The shadow of context: Neighborhood and school socioeconomic disadvantage, perceived social integration, and the mental and behavioral health of adolescents.

Abstract

The number of youths who experience mental distress has been increasing over the past years. Adolescents with mental health problems also show high rates of co-occurring substance-related behaviors such as illicit drug use. This study leverages large-scale and nationally representative Add Health data to evaluate whether the risks conferred by neighborhood and school socioeconomic disadvantages adversely impact adolescents' mental and behavioral health (i.e., depressive symptoms and illicit drug use). We further investigate whether levels of perceived social support from friends, parents, and teachers moderate the associations between contextual disadvantages and adolescents' mental and behavioral outcomes. Results from cross-classified multilevel modeling analysis suggest that neighborhood socioeconomic disadvantages, and to a lesser degree, school socioeconomic disadvantages, uniquely and simultaneously predict mental and behavioral outcomes of adolescents. Although social support is likely to offset the mental and behavioral consequences of disadvantaged social context to all, high levels of social support is most protective for adolescents of least disadvantaged neighborhoods. This study highlights the possibility that structural disadvantage- within both the school and neighborhood contexts-may adversely impact adolescents' mental well-being and increase their risk for illicit drug use.