the association between experiences of discrimination and adolescent health. 

Methods: 

We conducted a cross-sectional observational study of 9th – 12th grade students attending public high schools  in the Inland Empire (n = 1740). We measured discrimination using the validated adolescence discrimination distress index. Our primary outcomes include school engagement, substance use within the last 12 months, perceived stress, and depression. Logistic and linear regression models tested whether higher discrimination distress was associated with each outcome, adjusting for gender, parental level of education, race/ ethnicity, and clustering within schools.   Stratified analysis and interaction terms tested whether associations were moderated by race/ethnicity,  parenting style, and school disciplinary style. All analysis were conducted with StataNow/BE version 18.5. 

Results: 

Higher discrimination distress scores were associated with increased levels of depression (AOR = 0.198, p < 0.001), substance use within the last 12 months (AOR= 0.0753, p < 0.001), perceived stress (AOR = 1.113, p < 0.001)) and lower levels of school engagement (AOR = -3.112, p <0.001). Authoritative parenting styles significantly augmented the associations between discrimination distress and perceived stress and school engagement. Neglectful parenting style was also found to augment the negative association between discrimination distress and student engagement. In comparison, no mediating or augmenting effects were seen for school disciplinary styles. 

Conclusions: 

The findings of this study highlight the profound impact of discrimination on student well-being and academic engagement. Students who reported experiences of discrimination exhibited significantly higher levels of depression, perceived stress, and substance use, alongside lower levels of school engagement. These results underscore the urgent need to address discrimination as a critical determinant of both overall health and educational outcomes. Interventions aimed at reducing discriminatory environments within and beyond school settings are essential to fostering healthier, more supportive spaces for all students.