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Mental health problems more common in kids who feel racial discrimination

April 28, 2009

A new multicenter study involving UCLA and the RAND Corp. has found that perceived racial or ethnic discrimination is not an uncommon experience among fifth-grade students and that it may have a negative effect on their mental health.

Study results show that 15 percent of children surveyed reported experiencing what they perceived as discrimination and that the vast majority of these encounters occurred at school. The study also found that children who reported feeling discrimination were more likely to have symptoms of one or more of four different mental health disorders: depression, attention-deficit hyperactivity disorder, oppositional defiant disorder and conduct disorder.

The study will be published in the May issue of the American Journal of Public Health and is currently available online by subscription.

Racial and ethnic discrimination and their effect on mental health have been studied in adults and adolescents, but less is known about the effects of perceived discrimination on children's mental health.

"It was surprising to see positive associations between perceived racial and ethnic discrimination in the children and symptoms of all four examined mental health conditions," said lead author Dr. Tumani R. Coker, clinical instructor of pediatrics at Mattel Children's Hospital UCLA and an associate natural scientist at RAND. "Parents, clinicians and teachers should be aware that children may experience racial and ethnic discrimination in and out of school and that there may be detrimental effects on their mental health."

Researchers analyzed data from a 2004-06 study of 5,147 fifth-graders and their parents from public schools in Los Angeles, Houston and Birmingham, Ala.

The study found that a greater percentage of African American children (20 percent), Hispanic children (15 percent) and children identified as "other" (15 percent) reported perceived racial or ethnic discrimination than white children (7 percent).

The strongest and most consistent association of discrimination with mental health symptoms involved symptoms of depression in African American, Hispanic and "other" children reporting discrimination. This association was not significant for whites.

Other findings included:


* Among Hispanic children, those who reported perceived discrimination were more likely to have symptoms of each of the four mental health conditions.
* Among African American children, those who reported perceived discrimination were more likely to have symptoms of depression and conduct disorder.
* Among white children, those who reported perceived discrimination were more likely to have symptoms of oppositional defiant disorder and conduct disorder.

"It is concerning that children this young are already reporting that they have faced racial or ethnic discrimination," said senior author Dr. Mark A. Schuster, William Berenberg Professor of Pediatrics at Children's Hospital Boston and Harvard Medical School. "We need to examine what they are experiencing and how to address this issue."

The next stages of research will examine if racial and ethnic discrimination precede the symptoms of mental health conditions and also will look at the mechanisms by which discrimination might lead to poor mental health outcomes and how these mechanisms might differ by race and mental health condition.

"Many parents have discussions about school with their child's health care provider during regular check-ups," Coker said. "Because most children in our study with perceived racial or ethnic discrimination reported that it occurred at school, clinicians could address the topic as part of these school-related discussions."

Additional sites involved in the study included the University of Alabama at Birmingham and the University of Texas, Houston. The research was supported by the Centers for Disease Control and Prevention. The authors have no financial ties to disclose.

In addition to Coker, study authors included Marc N. Elliott, David E. Kanouse, Jo Anne Grunbaum, David C. Schwebel, Janice Gilliland, Susan R. Tortolero, Melissa F. Peskin and Mark A. Schuster.

UCLA