UCSF Philip R. Lee Institute for Health Policy Studies, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, United States.
UCSF Philip R. Lee Institute for Health Policy Studies, 490 Illinois Street, 7th Floor, San Francisco, CA, 94158, United States.
Soc Sci Med. 2023 Oct;335:116214. doi: 10.1016/j.socscimed.2023.116214. Epub 2023 Sep 7.
School racial segregation is increasingly recognized as a threat to US public health: rising segregation in recent decades has been linked to a range of poor health outcomes for Black Americans. Key theorized mediators of these harms remain underexamined, including experiences of interpersonal and institutional racism driving increased stress, and peers' health behaviors influencing students' own. Using cross-sectional survey data on a national sample of adolescents, we investigated associations between school segregation and these two potential mediating pathways, operationalized as adolescents' perceptions of prejudice from fellow students and the health behaviors of their peers (drinking and smoking). We further investigated whether associations were modified by individual race/ethnicity and school racial composition. Pooling across all schools and students, higher levels of school segregation were associated with decreased perceptions of peer prejudice (OR 0.54, 95% CI = 0.34-0.86), but not with peers' health behaviors. However, this masked important differences by respondents' race/ethnicity and school racial/ethnic composition. In predominantly White schools, school segregation was not associated with Black students' perceptions of peers' prejudice, but higher levels of segregation were associated with increased rates of peers' drinking and smoking. In predominantly non-White schools, in contrast-where most Black students are educated-higher levels of school segregation were not associated with perceived peer prejudice nor unhealthier peer behaviors for Black students (in fact, peers' health behaviors improved). And across both school types, higher levels of district segregation were associated with lower odds of reporting peer prejudice among non-Black students of color. Our findings suggest that the paths between school segregation and poor health depend on the type of school children attend in segregated districts. In schools predominantly serving students of color, structural factors upheld by school segregation-i.e., material, educational, disciplinary, or economic disadvantage-likely dominate over peer behaviors as the primary drivers of segregation's health harms.
美国的学校种族隔离现象日益受到关注，因为其被认为对公众健康构成了威胁。近几十年来，这种隔离现象越发严重，导致美国黑人的健康状况恶化。目前，许多理论上的中介因素仍未得到充分研究，其中包括人际和体制种族主义导致的压力增加，以及同伴的健康行为对学生自身的影响。本研究利用全国青少年的横断面调查数据，探讨了学校隔离与这两个潜在中介途径之间的关系，这两个途径分别为青少年对同学的偏见感知和同伴的健康行为（饮酒和吸烟）。我们进一步研究了这些关联是否因个体的种族/族裔和学校的种族构成而有所不同。在所有学校和学生中，学校隔离程度越高，青少年对同伴偏见的感知越低（OR 0.54，95%CI=0.34-0.86），但与同伴的健康行为无关。然而，这掩盖了因受访者的种族/族裔和学校的种族/族裔构成而产生的重要差异。在以白人为主的学校中，学校隔离与黑人学生对同伴偏见的感知无关，但隔离程度越高，同伴饮酒和吸烟的比例就越高。相比之下，在以非白人为主的学校中——在这些学校中，大多数黑人学生接受教育——学校隔离程度与黑人学生对同伴偏见的感知以及同伴的不健康行为无关（实际上，同伴的健康行为有所改善）。在这两种类型的学校中，较高的地区隔离程度与非裔学生报告的同伴偏见几率较低有关。我们的研究结果表明，学校隔离与健康状况不佳之间的关系取决于学生在隔离地区所上的学校类型。在以有色人种学生为主的学校中，由学校隔离所维护的结构性因素（即物质、教育、纪律或经济劣势）很可能比同伴行为更能主导隔离的健康危害，成为其主要驱动因素。
