Abstract
BackgroundYoung adults who were suspended from school during adolescence are more likely than matched non-suspended youth to be arrested, on probation, or not graduate from high school, which are STI risk factors. This study evaluates whether suspension is a marker for STI risk among young adults who avoid subsequent negative effects.MethodsThis study evaluated whether suspension predicts a positive test for chlamydia, gonorrhea, or trichomoniasis in a urine sample using matched sampling in the National Longitudinal Study of Adolescent and Adult Health (Add Health), and evaluated potential mediators between suspension and STI status using causal mediation analysis. We used Mahalanobis and exact matched sampling within propensity score calipers to compare 381 youth suspended for the first time in a 1-year period with 980 non-suspended youth. The suspended and non-suspended youth were similar on 67 pre-suspension variables. We evaluated STI outcomes 5 years after suspension.ResultsBefore matching, suspended youth were more likely to test positive for trichomoniasis and gonorrhea, but not chlamydia, than non-suspended youth. Suspended youth were more likely to test positive for trichomoniasis 5 years after suspension than matched non-suspended youth (OR = 2.87 (1.40, 5.99)). Below-median household income before suspension explained 9% of the suspension-trichomoniasis association (p = 0.02), but criminal justice involvement and educational attainment were not statistically significantly mediators.ConclusionsSchool suspension is a marker for STI risk. Punishing adolescents for initial deviance may cause them to associate with riskier sexual networks even if they graduate high school and avoid criminal justice system involvement. Suspension may compound disadvantages for youth from below-median-income families, who have fewer resources for recovering from setbacks.
Highlights
Young adults who were suspended from school during adolescence are more likely than matched non-suspended youth to be arrested, on probation, or not graduate from high school, which are sexually transmitted infections (STI) risk factors
This study evaluates whether youth who are suspended from school for the first time are more likely to test positive for chlamydia, trichomoniasis, and gonorrhea 5 years after first suspension than similar youth who had never been suspended, and uses causal mediation to evaluate the roles of household income during adolescence
Racial disparities in STIs Respondents who identified as Black were more likely to test positive for trichomoniasis and chlamydia than respondents who did not identify as Black, both in the full sample and after stratifying on suspension status
Summary
Young adults who were suspended from school during adolescence are more likely than matched non-suspended youth to be arrested, on probation, or not graduate from high school, which are STI risk factors. This study evaluates whether suspension is a marker for STI risk among young adults who avoid subsequent negative effects. It’s unknown whether school suspension predicts STIs. This study evaluates whether youth who are suspended from school for the first time are more likely to test positive for chlamydia, trichomoniasis, and gonorrhea 5 years after first suspension than similar youth who had never been suspended, and uses causal mediation to evaluate the roles of household income during adolescence. This study uses tests for chlamydia, trichomoniasis, and gonorrhea as objectively assessed potential health effects of suspension to avoid
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