Experiences of Racism in School and Associations with Mental Health, Suicide Risk, and Substance Use Among High School Students — Youth Risk Behavior Survey, United States, 2023

Racism is a fundamental determinant of health inequities among racial and ethnic groups and is understudied among adolescents.In 2023, the national Youth Risk Behavior Survey questionnaire included an item assessing experiences of racism in the school setting among students in grades 9-12 in the United States.This report estimates the prevalence of students who reported ever having experienced racism in school and compares prevalence by racial and ethnic groups.For each racial and ethnic group, prevalence differences and prevalence ratios were estimated comparing the prevalence of indicators of poor mental health, suicide risk, and substance use among students who reported that they have ever versus never experienced racism in school.In 2023, approximately one in three high school students (31.5%) said that they had ever experienced racism in school.Reported experiences of racism were most prevalent among Asian (56.9%), multiracial (48.8%), and Black or African American (Black) (45.9%) students and least prevalent among White students (17.3%).Black and Hispanic or Latino (Hispanic) students who reported experiencing racism had a higher prevalence of all health risk behaviors and experiences investigated, including indicators of poor mental health, suicide risk, and substance use compared with students of their racial and ethnic group who reported never experiencing racism.Many of these associations were also found among multiracial and White students.Student reports of racism were associated with indicators of mental health and suicide risk among American Indian or Alaska Native (AI/AN) and Asian students.Among students of color, including AI/AN, Asian, Black, Hispanic, and multiracial students, the prevalence of seriously considering and attempting suicide was more than two times higher among students who ever compared with never experienced racism.These findings demonstrate that racism in the school setting is experienced by high school students attending public and private schools and continues to disproportionately affect students of color.Students who reported experiencing racism had a higher prevalence of indicators of poor mental health, suicide risk, and substance use.Schools can incorporate policies and practices to prevent unfair treatment on the basis of race and ethnicity and offer resources to help students cope with these experiences.Abbreviation: PD = prevalence difference; PR = prevalence ratio.* Persons of Hispanic or Latino origin might be of any race but are categorized as Hispanic; all racial groups are non-Hispanic. N = 20,103 respondents.The total number of students answering each question varied.Data might be missing because 1) the question did not appear in that student's questionnaire, 2) the student did not answer the question, or 3) the response was set to missing because of an out-of-range response or logical inconsistency.Percentages in each category are calculated on the known data. Experiencing racism was categorized as ever for those who responded "rarely, " "sometimes, " "most of the time, " and "always, " and never for those who responded "never." Weighted prevalence estimate.** PR and PD comparing the prevalence of health risk behaviors and experiences, by ever versus never experiencing racism. Statistically significant; 95% CIs did not include 1.0. p value for prevalence difference based on t-test analysis with Taylor series linearization (<0.05).