Immigrants and mental disorders in the united states: New evidence on the healthy migrant hypothesis

OBJECTIVES

Despite experiencing migration-related stress and social adversity, immigrants are less likely to experience an array of adverse behavioral and health outcomes. Guided by the healthy migrant hypothesis, which proposes that this paradox can be explained in part by selection effects, we examine the prevalence and comorbidity of mental disorders among immigrants to the United States (US).

METHODS

Findings are based on the National Epidemiologic Survey on Alcohol and Related Conditions (2012-2013), a nationally representative survey of 36,309 adults in the US.

RESULTS

Immigrants were significantly less likely than US-born individuals to meet criteria for a lifetime disorder (AOR = 0.63, 95% CI = 0.57-0.71) or to report parental history of psychiatric problems. Compared to US-born individuals, the prevalence of mental disorders was not significantly different among individuals who immigrated as children; however, differences were observed for immigrants who arrived as adolescents (ages 12-17) or as adults (age 18+).

DISCUSSION

Consistent with the healthy migrant hypothesis, immigrants are less likely to come from families with psychiatric problems, and those who migrate after childhood-when selection effects are most likely to be observed-have the lowest levels of psychiatric morbidity.

Trends in depression among low-income mothers in the United States, 2005-2015

BACKGROUND

Prior research has examined the association between low-income status and maternal depression; however, important questions remain in terms of trends in the prevalence of major depressive episodes (MDE) and treatment seeking among mothers in the United States. The objective of the present study is to examine trends in MDE among low-income mothers and explore perceived barriers to mental health treatment seeking.

METHODS

Using data from the National Survey on Drug Use and Health (NSDUH; 2005-2015), we examined the prevalence of past-year MDE among mothers living in poverty (0-99% federal poverty line [FPL]; n = 23,264) and near-poverty (100-200% FPL; n = 21,655). Consistent with the Center for Disease Control and Prevention (CDC) guidelines, we conducted survey-adjusted logistic regression analyses to examine the significance of survey year in relation to MDE while controlling for key social demographic correlates.

RESULTS

The overall decreasing MDE trend was found only among mothers in near-poverty, not mothers in poverty. Only for mothers in poverty, financial (AOR = 0.70, 95% CI = 0.52-0.95) and information barriers (AOR = 0.53, 95% CI = 0.39-0.73) were associated with mental health service use.

LIMITATIONS

Self-reports of depressive symptoms and service receipt may have led to over or underreporting due to recall or social desirability bias. Additionally, NSDUH data are cross-sectional and thereby limit our ability to make causal inferences.

CONCLUSIONS

Greater attention should be paid to the prevention/treatment of depression among mothers in poverty. Efforts may include expanding financial assistance for mental health service use and educational campaigns to increase awareness of services available.

Abstention from Drug Use and Delinquency Increasing among Youth in the United States, 2002-2014

BACKGROUND

Trends in abstaining from substance use and delinquency among adolescent's ages 12-17 in the United States was examined.

METHODS

Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic white, African American, and Hispanic respondents (n = 98,620) and spanning the years 2002-2014. Logistic regression was used to examine significance of trend year and correlates of low-risk and high-risk behavioral groups relative to abstaining.

RESULTS

Overall, the prevalence of abstaining was 47.56% between 2002 and 2014. Prevalence increased significantly among all adolescents from 44.85% in 2002 to 53.58% in 2014. Relative to abstainers nonabstaining youth were more likely to be male, and report lower household income, poorer grades, depression, and lower levels of parental affirmation and control.

CONCLUSIONS

Findings indicate that there is a corresponding increase in abstaining mirroring the recent decreases found in adolescent drug use found in national surveys.

Trends in Perceived Access to Marijuana Among Adolescents in the United States: 2002-2015

OBJECTIVE

There is concern that changes in marijuana-related policy and public opinion may lead to increased access to marijuana among young people in the United States. However, little research has been conducted on changes in youth's perceptions of marijuana access, and studies have yet to systematically examine trends in perceived access across key sociodemographic and externalizing behavioral subgroups.

METHOD

Using population-based data collected between 2002 and 2015 as part of the National Survey on Drug Use and Health, we examined trends in perceived marijuana access among non-Hispanic White, African American, and Hispanic adolescents (ages 12-17, n = 221,412). Following the trend analysis method outlined by the Centers for Disease Control and Prevention, we conducted logistic regression analyses to test for secular trends.

RESULTS

Between 2002 and 2015, we observed a 27% overall reduction in the relative proportion of adolescents ages 12-17-and a 42% reduction among those ages 12-14-reporting that it would be "very easy" to obtain marijuana. This pattern was uniformly observed among youth in all sociodemographic subgroups (i.e., across age, gender, race/ethnicity, household income) and among youth reporting involvement/no involvement in most measures of substance use (alcohol, marijuana) and delinquency (handgun carrying, attacks). However, perceived very easy access remained stable among youth reporting tobacco use and criminal justice system involvement.

CONCLUSIONS

Despite the legalization of recreational and medical marijuana in some states, our findings suggest that, with the notable exception of adolescent tobacco users and juvenile offenders, perceptions that marijuana would be very easy to obtain are on the decline among American youth.

The Acceptability of Biobehavioral Research With Latino Youth in the United States

In this study, we explored Latinx adolescents’ knowledge and perceptions of biobehavioral research and their willingness to participate in such studies. We conducted four focus groups in the summer of 2014 with Latinx adolescents in Texas between the ages of 12 and 17 years ( n = 17; 53% male; M age = 14.6 years [ SD = 1.66]) who were recruited from a community-based clinic. Five themes emerged from our content analysis: (a) protection of human subjects is important to participants, (b) comfort with providing different types of biological data varies depending on different factors, (c) engagement in biobehavioral research should be grounded in a cultural lens, (d) providing bilingual research staff is essential, and (e) adolescents have various motivations for participating. Findings highlighted how various factors could serve as both barriers and facilitators to participation. Our study provides insight into strategies for conducting biobehavioral research with Latinxs, who are the fastest growing group of adolescents in the United States and experience disparities in health-risk behaviors that can be better understood through research approaches that integrate biological and psychological measures. Without considering the perspectives of historically marginalized or understudied populations, we jeopardize the quality and validity of research findings, and risk harming participants.

An Epidemiological Study of Burglary Offenders: Trends and Predictors of Self-Reported Arrests for Burglary in the United States, 2002-2013

Burglary is serious property crime with a relatively high incidence and has been shown to be variously associated with other forms of criminal behavior. Unfortunately, an epidemiological understanding of burglary and its correlates is largely missing from the literature. Using public-use data collected between 2002 and 2013 as part of the National Survey on Drug Use and Health (NSDUH), the current study compared those who self-reported burglary arrest in the prior 12 months with and without criminal history. The unadjusted prevalence estimates of self-reported burglary arrest were statistically different for those with a prior arrest history (4.7%) compared with those without an arrest history (0.02%) which is a 235-fold difference. Those with an arrest history were more likely to report lower educational attainment, to have lower income, to have moved more than 3 times in the past 5 years, and to use alcohol, tobacco, illicit drugs, and engage in binge drinking. Moreover, those with prior arrest histories were younger and more likely to be male. There is considerable heterogeneity among burglars with criminal history indicating substantially greater behavioral risk.

Advancing Alcohol and Other Drug Education among Social Work Faculty: An Evaluation of Social Work Faculty Immersion Training

This study is an educational evaluation of participants (N = 50) in a four-day immersion training program funded by the National Institute of Alcohol Abuse and Alcoholism. Using a pretest-posttest design, clinical social work faculty participants showed statistically significant (p < .001) improvement in overall alcohol and other drug-related knowledge (Baseline: Mean[SD] = 8.75 [2.44]; Post-Intervention: Mean[SD] = 13.88[1.96], Cohen's d = -2.16) in the domains of screening/assessment, brief intervention, medication-assisted treatment, and recovery and relapse prevention. Corresponding increases were also observed for faculty confidence in teaching clinical skills related to alcohol and other drug screening, assessment, and treatment.

Are trajectories of a syndemic index in adolescence linked to HIV vulnerability in emerging and young adulthood?

OBJECTIVES

To examine trajectories of adolescent psychosocial risk - drug use, depressive and anxiety symptoms, and violence victimization and observation - and the longitudinal relationship between psychosocial risk trajectories during adolescence and HIV risk behaviors in adulthood.

METHODS

The 18-year longitudinal study was conducted from September 1994 through May 2013, in Michigan. Eight hundred and fifty predominantly (80%) African-American adolescents completed demographics and measures of drug use, depressive and anxiety symptoms, violence victimization and observation at Times 1-4, sexual risk behaviors at Times 5 and 6, and social conditions (i.e. family, peer, and community-level factors) between 14.9 and 32.0 years of age.

RESULTS

Growth mixture modeling revealed two trajectories of psychosocial risk factors which can be characterized as a syndemic index: high-frequency and low-frequency. The high-frequency class was more likely to report HIV risk behaviors, including condomless sex at last sexual intercourse with their primary and secondary partner, sexual intercourse with someone they just met, at least four sexual partners, and licit and illicit drug use prior to sexual intercourse at Time 5 (mean age 23.1). At Time 6 (mean age 32.0), the high-frequency class was more likely to report sexual intercourse with someone they just met and at least four sexual partners, relative to the low-frequency class. In addition, the high-frequency class was linked to peer and family-level indicators of social conditions.

CONCLUSION

A syndemic index comprised of co-occurring psychosocial risk factors in adolescence seem to have lasting effects on the vulnerability to engage in HIV risk behaviors in emerging adulthood, some of which extend into young adulthood.

Introduction to the Special Issue: Educating Social Workers about Alcohol and Other Drug Use Disorders

This Special Issue of Journal of Social Work Practice in the Addictions focuses on an emerging effort, the Alcohol and Other Drugs Education Program (ADEP), designed to advance social work faculty knowledge and teaching in the area of alcohol and other drug (AOD) use. In June 2017, with grant support from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the inaugural ADEP program provided in-depth, immersion-based training to 50 full-time, clinical faculty from social work programs across the United States. As detailed in this Special Issue, the preliminary results of our program were highly promising and we look forward to training more social work faculty in June 2018, and in years to come. The ADEP program is predicated on the idea that faculty training in evidence-based AOD identification and treatment methods will help faculty to provide higher-quality instruction in AOD and, in turn, that their students will be better prepared to serve clients experiencing AOD-related problems. While this Special Issue focuses primarily on the ADEP program, we do so with the hope that the work presented here reaches far beyond the specifics of our faculty training program to underscore the need to advance AOD-related training and offer a template for social work educators looking adapt their teaching to address the nation's very serious challenges with AOD.

Gender differences in the trends and correlates of major depressive episodes among juvenile offenders in the United States

PURPOSE

Although it is well-established that juvenile offenders are at an elevated risk for depression and that, within this group, females have the highest risk, little is known regarding the trends in the prevalence of depression among juvenile offenders in the United States. In the present study, we systematically examine secular trends in major depressive episodes (MDE) and their correlates among male and female juvenile offenders and non-offenders in the United States.

METHODS

Data were collected between 2005 and 2014 as part of the National Survey on Drug Use and Health (NSDUH). The NSDUH uses multistage area probability sampling methods to select a representative sample of the civilian, non-institutionalized population in the United States. Participants included 171,118 youth aged 12-17 (159,449 non-offenders and 11,669 offenders). The primary variable of interest was self-reported past year MDE. Logistic regression assessed whether sociodemographic factors and psychosocial and behavioral correlates affected the risk of MDE.

RESULTS

Between 2005 and 2014, the prevalence of MDE among female youth increased for both offender and non-offender groups: from 24.4% to 33.0% for the offenders and from 12.4% to 16.7% for the non-offenders. No significant trend changes were observed among male youth. In both male and female juvenile offenders, MDEs were associated with increased risk of illicit drug use (males OR=1.61, 95% CI=1.18-2.18; females OR=1.83, 95% CI=1.45-2.31). Additional correlates include alcohol use among male offenders (OR=1.36, 95% CI=1.01-1.83), and binge drinking in female offenders (OR=1.24, 95% CI=1.02-1.49).

CONCLUSIONS

The prevalence of past year major depressive episodes is increasing for female juvenile offenders, highlighting a need for improved efforts to target these populations for prevention and treatment.

Substance use disorders among immigrants in the United States: A research update

INTRODUCTION

There is a critical need for the most current information available on the prevalence of substance use disorders (SUD) among immigrants vis-à-vis that of individuals born in the United States (US). We report the prevalence of SUDs among immigrants from major world regions and top immigrant-sending countries, and assess key moderators (i.e., age, gender, family income, age of migration, time in US) of the relationship between immigrant status and SUD risk.

METHOD

The data source used for the present study is the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III, 2012-2013), a nationally representative survey of 36,309 civilian, non-institutionalized adults ages 18 and older in the US. Logistic regression was employed to examine the relationship between immigrant status and SUD risk.

RESULTS

Immigrants were found to be substantially less likely than US-born individuals to be diagnosed with a past-year or lifetime SUD, including alcohol, cannabis, cocaine, and opioid use disorders. These findings held across major world region and among immigrants from the top-ten immigrant sending nations, and across differences in age, gender, family income, age of migration, and time spent in the US.

CONCLUSIONS

Results from the present study provide up-to-date and cogent evidence that immigrants use alcohol and drugs, and meet criteria for SUDs, at far lower rates than do US-born individuals. Moreover, we provide new evidence that the protective effect of nativity holds for immigrants from an array of global regions and sending countries, and across key demographic and migration-related differences.

The Usability and Acceptability of an Adolescent mHealth HIV/STI and Drug Abuse Preventive Intervention in Primary Care

Human Immunodeficiency Virus (HIV)/sexually transmitted infection (STI) risk behaviors among adolescents remain significant public health concerns. Shifts in policy and advances in technology provide opportunities for researchers and clinicians to deliver and evaluate mobile-health (mHealth) prevention programs in primary care, however, research is limited. This study assessed the usability and acceptability of Storytelling 4 Empowerment-a mHealth HIV/STI and drug abuse preventive intervention app-among adolescents in primary care. Informed by principles of community-based participatory research, we recruited a purposive sample of 30 adolescents from a youth-centered community health care clinic in Southeast Michigan. The study sample is primarily African American and female. Adolescents who participated in the Storytelling 4 Empowerment intervention assessed its usability and acceptability, and self-reported their HIV/STI risk behaviors. We used a multiple-methods approach. Adolescents reported high acceptability of the content, process, and format of Storytelling 4 Empowerment, as evidenced by qualitative data and mean scores from the Session Evaluation Form for the HIV/STI and Alcohol/Drug content, overall Storytelling 4 Empowerment intervention, and Client Satisfaction Questionnaire-8. Findings indicate that Storytelling 4 Empowerment is acceptable among adolescents in primary care. A next step is to examine the effect of Storytelling 4 Empowerment on adolescent sexual risk and drug use behaviors and HIV/STI testing.

A Social Work Approach to Policy: Implications for Population Health

The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.

Randomized Controlled Trials of Technology-Based HIV/STI and Drug Abuse Preventive Interventions for African American and Hispanic Youth: Systematic Review

BACKGROUND

HIV/sexually transmitted infections (STIs) and drug abuse remain significant public health concerns in the United States, and African American and Hispanic youth are disproportionately affected. Although technology-based interventions are efficacious in preventing and reducing HIV/STI and licit/illicit drug use behaviors, relatively little is known regarding the state of the science of these interventions among African American and Hispanic youth.

OBJECTIVE

The aim of this review is to identify and examine randomized controlled trials (RCTs) of technology-based HIV/STI and/or drug abuse preventive interventions for African American and Hispanic youth.

METHODS

We searched electronic databases (ie, PubMed, Proquest, PsycINFO, Ebscohost, Google Scholar) to identify studies between January 2006 and October 2016. RCTs of technology-based interventions targeting African American and Hispanic youth HIV/STI risk behaviors, including sexual risk, licit and illicit drug use, and HIV/STI testing were included.

RESULTS

Our search revealed a total of three studies that used an RCT design and included samples comprised of >50% African American and/or Hispanic youth. The follow-up assessments ranged from two weeks to six months and the number of participants in each trial ranged from 72 to 141. The three interventions were theory-driven, interactive, and tailored. The long-term effects of the interventions were mixed, and outcomes included reductions in sex partners, licit drug use, and condomless anal sex acts.

CONCLUSIONS

Although technology-based interventions seem promising in the prevention of HIV/STI and drug abuse among African American and Hispanic youth, more research is needed.

Trends in drug offers among adolescents in the United States, 2002-2014

BACKGROUND

Being offered illicit drugs is a critical factor leading to drug initiation and other psychosocial risk behaviors among adolescents in the United States. However, there exist few studies examining the recent trends in drug offers among adolescents, particularly across racial/ethnic subgroups. The present study examines trends and psychosocial/behavioral correlates of drug offers among adolescents of the three largest racial/ethnic groups.

METHODS

We used data from the 2002-2014 National Survey on Drug Use and Health of adolescents aged 12-17, which include African-American, Hispanic, and White adolescents (n = 199,700) in the U.S. We estimated the prevalence of past-month drug offers by race/ethnicity, and conducted logistic regression analyses to test the significance of the trends and to examine the correlates of drug offers.

RESULTS

Overall, the prevalence of drug offers decreased significantly from 16.3% in 2002 to 12.3% in 2014, reflecting a 24.5% reduction in the relative proportion of adolescents who were offered drugs. While the decreasing trends were observed in all subgroups (e.g., race/ethnicity), the decreases were more limited among African-American and Hispanic youth than White youth. As a result, while no differences were observed at the outset of the study, a higher proportion of African-American and Hispanic adolescents were offered drugs between 2012 and 2014.

CONCLUSIONS

Findings suggest a general decline in drug offers among adolescents in the U.S., but racial/ethnic differences in prevalence were identified. This underscores the importance of further efforts to understand the racial/ethnic differences in drug offers and suggests the need for culturally-sensitive drug prevention programs.

Marijuana use during pregnancy: A comparison of trends and correlates among married and unmarried pregnant women

BACKGROUND/PURPOSE

While recent evidence indicates increases in marijuana use among adult women in the United States (US), important questions remain with respect to marijuana use during pregnancy. This study examines trends and correlates of prenatal marijuana use and the effects of marijuana-specific risk/protective factors on marijuana use trends using a nationally representative sample.

METHOD

Data were derived from the National Survey on Drug Use and Health (2005-2014), a nationally representative survey that included 3640 married and 3987 unmarried pregnant women in the United States. The significance of marijuana use trends was tested using logistic regression analyses while adjusting for complex sampling design effects and controlling for sociodemographic and marijuana-specific factors.

RESULTS

From 2005-2014, marijuana use prevalence among unmarried pregnant women increased by 85% from 5.4% to 10.0% while the prevalence among married pregnant women remained stable (mostly under 1.5%). The increasing trend among unmarried pregnant women was associated with their lower disapproval and risk perceptions of marijuana use. In addition, past-year anxiety (AOR=3.30, 95% CI=1.87-5.82) and depression (AOR=3.85, 95% CI=2.33-6.36) diagnoses were linked with marijuana use among unmarried, but not married, pregnant women.

DISCUSSION

Increased attention should be paid to reducing prenatal marijuana use among unmarried women. Findings also suggest the need to attend to unmarried pregnant women's mental health problems as well as their physical health-risk behaviors.

Substance use among bi/multiracial youth in the United States: Profiles of psychosocial risk and protection

BACKGROUND

Bi/multiracial youth face higher risk of engaging in substance use than most monoracial youth.

OBJECTIVES

This study contrasts the prevalence of substance use among bi/multiracial youth with that of youth from other racial/ethnic groups, and identifies distinct profiles of bi/multiracial youth by examining their substance use risk.

METHODS

Using data from the National Survey on Drug Use and Health (collected between 2002 and 2014), we analyze data for 9,339 bi/multiracial youth ages 12-17 living in the United States. Analyses use multinomial regression and latent class analysis.

RESULTS

With few exceptions, bi/multiracial youth in general report higher levels of tobacco, alcohol, marijuana, and other illicit drug use compared to other youth of color. Bi/multiracial youth also report higher levels of marijuana use compared to non-Hispanic white adolescents. However, latent class modeling also revealed that a majority (54%) of bi/multiracial youth experience high levels of psychosocial protection (i.e., strong antidrug views and elevated parental engagement) and low levels of psychosocial risk (i.e., low peer substance use, school-related problems, and social-environmental risk), and report very low levels of substance use. Substance use was found to be particularly elevated among a minority of bi/multiracial youth (28%) reporting elevated psychosocial risk and low levels of protection. Bi/multiracial youth characterized by both elevated psychosocial risk and elevated psychosocial protection (22%) reported significantly elevated substance use as well.

CONCLUSIONS

While bi/multiracial youth in general exhibit elevated levels of substance use, substantial heterogeneity exists among this rapidly-growing demographic.

Immigrants from Mexico experience serious behavioral and psychiatric problems at far lower rates than US-born Americans

PURPOSE

To examine the prevalence of self-reported criminal and violent behavior, substance use disorders, and mental disorders among Mexican immigrants vis-à-vis the US born.

METHODS

Study findings are based on national data collected between 2012 and 2013. Binomial logistic regression was employed to examine the relationship between immigrant status and behavioral/psychiatric outcomes.

RESULTS

Mexican immigrants report substantially lower levels of criminal and violent behaviors, substance use disorders, and mental disorders compared to US-born individuals.

CONCLUSION

While some immigrants from Mexico have serious behavioral and psychiatric problems, Mexican immigrants in general experience such problems at far lower rates than US-born individuals.

Truancy in the United States: Examining Temporal Trends and Correlates by Race, Age, and Gender

BACKGROUND

Truancy has long been regarded a common problem in urgent need of effective intervention. Knowledge about factors associated with truancy can guide the development and implementation of interventions.

METHOD

This paper examined trends in truancy rates between 2002-2014 and correlates of truancy across racial/ethnic groups. Variables of interest included sociodemographic factors (e.g., age, gender, socio-economic background), behavioral factors (e.g., substance use, violence), and psychosocial factors (e.g., academic engagement, grades, parental control). Using data from a large sample of adolescents (n=209,393; 12-17 years) we estimated truancy prevalence rates and examined trends and correlates via regression analyses.

RESULTS

Truancy rates remained constant between 2002 (10.8%) and 2014 (11.1%). Rates were highest among older youth, females, and Hispanic youth. For all racial/ethnic groups, truancy was significantly correlated with alcohol and marijuana use, fighting, the propensity to take risks, and lower academic engagement and school grades. Other factors were differentially associated with racial/ethnic groups. This divergence in risk patterns for different racial/ethnic groups points to some heterogeneity amongst truant youth.

DISCUSSION

Despite truancy reduction efforts, truancy rates have remained stable. Efforts to prevent truancy and to intervene with truant youth may need to target risk factors more prevalent in specific racial/ethnic groups.

Adverse Childhood Experiences Among Immigrants to the United States

A growing number of studies have examined the "immigrant paradox" with respect to health behaviors in the United States. However, little research attention has been afforded to the study of adverse childhood experiences (ACE; neglect, physical and sexual abuse, and witnessing violence) among immigrants in the United States. The present study, using Waves I and II data from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), aims to address these gaps by comparing forms of ACE of first- and second-generation immigrants with native-born American adults in the United States. We also examined the latent structure of ACE among immigrants and conducted analyses to assess the psychiatric correlates of identified latent classes. With the exception of neglect, the prevalence of ACE was markedly higher among native-born Americans and second-generation immigrants compared with first-generation immigrants. Four latent classes were identified-limited adverse experience ( n = 3,497), emotional and physical abuse ( n = 1,262), family violence ( n = 358), and global adversity ( n = 246). The latter three classes evinced greater likelihood of being diagnosed with a mood, anxiety, personality, and substance use disorder, and to report violent and non-violent antisocial behavior. Consistent with prior research examining the associations between the immigrant paradox and health outcomes, results suggest that first-generation immigrants to the United States are less likely to have experienced physical and sexual abuse and witness domestic violence. However, likely due to cultural circumstances, first-generation immigrants were more likely to report experiences that are deemed neglectful by Western standards.

Trends in Fighting and Violence Among Adolescents in the United States, 2002-2014

OBJECTIVES

To examine trends in and correlates of fighting and violence among youths from the 3 largest racial/ethnic groups in the United States.

METHODS

We derived race/ethnicity-specific prevalence estimates for fighting, group fighting, and attacks with intent to harm from the National Survey on Drug Use and Health, a population-based study of youths aged 12 to 17 years.

RESULTS

The prevalence of youth fighting and violence decreased significantly in all racial/ethnic groups over the study period (2002-2014), dropping from a high of 33.6% in 2003 to a low of 23.7% in 2014, reflecting a 29% decrease in the relative proportion of young people involved in these behaviors. However, there was also a clear severity gradient in which year-by-year point estimates for fighting and violence were consistently highest among non-Hispanic African American youths, followed by Hispanic and then non-Hispanic White youths.

CONCLUSIONS

Although fighting and violence are on the decline among young people in general and across racial/ethnic subgroups, there is a stable pattern of disparities in youth involvement in these behaviors.