Polos Jessica A, Koning Stephanie M, Hargrove Taylor W, Kershaw Kiarri N, McDade Thomas W
Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL, 60208-4100, USA.
Public Health Program, DePaul University, 14 East Jackson Boulevard, Chicago, IL, 60604, USA.
SSM Popul Health. 2022 Sep 21;19:101237. doi: 10.1016/j.ssmph.2022.101237. eCollection 2022 Sep.
Racial discrimination is an important predictor of racial inequities in mental and physical health. Scholars have made progress conceptualizing and measuring structural forms of racism, yet, little work has focused on measuring structural racism in social contexts, which are especially relevant for studying the life course consequences of racism for health. Using the National Longitudinal Study of Adolescent to Adult Health, we take a biosocial, life course approach and develop two life stage-specific indices measuring manifestations of structural racism in school contexts in adolescence, a sensitive period of development. The first is a school contextual disadvantage index (CDI), which captures differences in resources and opportunities across schools that have been partly determined by socio-historic structural racism that has sorted Black students into more disadvantaged schools. The second is a school structural racism index (SRI), which measures differences in resources and opportunities between Black and white students within schools. Then, we relate these indices to adolescent depressive symptoms. We find that among both Black and white students of both genders, higher CDI levels are associated with more depressive symptoms. However, Black students are twice as likely to be in schools with a CDI above the median compared to white students. We also find that, controlling for the CDI, the SRI is positively associated with depressive symptoms among Black boys and girls only. Finally, the CDI and the SRI interact to produce a pattern where the likelihood of depressive symptoms increases as the SRI increases, but only among Black boys and girls in low-disadvantage schools. These findings underscore the importance of measuring structural racism in social contexts in multifaceted ways to study life course health inequities.
种族歧视是心理健康和身体健康方面种族不平等的一个重要预测因素。学者们在对种族主义的结构形式进行概念化和测量方面取得了进展，然而，很少有研究关注在社会背景下测量结构种族主义，而社会背景对于研究种族主义对健康的生命历程影响尤为重要。利用全国青少年到成人健康纵向研究，我们采用生物社会和生命历程的方法，开发了两个针对特定生命阶段的指数，用于测量青少年时期（一个敏感的发育阶段）学校环境中结构种族主义的表现。第一个是学校背景劣势指数（CDI），它捕捉了不同学校在资源和机会方面的差异，这些差异部分是由社会历史结构种族主义决定的，这种种族主义将黑人学生分到了更弱势的学校。第二个是学校结构种族主义指数（SRI），它衡量学校内黑人和白人学生在资源和机会方面的差异。然后，我们将这些指数与青少年抑郁症状联系起来。我们发现，在不同性别的黑人和白人学生中，较高的CDI水平都与更多的抑郁症状相关。然而，与白人学生相比，黑人学生进入CDI高于中位数学校的可能性是白人学生的两倍。我们还发现，在控制了CDI之后，SRI仅与黑人男孩和女孩的抑郁症状呈正相关。最后，CDI和SRI相互作用，产生了一种模式，即随着SRI的增加，抑郁症状的可能性增加，但仅在低劣势学校的黑人男孩和女孩中如此。这些发现强调了以多方面的方式在社会背景下测量结构种族主义对于研究生命历程健康不平等的重要性。
