Am J Prev Med. 2023 Jun 27:S0749-3797(23)00280-5. doi: 10.1016/j.amepre.2023.06.017. Online ahead of print.
ABSTRACT
INTRODUCTION: Structural racism has clear and pernicious effects on population health. However, there is limited understanding of how structural racism impacts young peoples’ well-being. The objective of this ecological cross-sectional study was to assess the relationship between structural racism and well-being for 2,009 United States counties from 2010-2019.
METHODS: Population-based data on demographics, health, and other variables related to young peoples’ ability to thrive are used to construct a previously validated composite index that serves as a proxy of young peoples’ well-being. The index is regressed on several forms of structural racism (segregation, economic, and educational) both independently and jointly, while accounting for county fixed effects, time trends, and state-specific trends, as well as weighting for child population. Data was analyzed from November 2021 through March 2023.
RESULTS: Higher levels of structural racism are associated with lower well-being. A one-standard-deviation increase in Black-White child poverty disparity is associated with a -0.034 [95% CI: -0.019 – -0.050] standard-deviation change in index score. When accounting for multiple structural racism measures, associations remain statistically significant. In joint models, only estimates for economic racism measures remain significant when additionally controlling for demographic, socioeconomic, and adult health measures [β=-0.015; 95% CI: -0.001 – -0.029]. These negative associations are heavily concentrated in counties where Black and Latinx children are overrepresented.
CONCLUSIONS: Structural racism-particularly of the kind that produces racialized poverty outcomes-has a meaningful adverse association with child and adolescent well-being, which may produce lifelong effects. Studies of structural racism among adults should consider a lifecourse perspective.
PMID:37385571 | DOI:10.1016/j.amepre.2023.06.017
