Chiang Amy Yunyu, Schwartz Gabriel, Hamad Rita
Department of Medicine, University of California San Francisco, San Francisco, California.
Department of Health Management & Policy, Drexel Dornsife School of Public Health, Philadelphia, Pennsylvania.
J Adolesc Health. 2024 Aug;75(2):323-332. doi: 10.1016/j.jadohealth.2024.04.014. Epub 2024 Jun 8.
Contemporary school racial segregation is a manifestation of structural racism shown to harm Black children's health. Yet, evidence on its long-term impacts throughout life, as well as effects among children of other racial backgrounds, is sparse.
Data on Black and White children were drawn from the National Longitudinal Study of Adolescent to Adult Health. Using multilevel models, we estimated associations between district-level school segregation and measures of short-term and long-term health, including self-reported outcomes and biomarkers. Models were run separately for Black and White children, adjusting for individual- and district-level covariates. We further carried out subgroup analyses by school racial composition (i.e., majority White vs. majority non-White schools).
School segregation was associated with worsened short- and long-term risk factors of chronic disease among both Black and White students in terms of exercise and body mass index, but only in majority non-White schools. Moreover, Black students in these schools demonstrated less adolescent drinking and smoking with increased racial segregation and better self-reported health in young adulthood.
Our findings suggest that segregated majority non-White schools may be targets of systemic disinvestment and may therefore lack sufficient resources for physical education or nutrition. Improvements in some outcomes among Black children may reflect peer influence (i.e., Black adolescents generally drink less than White adolescents), reduced exposure to interpersonal racism from White peers, or positive health fostered by feelings of belonging in Black community. Ensuring all students go to schools with the resources they need to thrive may have positive spillovers for population health.
当代学校种族隔离是结构性种族主义的一种表现，已被证明会损害黑人儿童的健康。然而，关于其对一生的长期影响以及对其他种族背景儿童的影响的证据却很少。
关于黑人和白人儿童的数据来自全国青少年到成人健康纵向研究。我们使用多层次模型估计了地区层面的学校隔离与短期和长期健康指标之间的关联，包括自我报告的结果和生物标志物。针对黑人和白人儿童分别运行模型，并对个体和地区层面的协变量进行了调整。我们还按学校种族构成（即白人占多数的学校与非白人占多数的学校）进行了亚组分析。
在运动和体重指数方面，学校隔离与黑人和白人学生患慢性病的短期和长期风险因素恶化有关，但仅在非白人占多数的学校中如此。此外，这些学校中的黑人学生随着种族隔离程度的增加，青少年饮酒和吸烟行为减少，在成年早期自我报告的健康状况更好。
我们的研究结果表明，以非白人为主的隔离学校可能是系统性投资不足的目标，因此可能缺乏足够的体育教育或营养资源。黑人儿童某些结果的改善可能反映了同伴影响（即黑人青少年通常比白人青少年饮酒少）、减少了来自白人同伴的人际种族主义暴露，或者是黑人社区归属感所促进的积极健康状况。确保所有学生都能进入拥有他们茁壮成长所需资源的学校，可能会对人口健康产生积极的溢出效应。
