Learning Objectives: Recognize how hierarchical linear modeling can be used to identify how discrimination experienced by students and various school-level factors might be related to smoking status of in-school youth.
Abstract:
Problem/Objective:Although racial/ethnic discrimination has been shown to have negative effects on the health of racial/ethnic minorities, little research has explored the impact of racial discrimination on adolescent health behavior. Furthermore, few studies have examined the relationship between discrimination and smoking habits of adolescents controlling for school-level factors as well as student factors.
Methods:Student-level data were from the California Healthy Kids Survey, which assessed health behaviors among 247,835 California youth in 7, 9, and 11th grade. School-level information was from 2000 Census data linked to the geographic location of schools. The effect of experiencing racial discrimination on 30-day smoking was assessed, controlling for student-level factors including gender, age, and ethnicity and school-level factors including type of school, population size, and median income of school neighborhood.
Results:Discrimination was positively related to 30-day smoking status (p< 0.001). After controlling for gender, age, and ethnicity, discrimination still had a significant effect on smoking status (p< 0.001). Median income of school neighborhood was not associated with smoking status (p=0.94). However, school type was related to smoking status, with high schools having increased 30-day smoking compared to other types of school.
Conclusions:Racial discrimination is related to the smoking status of in-school youth. School type also has an impact on adolescent smoking. The results of this study illustrate the benefits of using hierarchical linear modeling to identify the simultaneous impact of a student-level factor such as perceived discrimination and a school-level factor such as school type on adolescent smoking behavior.
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