eAppendix. Adolescent Brain Cognitive Development Study Sites
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Nagata JM, Ganson KT, Sajjad OM, Benabou SE, Bibbins-Domingo K. Prevalence of Perceived Racism and Discrimination Among US Children Aged 10 and 11 Years: The Adolescent Brain Cognitive Development (ABCD) Study. JAMA Pediatr. 2021;175(8):861–863. doi:10.1001/jamapediatrics.2021.1022
Research has consistently shown that racism is detrimental to the health of children, adolescents, and their families.1 These consequences range from higher infant mortality to poorer mental health and juvenile justice involvement.1 Despite the plethora of known adverse outcomes associated with racism among young people, little is known regarding the number of children who report that they experience racism and discrimination directly. Identifying the prevalence of racism and discrimination among a crucial developmental age group is imperative to curtail poor outcomes, adjust public health measures, and improve medical and mental health assessments and treatments. Therefore, the objective of this study was to assess the national prevalence of perceived racism and discrimination among 10- and 11-year-old children.
In this study, cross-sectional data of children aged 10 and 11 years from the Adolescent Brain Cognitive Development (ABCD) Study, a large, diverse, population-based sample, at year 1 (2017-2019 release 3.0) were analyzed in 2020. Institutional review board approval was obtained from the University of California, San Diego and at each of the 21 study sites (eAppendix in the Supplement), and caregivers provided written informed consent. This study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines. Discrimination was measured from the Perceived Discrimination Scale,2,3 which was originally developed to measure adolescents’ perception of being treated unfairly or feeling unaccepted in society owing to their racial or ethnic background. The unadjusted prevalence of racial and ethnic discrimination was estimated by race/ethnicity. Significant differences in racial and ethnic discrimination by race/ethnicity were determined by the adjusted F, a variant of the second-order Rao-Scott adjusted χ2 statistic.
A logistic regression analysis was conducted, with perceived discrimination as the dependent variable and race/ethnicity (as reported by the parent or caregiver), sex, annual household income (dichotomized as ≥$75 000 or <$75 000, the approximate median income in the United States), and parental educational level as the independent variables. Analyses were conducted using Stata version 15.1 (StataCorp) and incorporated propensity weights based on the American Community Survey.4 Statistical significance was defined as 2-sided P < .05.
The sample consisted of 10 354 children aged 10 and 11 years, and included 51.1% boys (all percentages are weighted), 48.9% girls, and 45.2% children of racial/ethnic minorities (19.2% Latino/Hispanic, 16.0% Black, 5.5% Asian/Pacific Islander children). Altogether, 4.8% of the children reported discrimination based on race/ethnicity (Table 1), and the prevalence of perceived discrimination owing to race/ethnicity was highest among Black children (10.0%). Although reported discrimination was most commonly perpetrated by peers (12.0%), discrimination by adults, including teachers, was also reported (8.4% among Black children, 7.6% among Native American children, 5.2% among Latino/Hispanic children, 2.2% among Asian/Pacific Islander children, and 1.8% among White children). Black, Latino/Hispanic, and Native American children reported the highest rates of not feeling accepted in society (6.4% of Black children, 3.6% of Latino/Hispanic children, and 3.1% of Native American children vs 1.5% among White children; adjusted F = 4.7; P < .001).
In logistic regression models adjusted for other demographic factors, Asian/Pacific Islander (adjusted odds ratio [AOR], 2.76; 99% CI, 1.64-4.65); Black (AOR, 2.64; 95% CI, 1.89-3.68); Native American (AOR, 1.86; 95% CI, 1.01-3.44); and Latino/Hispanic (AOR, 1.84; 95% CI, 1.23-2.76) children had higher odds of perceived racism compared with White children (Table 2). Annual household income modified the association between being Black and perceived racism but not for other racial/ethnic groups. Black race was associated with 8.23 (95% CI, 5.18-13.08) higher odds of perceived racism among children with household incomes of $75 000 or higher compared with 2.43 (95% CI, 1.62-3.67) higher odds of perceived racism among children with household incomes less than $75 000 (P < .001 for interaction).
Racism has been shown to be detrimental to the health of individuals and families.1 This analysis of population-based, demographically diverse, national data suggests that children in the United States are not impervious to racism and discrimination in their daily lives, with 4.8% reporting being treated unfairly because of their race, ethnicity, or color. Overall, children from non-White groups or from lower-income households were more likely to report discrimination. Among Black children, 10.0% reported racism, with a higher likelihood of these experiences among Black children in households with higher incomes. Although the perpetrators of racism were mostly peers, teachers and other adults were often reported as the source of this unfair treatment, highlighting the critical need to ensure antiracism practice and address structural racism within educational communities, which are important social determinants of health.5 Limitations of this study include the use of self-reported data. Pediatricians should consider screening for racism as a component of adverse childhood experiences.6 Mitigating the effects of racism on health should start with interventions in childhood.
Accepted for Publication: March 24, 2021.
Published Online: May 17, 2021. doi:10.1001/jamapediatrics.2021.1022
Correction: This article was corrected on June 21, 2021, to fix typographical errors in Tables 1 and 2.
Corresponding Author: Jason M. Nagata, MD, MSc, Department of Pediatrics, University of California, San Francisco, 550 16th St, Fourth Floor, PO Box 0110, San Francisco, CA 94158 (email@example.com).
Author Contributions: Dr Nagata had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: All authors.
Acquisition, analysis, or interpretation of data: Nagata, Ganson, Bibbins-Domingo.
Drafting of the manuscript: Nagata, Ganson, Benabou.
Critical revision of the manuscript for important intellectual content: Nagata, Ganson, Sajjad, Bibbins-Domingo.
Statistical analysis: Nagata, Ganson.
Administrative, technical, or material support: Nagata, Sajjad, Benabou.
Conflict of Interest Disclosures: None reported.
Funding/Support: Dr Nagata was funded by Career Development Award CDA34760281 from the American Heart Association. The Adolescent Brain Cognitive Development (ABCD) Study was supported by the National Institutes of Health and additional federal partners under awards U01DA041022, U01DA041025, U01DA041028, U01DA041048, U01DA041089, U01DA041093, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, and U24DA041147. The ABCD federal partners are the National Institute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism, National Cancer Institute, National Institute of Mental Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Heart, Lung, and Blood Institute, National Institute of Neurological Disorders and Stroke, National Institute on Minority/Health and Health Disparities, NIH Office of Behavior and Social Sciences Research, NIH Office of Research on Women’s Health, Centers for Disease Control and Prevention–Division of Violence Prevention, National Institute of Justice, Centers for Disease Control and Prevention–Division of Adolescent and School Health, National Science Foundation, and National Endowment for the Arts.
Role of the Funder/Sponsor: The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Disclaimer: The ABCD consortium investigators designed and implemented the study, provided data, or both, but did not necessarily participate in the analysis or writing of this report.
Additional Information: A complete listing of the ABCD study investigators can be found at https://abcdstudy.org/principal-investigators.html.