Abstract
ObjectivesAlthough racial stigma in school is associated with adolescent risky health behaviors, there are no studies investigating how gender stigma relates to adolescent risky health behaviors among low-income, minority youth. We sought to determine whether gender stigma awareness is associated with adolescent risky health behaviors (delinquency, fighting, and substance use) and whether this association is mediated by school disengagement (low perceived teacher support, low school engagement, cutting classes, and breaking school rules) among low-income, minority students.MethodsWe analyzed cross-sectional survey data, collected from 2017 to 2019, from 412 high school students. Multi-level logistic regressions tested whether gender stigma awareness was associated with delinquency, fighting, and substance use, controlling for covariates, baseline behaviors, and clustering within schools. Mediation analyses tested whether school disengagement (low school engagement, perceived teacher support, cutting class, and breaking school rules) mediated these associations. Secondary analyses explored whether associations differed for male versus female, high-performing versus low-performing, and Latinx versus non-Latinx students.ResultsIn this predominantly Latinx (83%) sample, gender stigma awareness was associated with delinquency (AOR = 1.48, P< 0.001) and fighting (AOR = 1.15, P< 0.001). School engagement, perceived teacher support, breaking school rules, and cutting classes mediated 42.7% of the association between gender stigma awareness and delinquency and 65.42% of the association between gender stigma awareness and fighting. Gender stigma awareness was also associated with substance use for low-performing (AOR = 1.68, P = 0.003) and non-Latinx adolescents (AOR = 3.80, P = 0.03). School disengagement did not mediate the association between gender stigma awareness and substance use for non-Latinx students but mediated 50% of this association for low-performing students.ConclusionsGender stigma awareness is associated with adolescent risky health behaviors. A decreased sense of acceptance in the school community and increased school misbehavior may mediate these associations. School environments that value and accept all students may better support adolescent health.
Highlights
Adolescent risky health behaviors exacerbate the school-to-prison pipeline and are associated with poor adult health outcomes: worse adult general health, depression, and suicidality [1]
Gender stigma awareness is associated with adolescent risky health behaviors
Recent studies show that Latinx adolescents had higher levels of substance use in early adolescence and African American students had higher final levels of smoking and marijuana use compared to students of other racial groups [2, 3]
Summary
Adolescent risky health behaviors (delinquency, fighting, and substance use) exacerbate the school-to-prison pipeline and are associated with poor adult health outcomes: worse adult general health, depression, and suicidality [1]. Being an African American student, compared to being a white student, was associated with lower delinquent behavior scores, adolescent fighting was most frequent among African American and Latinx students [4, 5]. Feeling threatened by racial- or ethnic-based stereotypes is associated with poor academic performance, risky decision-making, and aggression [7]. Experiencing stigma based on racial stereotypes is associated with low academic performance in college, negative health outcomes in early adulthood (e.g., anxiety, hypertension, and inflammation), avoidance of healthcare, lack of communication with health care providers, and non-adherence to treatment plans in adulthood [8,9,10,11]
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