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

Abstract

Perceived racism in school (i.e., a student’s report of being treated badly or unfairly because of their race or ethnicity) is an important yet understudied determinant of adolescent health and well-being. Knowing how perceived racism influences adolescent health can help reduce health inequities. CDC’s 2021 Adolescent Behaviors and Experiences Survey (ABES), an online survey of a probability-based, nationally representative sample of U.S. public- and private-school students in grades 9–12 (N = 7,705), was conducted during January–June 2021 to assess student behaviors during the COVID-19 pandemic. CDC analyzed data from ABES to measure perceived racism and the extent to which perceptions of racism are associated with demographic, mental health, and behavioral characteristics. Mental health and behavioral characteristics analyzed included mental health status; virtual connection with others outside of school; serious difficulty concentrating, remembering, or making decisions; and feeling close to persons at school. Demographic characteristics analyzed included sex, race and ethnicity, and grade. Prevalence of perceived racism and associations between perceived racism and demographic, mental health, and behavioral characteristics are reported overall and stratified by race and ethnicity. Approximately one third (35.6%) of U.S. high school students reported perceived racism. Perceived racism was highest among Asian (63.9%), Black (55.2%), and multiracial students (54.5%). Students who reported perceived racism had higher prevalences of poor mental health (38.1%); difficulty concentrating, remembering, or making decisions (44.1%); and not feeling close to persons at school (40.7%). Perceived racism was higher among those students who reported poor mental health than those who did not report poor mental health during the pandemic among Asian (67.9% versus 40.5%), Black (62.1% versus 38.5%), Hispanic (45.7% and 22.9%), and White students (24.5% versus 12.7%). A better understanding of how negative health outcomes are associated with student experiences of racism can guide training for staff and students to promote cultural awareness and antiracist and inclusivity interventions, which are critical for promoting safe school environments for all students.

Young Adults’ Mental Health and Unmet Service Needs in the Context of the COVID-19 Pandemic Across Canada and France

“…Our study also suggests that young adults who self-reported experiences of ethno-racial discrimination were less likely to access mental health services. This finding is particularly concerning given that young adults who experienced ethno-racial discrimination during the pandemic have higher risks of reporting negative mental health outcomes, including poor mental health, psychological distress and depression (Hahm et al, 2021 ; Mpofu et al, 2022 ; Oh et al, 2021 ). A systematic review also indicated that the COVID-19 pandemic contributed to increased ethno-racial discrimination in high-income countries, including in social spaces, school/work or within clinical settings (Yashadhana et al, 2021 ).…”

Future Directions in Mental Health Treatment with Stigmatized Youth

“…Now more than ever, stigmatized youth (i.e., children, adolescents, and young adults with one or more stigmatized identities; e.g., youth of Color, girls, transgender youth) are in need of effective mental health treatment. Inequities in mental health problem severity, diagnosis, and treatment between stigmatized and privileged groups (e.g., youth of Color vs. White youth, lesbian, gay, bisexual, or other sexual minority vs. heterosexual youth) are longstanding (Alegria et al, 2010;Bui & Takeuchi, 1992;Connolly et al, 2016;Garland et al, 2005;Rodgers et al, 2021;Russell & Fish, 2016), and these gaps are widening in the ongoing pandemic (Banks, 2021;Benton et al, 2022;Bhogal et al, 2021;Fish et al, 2020;Hawke et al, 2021;Mpofu, 2022;Penner et al, 2021;Rothe et al, 2021;Saunders et al, 2021). These inequities are primarily attributable to these youth's experiences of stigma at multiple levels: (1) internalized stigma (i.e., self-stigma), or one's adoption of stigma-related beliefs resulting from exposure to stigmatizing environments or relationships (e.g., a girl believing that being assaulted was because of her physical attractiveness; Moses, 2009), (2) interpersonal stigma, which stigmatized individuals experience in interpersonal interactions (e.g., a peer saying "no homo;" sexual violence against girls; Fish, 2020;Jones & Neblett, 2017); and (3) structural stigma, or laws/policies (e.g., a state policy prohibiting gender-affirming care for transgender youth) and norms/attitudes (e.g., the belief that Black people will bring violence into neighborhoods they move into; Krieger et al, 2010) that negatively impact stigmatized people (Alvarez et al, 2021;Beccia et al, 2022;Castro-Ramirez et al, 2021;Hatzenbuehler, 2017).…”

Future Directions in Mental Health Treatment with Stigmatized Youth

“…Now more than ever, stigmatized youth (i.e., children, adolescents, and young adults with one or more stigmatized identities; e.g., youth of Color, girls, transgender youth) are in need of effective mental health treatment. Inequities in mental health problem severity, diagnosis, and treatment between stigmatized and privileged groups (e.g., youth of Color vs. White youth, lesbian, gay, bisexual, or other sexual minority vs. heterosexual youth) are longstanding (Alegria et al, 2010;Bui & Takeuchi, 1992;Connolly et al, 2016;Garland et al, 2005;Rodgers et al, 2021;Russell & Fish, 2016), and these gaps are widening in the ongoing pandemic (Banks, 2021;Benton et al, 2022;Bhogal et al, 2021;Fish et al, 2020;Hawke et al, 2021;Mpofu, 2022;Penner et al, 2021;Rothe et al, 2021;Saunders et al, 2021). These inequities are primarily attributable to these youth's experiences of stigma at multiple levels: (1) internalized stigma (i.e., self-stigma), or one's adoption of stigma-related beliefs resulting from exposure to stigmatizing environments or relationships (e.g., a girl believing that being assaulted was because of her physical attractiveness; Moses, 2009), (2) interpersonal stigma, which stigmatized individuals experience in interpersonal interactions (e.g., a peer saying "no homo;" sexual violence against girls; Fish, 2020;Jones & Neblett, 2017); and (3) structural stigma, or laws/policies (e.g., a state policy prohibiting gender-affirming care for transgender youth) and norms/attitudes (e.g., the belief that Black people will bring violence into neighborhoods they move into; (e.g., the belief that Black people will bring violence into neighborhoods they move into; Krieger et al, 2010) that negatively impact stigmatized people (Alvarez et al, 2021;Beccia et al, 2022;Castro-Ramirez et al, 2021;Hatzenbuehler, 2017).…”