Youth-Caregiver Racial Identity Divergence and Perceived Racial Discrimination Among US Youth

Pediatric practice, research, and guidelines rely on caregiver-reported race and ethnicity to characterize children’s race, which assumes that youth self-identify similarly. Yet adolescents may adopt a racial and ethnic identity that aligns more closely with their social experiences than caregiver-assigned identities,1 a phenomenon we term “youth-caregiver racial/ethnic identity divergence.” This understudied dynamic process underscores fluid and discordant experiences within families.2 Specifically, youth who diverge from their parent-assigned racial and ethnic identities may have experienced racist incidents that lead them to identify with a racial and ethnic group with similar experiences. Additionally, youth with racial and ethnic identities different from that of their parents may be more vigilant to racial and ethnic discrimination. Perceived racial discrimination (ie, personally mediated racism) is prevalent among US adolescents, with roughly 1 in 5 reporting such experiences.3 It is associated with adverse outcomes, including heightened allostatic load and disrupted family processes.4Given the reliance on caregiver-reported race, high prevalence of perceived racial discrimination affecting youth, and calls for pediatricians to address race and racism in the United States,5,6 we examined youth-caregiver racial identity divergence, its sociodemographic correlates, and its association with perceived racial discrimination in a large, diverse adolescent cohort. We hypothesized that youth reporting greater interpersonal racial discrimination exposure would be more likely to have a divergent racial identity.We used Baseline (2015–2016), Wave 2 (2017–2019), and Wave 3 (2019–2022) data from the Adolescent Brain and Cognitive Development study.7 Youth-caregiver divergent race and ethnicity was measured as a binary variable indicating whether the caregiver- and self-reported youth race and ethnicity matched (Supplemental Material 1). Racial discrimination was measured at Wave 2 using the youth-reported perceived discrimination scale,8 which derives a mean score across 7 items with higher values indicating greater discrimination exposure (Supplemental Material 2).Descriptive statistics (overall and by discordancy) were summarized with chi-square and one-way analysis of variance tests. Multivariable logistic regression tested whether perceived discrimination predicted youth-caregiver race discordance, adjusting for age (continuous: months), sex at birth (male or female), nativity status (US-born or non–US-born), caregiver education (high school or less, some college, associate’s or bachelor’s degree, or graduate degree), caregiver’s race and ethnicity (white, Black, Hispanic, Asian or Native Hawaiian or Pacific Islander, multiracial, or other), and caregiver-child relationship (biological parent or adoptive, custodial, or other.) Covariates were selected based on the Family Stress model9 and integrative model of racial socialization10 to account for multilevel factors associated with youth racial discrimination.4,11 Caregiver race and ethnicity and caregiver-child relationship quality were selected because family processes can shape youth resilience and identity formation.10,11 Analyses were conducted using Stata/SE version 17 (StataCorp LLC, College Station, TX). This study was deemed nonhuman subjects research by the Tufts University Institutional Review Board.The final sample included 7868 participants (Mage = 144.5 months at Wave 2), with 2.9% being born outside the United States (Table 1.) Discrimination scores ranged between 1 and 5 (mean, 1.13; SD, 0.32), suggesting youth experienced discrimination infrequently. Youth-caregiver divergent racial and ethnic identity was found in 14.6% of participants.Adjusted logistic regression results (Table 2) showed that each 1-U increase in perceived discrimination was associated with 27% higher odds of divergent racial identity (adjusted odds ratio [aOR], 1.27; 95% CI, 1.05–1.53). Adopted and foster children had 53% higher odds than those living with biological parent(s) (aOR, 1.53; 95% CI, 1.11–2.09). Odds were higher among children with Hispanic race (aOR, 3.52; 95% CI, 2.97–4.19), Asian race (aOR, 3.94; 95% CI, 2.99–5.20), other race (aOR, 10.61; 95% CI, 5.22–21.56), or multiracial (aOR, 15.76; 95% CI, 12.05–20.62) caregivers than with white caregivers. Compared with a high school diploma or less, higher parental education was associated with increased odds of divergent race (some college [aOR, 1.58; 95% CI, 1.23–2.03], associate’s or bachelor’s degree [aOR, 1.53; 95% CI, 1.23–1.91], or graduate degree [aOR, 1.30; 95% CI, 1.02–1.66]).Our findings supported our hypothesis that youth reporting greater interpersonal racial discrimination exposure were more likely to have a divergent racial identity. Approximately 15% of caregiver-child dyads reported the child’s racial identity differently, indicating a substantial proportion of US youth may differ from their caregivers in racial and ethnic identification. This reflects potentially widespread tension between adolescents’ self-identification and caregiver perceptions, although future research should confirm generalizability. Findings are especially relevant to pediatric clinicians and researchers who could incorporate adolescent self-identified race into data collection procedures to better assess and address racism and its health implications.5 At minimum, such changes would reduce race and ethnicity measurement error and improve the validity of population-health surveillance.New interventions and policies are needed to support a cohesive and resilient sense of self in adolescents as a protective factor against the harms of racism. Effective family- and school-based programs, such as the school-level Actions Against Racism program,12 have shown that interventions that strengthen caregiver racial socialization as well as youth racial identity and school belonging can mitigate the harms of racism.11 Institutional responses, such as culturally affirming kindergarten through grade 12 legislation that protects ethnic studies curriculum, can also foster affirmative and supportive social environments.3 Simultaneously, parents and caregivers should engage in conversations with children about identity and experiences shaping it.This study underscores the limitations of relying solely on caregiver-reported race in clinical and research contexts and provides the foundation for future research identifying overlooked youth populations at disproportionate risk for the physical and mental tolls of racism. As US pediatric populations continue to diversify, we require more nuanced demographic surveillance and stronger focus on racism as a health determinant in health care settings.6