Discrimination and early substance use among racial-ethnically minoritized youth: Self-reports and hair samples

Racial-ethnically minoritized youth are at elevated risk for early substance use (SU; typically defined as occurring before age 15). Research rarely investigates how different forms of discrimination, such as racial-ethnic and weight discrimination, may operate differently by sex. The current study investigated how these two forms of discrimination differentially relate to early SU, assessed subjectively and objectively, among racial-ethnically minoritized boys and girls.

Data were drawn from 571 U.S. racial-ethnically minoritized youth (51% female; M_age=11.75 years old) in the Adolescent Brain Cognitive Development (ABCD) Study, which began in 2016-18. Main exposure variables included racial-ethnic and weight discrimination. Main outcomes included self-reported SU over the past year and hair sample-based SU over the past three months. Sociodemographic and psychosocial covariates that may be related to SU were included. Cross-sectional and longitudinal analyses were conducted, separately by sex assigned at birth.

Logistic regression-based path analysis (accounting for non-independence) revealed sex-specific patterns. Among racial-ethnically minoritized boys, racial-ethnic discrimination was associated with increased likelihood of self-reported early SU concurrently (OR = 1.42; 95%CI = [1.19, 1.71]). Among racial-ethnically minoritized girls, weight discrimination was associated with increased likelihood of hair sample-based early SU concurrently (OR = 3.48; 95% CI = [1.37, 8.83]) and one year later (OR = 3.61; 95% CI = [1.07, 12.23]).

This study underscores the unique influences of racial-ethnic and weight discrimination faced by racial-ethnically minoritized boys and girls, separately. Results highlight the need for programs and practices to address these unique experiences to effectively prevent early SU.