Disparities in Discrimination Distress Among U.S. Youth.

Introduction: Racial and ethnic discrimination differentially affects youth in the U.S. However, evidence of U.S. youth discriminatory experiences at the national level is scant. Methods: Using data from the 2023 National Youth Tobacco Survey on youth aged ≥9 years (N=22,069), the authors used the 15-item Adolescent Discrimination Distress Index to create a binary indicator of any discrimination and mean summary scale (i.e., overall) and subscales (i.e., educational, institutional, and peer) representing frequencies of distress. The authors estimated the distribution of each discrimination measure overall and examined differences by the intersection of gender, race, and ethnicity. Results: More than half the sample (56.2%) experienced any discrimination, with proportions highest among non-Hispanic Asian female youth (78.4%). The mean overall discrimination distress score was 0.32 (95% CI=0.29, 0.34), and youth reported higher levels of educational discrimination distress (mean=0.38; 95% CI=0.35, 0.40) than peer (mean=0.32; 95% CI=0.29, 0.35) and institutional (mean=0.26; 95% CI=0.23, 0.28) distress. Most gender and racial and ethnic minoritized youth reported higher levels of overall distress than non-Hispanic White males and females, with levels generally highest for groups such as Hispanic female (mean=0.49; 95% CI=0.44, 0.55), non-Hispanic Black female (mean=0.47; 95% CI=0.41, 0.53), and non-Hispanic multiracial female (mean=0.45; 95% CI=0.30, 0.59) youth. Conclusions: Gender and racial and ethnic minoritized youth experience higher levels of discrimination distress than non-Hispanic White male and female youth, with variation observed by type of discrimination. Efforts mitigating discrimination for specific at-risk populations are needed to promote health equity.