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YOUNG ADULTS WHO HAVE EXPERIENCED DISCRIMINATION are at higher risk for both shortand long-term behavioral and mental health problems, a UCLA study has found. Researchers examined a decade’s worth of health data on 1,834 Americans who were between 18 and 28 years old when the study began. They found that the effects of discrimination may be cumulative — that the greater number of incidents of discrimination someone experiences, the more their risk for mental and behavioral problems increases.
The study also suggests that the effects of discrimination in young adults are connected with disparities in care for mental health concerns and institutional discrimination in hea lth care overall , including inequit ies in diagnoses, treatments and health outcomes. Previous studies have linked discrimination — whether due to biases against race, sex, age, physical appearance or other attributes — to increased risk for mental illness, psychological distress and drug use. This new study is the first to focus on the transition to adulthood and to follow the same group of individuals over time.
“With 75% of all lifetime mental health disorders presenting by age 24, the transition to adulthood is a crucial time to prevent mental and behavioral health problems,” says Yvonne Lei, a medical s tudent in the David Geffen School of Medicine at UCLA and the study’s corresponding author. “The COVID-19 pandemic has brought to the forefront new mental health challenges — particularly for vulnerable populations. We have the opportunity to rethink and improve mental health services to acknowledge the impact of discrimination, so we can better address it to provide more equitable care delivery.”
Researchers used data spanning 2007 to 2017 from the University of Michigan’s Transition to Adulthood Supplement of the Panel Study of Income Dynamics survey. Approximately 93% of the people in the study repor ted experiencing discrimination; the most common factors they cited were age (26%), physical appearance (19%), sex (14%) and race (13%). The analysis showed that participants who experienced frequent discrimination, defined as a few times per month or more, were roughly 25% more likely to be diagnosed with a mental illness and twice as likely to develop severe psychological distress than those who had not experienced discrimination or had experienced it a few times per year or less.
Overall, people who experienced any amount of discrimination had a 26% greater risk for poor health than people who said they did not experience discrimination. During the 10-year period, young adults in the study who had experienced multiple successive years of highfrequency discrimination showed a much more pronounced, cumulative r isk for mental i l lness, psychological distress, drug use and worse overall health.
“The associations we found a re likely also intertwined with mental health care service disparities — including inequities in care access, provider biases and structural and institutional discrimination in health care — leading to inequities in diagnoses, treatments and outcomes,” says Adam Schickedanz, MD (FEL ’16, ’18), assistant professor of pediatrics, the study’s senior author.
—Evelyn Tokuyama
“Discrimination and Mental Health in Young Adults,”Pediatrics, November 8, 2021