Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Information Management Services, Inc, Calverton, MD.
J Pediatr. 2023 Dec;263:113618. doi: 10.1016/j.jpeds.2023.113618. Epub 2023 Jul 18.
To examine associations between race, ethnicity, and parent-child nativity, and common mental health conditions among U.S. children and adolescents.
Data were from 2016 to 2019 National Survey of Children's Health, a US population-based, serial cross-sectional survey, and restricted to children who had access to health care. We used weighted multivariable logistic regression to examine the associations between race and ethnicity (Asian, Black, Hispanic, White, Other-race); mental health outcomes (depression, anxiety, and behavior/conduct problems) stratified by household generation; and between household generation and outcomes stratified by race and ethnicity, adjusting for demographics (age, sex, family income to poverty ratio, parental education), and an adverse childhood experience (ACE) score.
When stratifying by household generation, racial and ethnic minority children generally had similar to lower odds of outcomes compared with White children, with the exception of higher odds of behavior/conduct problems among third + -generation Black children. When stratifying by race and ethnicity, third + generation children had increased odds of depression compared to their first-generation counterparts. Third + generation, racial and ethnic minority children had increased odds of anxiety and behavior/conduct problems compared with their first-generation counterparts. The associations generally remained significant after adjusting for the ACE score.
Lower odds of common mental health conditions in racial and ethnic minority children could be due to factors such as differential reporting, and higher estimates, including those in third + generation children, could be due to factors including discrimination; systemic racism; and other factors that vary by generation and need further investigation to advance health equity.
探讨美国儿童和青少年的种族、民族和亲子出生背景与常见心理健康状况之间的关系。
数据来自 2016 年至 2019 年的全国儿童健康调查,这是一项基于美国人口的连续横断面调查,仅限于有医疗保健服务的儿童。我们使用加权多变量逻辑回归来检查种族和民族(亚裔、黑人、西班牙裔、白人、其他种族)与心理健康结果(抑郁、焦虑和行为/品行问题)之间的关系,这些结果按家庭代际分层;以及家庭代际与按种族和民族分层的结果之间的关系,调整了人口统计学因素(年龄、性别、家庭收入与贫困率之比、父母教育程度)和不良童年经历(ACE)评分。
按家庭代际分层时,与白人儿童相比,少数民族儿童的种族和民族通常具有相似或较低的结果几率,但第三代及以上的黑人儿童出现行为/品行问题的几率较高。按种族和民族分层时,与第一代相比,第三代及以上的儿童出现抑郁的几率增加。与第一代相比,第三代及以上的少数民族儿童出现焦虑和行为/品行问题的几率增加。调整 ACE 评分后,这些关联仍然显著。
少数民族儿童常见心理健康状况的几率较低可能是由于报告差异等因素造成的,而包括第三代及以上儿童在内的更高估计可能是由于歧视、系统性种族主义和其他因代际而异的因素造成的,需要进一步调查以促进健康公平。