This appendix focuses in greater detail on the adverse effects of continuing patterns of prejudice and discrimination1 on the health and well-being of young adults summarized in Chapter 2. We take note of variations across racial and ethnic groups, and summarize what is known about factors that protect or buffer young people against these effects.
EXPERIENCE OF BIAS AND DISCRIMINATION
As noted in Chapter 2, the experience of being exposed to biased and discriminatory behavior has been characterized as a pervasive and normative stressor in the lives of people of color (García Coll et al., 1996) and can take a toll on adolescents and young adults, negatively affecting their future well-being. Importantly, during adolescence and young adulthood, many minority youth start to make meaning of their ethnic and racial group membership as a core component of their identity and may become increasingly aware of negative societal views of and prejudices toward their group, which can heighten sensitivity to perceived bias and discrimination (Cross and Cross, 2008). Thus, normative processes of identity development can
1Prejudice and bias are used synonymously to refer to attitudes even if unaccompanied by discriminatory behavior. Although surveys of minorities ascertain their perceptions of biased or discriminatory behavior rather than the intentions of the persons exhibiting the behavior, we have not inserted the word “perceived” in every instance. Finally, when used generally (and not being used to report on a specific study), the term discrimination is meant to encompass bias or prejudice. We generally do not use the term racism because we typically are referring to bias and discrimination based on either ethnicity or race.
potentially increase vulnerabilities; at the same time, these processes can play a protective role in attenuating the negative effects of bias and discrimination, which we address in more detail later in this appendix.
As reported in Chapter 2, results of a 2013 national survey of adults by the Pew Research Center (2013b) indicate that 88 percent of non-Hispanic blacks and 57 percent of non-Hispanic whites believe that African Americans are subject to “some”/“a lot” of discrimination in the United States, while another report found that among all adults, 73 percent and 65 percent, respectively, hold that view of Muslim Americans and Hispanics (Pew Research Center, 2013a). Interestingly, the perception that racial or ethnic minorities face discrimination is more widespread among young adults (aged 18-29) of all racial/ethnic backgrounds than among older age groups of all backgrounds (Pew Research Center, 2013a).
Until recently, research on racial/ethnic bias and discrimination in the United States focused primarily on African Americans. A substantial majority of blacks report that they have personally been exposed to race-related stimuli perceived as biased or discriminatory (Clark, 2000; Seaton et al., 2008; Simons et al., 2002; Williams et al., 2003). In the National Survey of African Life, the majority of black young adults (in this instance, African American and Caribbean blacks) reported experiencing at least one discriminatory event in the previous year, with increased episodes occurring as they transitioned into young adulthood (Seaton et al., 2008). A higher incidence of discrimination was reported among females from both ethnic groups. African Americans and Caribbean Americans reported equal numbers of discriminatory incidents; however, one interesting finding was that exposure to discrimination was associated with greater vulnerability and more negative outcomes for Caribbean American young adults compared with their African American counterparts. The authors speculate that lack of preparation for negative race-related stress among the recent Caribbean immigrants may explain the variability in the groups’ responses. Importantly, these differences reveal that people from the same pan-racial group have diverse experiences with discrimination that are affected by differences in patterns of immigration and cultural norms. In addition to African Americans, evidence is growing that other immigrant groups, such as Asians and Hispanics, are reporting discrimination that is associated with physical and mental health issues, harmful health behaviors, and decreased access to quality health care (Viruell-Fuentes et al., 2012). Further, the longer immigrants reside in the United States, the more likely they are to have heightened exposure to bias and discrimination (Viruell-Fuentes et al., 2012), although bias and discrimination can be particularly salient for immigrants in the context of anti-immigration legal policies and social messages (Lopez et al., 2010).
According to the minority stress theory, minorities who are openly gay
(e.g., gay African Americans, Asian Americans, or Hispanics) are at greater risk of experiencing discrimination at the structural and institutional levels (Krieger and Sidney, 1997; Kyung-Hee et al., 2013; Mays and Cochran, 2001; Schmitt et al., 2014), including in housing, employment, and health care, and are at increased risk of substance use, particularly when experiencing discrimination targeting multiple social group memberships (e.g., gender, race, sexual orientation) (McCabe et al., 2010). Of course, in the United States, all disadvantaged and marginalized groups, including people of color, individuals of low-income status, immigrants, religious minorities (e.g., Muslims), sexual minorities, individuals with disabilities, and those in low-resource settings (e.g., public housing) are at risk of experiencing some form of bias or discrimination. Results of a 2014 review of both correlational and experimental studies that manipulated perceptions of discrimination in laboratories offer support for the detrimental effects of perceived discrimination for groups stigmatized because of sexual orientation, race/ethnicity, gender, or disabilities (Schmitt et al., 2014).
EFFECTS OF DISCRIMINATION ON WELL-BEING
Impact on Educational Performance and Employment
As noted in Chapter 2, African Americans and Hispanics are overrepresented among high school dropouts. This problem, which has its roots in grade school, is widely perceived to have been magnified by harsh enforcement of “zero tolerance” school discipline policies, including suspension and expulsion, and by increased use of law enforcement officers in school settings, thereby creating the so-called schools-to-prisons pipeline (Alfaro et al., 2009; NRC, 2013; U.S. Department of Education and National Center for Education Statistics, 2014). The associations between early school leaving and young adults’ future outcomes, including joblessness, have been well established (see Chapter 4 of this report). Future research is needed to determine the extent to which young adults’ perceptions and experiences of racial discrimination at the interpersonal and structural levels limit their ability to succeed in education and employment.
Psychological and Physical Functioning
Several systematic reviews and recent studies (Lee et al., 2009; Priest et al., 2013; Williams and Williams-Morris, 2000; Williams et al., 2003) have found strong associations between racial discrimination and mental health outcomes among all racial/ethnic groups. According to the results of one review (Priest et al., 2013), 76 percent of 121 studies demonstrate a significant association between exposure to racial discrimination and men-
tal health outcomes such as depression and anxiety. A recent meta-analytic review of experimental and correlational studies concludes that perceiving pervasive instances of discrimination negatively affects psychological well-being across a wide range of measures (Schmitt et al., 2014). Perceived discrimination by both peers and adults is significantly associated with decreased self-esteem and increased symptoms of depression among African American, Asian American, and Latino/a high school students (Greene et al., 2006). Exposure to race-related stress can evoke feelings of anger, hurt, frustration, bitterness, helplessness, and hopelessness and a desire to lash out (Wagner et al., 2011), which in turn can elevate depressive symptoms and anxiety. Individuals may attempt to manage their psychological state by relying on various self-soothers, such as overeating and use of alcohol and other substances, which over time can lead to chronic health problems (Karlamangla et al., 2006b; Ogden, 2012).
Negative emotions that may emanate from race-related stress also have been associated with the amplification of biological and physiological responses, including increased blood pressure, elevated fasting glucose, and increased plasma lipid levels, which forecast cardiovascular problems among African American young adults (Brody et al., 2014; Karlamangla et al., 2010); similar patterns are evinced among Asian Americans and Hispanics (Earnshaw et al., 2013; Lee et al., 2009). Living in a society where one’s everyday life experiences are filtered through prejudice and racism triggers negative reactivity and the use of coping behaviors that may increase one’s vulnerability to the onset and escalation of chronic diseases (Harrell et al., 2003; Williams and Williams-Morris, 2000). Further, exposure to racism, directly and indirectly, even during childhood, can have long-term consequences (Martin et al., 2011; Williams and Williams-Morris, 2000).
Persistent exposure to incidents of racism can negatively affect physical health by creating demands on individuals to respond to stress-inducing stimuli, requiring the activation of one’s psychological and physiological systems to operate at high levels. This constant engagement of the “flight-fight” response, commonly referred to as “allostatic load,” has been linked to increased inflammation and compromised autoimmune functioning, and is a significant predictor of the onset and escalation of major chronic diseases (Karlamangla et al., 2006a). Stress-response dysfunction increases blood pressure, which in turn increases vascular restriction and cardio output. Elevated blood pressure over time causes vascular resistance. The cycle of heightened physiological responses causes wear and tear on biological systems, including damage to the cardiovascular system. This cyclic link between race-related stress and cardiovascular risk vulnerabilities has been implicated as a major predictor of a range of developmental and health outcomes, including sleep disorders (Beatty et al., 2011), higher visceral
fat, poor ambulatory blood pressure responses, and increases in vascular reactivity (Clark, 2000).
Childhood exposure to racism is associated with less healthy pregnancy outcomes among African American women of childbearing age (Hilmert et al., 2014). This finding reveals that one can be greatly affected by witnessing race-related events occurring to someone else, and that such experiences can be linked to blood pressure and depressive symptoms many years later (Caughy et al., 2004; Simons et al., 2002). Further, race-related stress has consistently been linked to preterm and low-birthweight infants among African American and Puerto Rican women (Earnshaw et al., 2013). Decline in psychological functioning and elevated blood pressure in response to race-related stress create a toxic maternal-fetal environment, causing reduced fetal growth and early delivery (Earnshaw et al., 2013; Hilmert et al., 2014). Additional research is needed to determine and explain how exposure to racism is transmuted from psychosocial experiences into physiological outcomes and to identify the etiological mechanisms by which experiences of racism and discrimination affect the health and well-being of adolescents and young adults of color.
Acts of discrimination toward individuals because of immigrant status, legal status, skin tone, and language can contribute to acculturation stress. Immigrant status, skin tone, and phenotypic characteristics intersect through social interactions with members of the dominant culture among adolescents and young adults of color. They are faced with decisions that require negotiation of their “home culture” and internalization of the dominant culture, creating individual-level acculturation stress in determining the degree to which they should or can assimilate. Many, but not all, adolescents and young adults who abandon their home culture and fully assimilate in the dominant culture fare less well than those who maintain the home culture (Berry, 2005). Assimilation heightens family conflict that can reduce cultural support systems shown to buffer persons of color from negative outcomes often associated with stress-inducing events (Burnam et al., 1987; Cuéllar, 2000; Cuéllar et al., 1997; Heilemann et al., 2002).
Acculturation stress has been associated with increased depression in immigrants (Heilemann et al., 2002). It also has been associated with higher odds of a past suicide attempt among immigrants compared with individuals born in the United States (Gomez et al., 2011). Further, acculturative stress and perceived discrimination have been found to be strong predictors of hopelessness and depressive symptoms among Asian Americans, Latina/os, and Native Americans (Fritz et al., 2008; Kalibatseva and Leong, 2011; LaFromboise et al., 2010; Stein et al., 2012). On the other hand, the
experience of bias or discrimination may foster stronger connections to one’s own culture as young adults reject pressures to adapt and assimilate to the dominant society and instead maintain norms, attitudes, behaviors, and practices of their home culture (Padilla, 2002). Deeper understanding of this potentially protective process is needed.
Current patterns of discrimination are associated with structural factors (e.g., economic and/or residential segregation, institutional racism) that restrict opportunity and well-being in pervasive ways. However, it is also important to recognize that disadvantaged cultural groups have developed productive, adaptive means of coping with their deprivations and that individual resilience and family strengths play important roles in supporting the healthy development of ethnic minority young adults even in the face of societal stressors (García Coll et al., 1996). Several studies have identified factors that buffer, protect against, or reduce the impact of racism and discriminatory experiences on individuals (Luthar, 2006).
Social Support, Connections, and Belongingness
Racial and ethnic identity, perceived to reflect closeness to members of one’s own group, has been shown to serve a protective function for people of color. Across all racial/ethnic groups, high self-regard for one’s ancestral heritage has been associated with the promotion of a sense of belongingness, supportiveness, and ethnic affirmation, which in turn bolsters self-esteem, self-control, and future orientation (Berkel et al., 2010; Seaton et al., 2011; Sellers et al., 2006; Wills et al., 2007). In addition, racial/ethnic group connections counteract potential adverse effects of perceived discrimination, protecting individuals from negative mental health outcomes, including internalizing behaviors, such as depression, shyness, and social isolation, and externalizing behaviors, such as aggression, violence, anger, and substance use (Neblett et al., 2012: Stock et al., 2013). Racial and ethnic identity, therefore, buffers the deleterious effects of discrimination on mental health functioning through parental/family adaptive cultural socialization (discussed in the following section) that prepares individuals to reject the internalization of bias and discriminatory messages (Berkel et al., 2010; Hughes et al., 2009). In addition, racial identity reduces the negative effects of discrimination on individual well-being through the protection of psychosocial resources, specifically social relationships and social support (Ida and Christie-Mizell, 2012).
All individuals experience socialization processes that prepare them to be functional members of a society (Farver et al., 2007). Parents of racial and ethnic minorities also socialize their children into their own ethnic or natal culture and into the dominant culture, processes that include being aware of, understanding, and developing skills to resolve inconsistencies and conflicting views across cultures (Boykin, 1986; Farver et al., 2007). These parenting socialization processes, which encompass racial socialization (Harris-Britt et al., 2007; Hughes et al., 2006) and acculturation socialization (Dumka et al., 2009; Hill, 2011; Kim et al., 2013), may foster culturally specific forms of resilience and self-regulation, which can contribute to the development of adaptive coping mechanisms throughout childhood and lessen the likelihood of maladaptive behavior in adolescence and young adulthood (Yasui and Dishion, 2007).
A highly salient feature of growing up in America today is the increasingly multicultural character of the society, marked by significant increases in immigration from many different parts of the world. Today’s young adults and their successors will be in their middle years when the country becomes majority minority. As the face of the nation changes, the social experiences of young people maturing in an increasingly diverse population will differ substantially from those of their elders. At the same time, this country still struggles to overcome its legacy of racial oppression and to ensure equal opportunity for all, regardless of race, ethnicity, sexual preference, and disability. By itself, the increasing diversity of the population provides no assurance that existing patterns of bias, stereotyping, and discrimination will be erased. However, young adults are the leading edge of the demographic change and can also become the most powerful force for equal rights in the 21st century.
Alfaro, E. C., A. J. Umaña-Taylor, M. A. Gonzales-Backen, M. Y. Bámaca, and K. H. Zeiders. 2009. Latino adolescents’ academic success: The role of discrimination, academic motivation, and gender. Journal of Adolescence 32(4):941-962.
Beatty, D. L., M. H. Hall, T. A. Kamarck, D. J. Buysse, J. F. Owens, S. E. Reis, E. J. Mezick, P. J. Strollo, and K. A. Matthews. 2011. Unfair treatment is associated with poor sleep in African American and Caucasian adults: Pittsburgh SleepSCORE project. Health Psychology 30(3):351.
Berkel, C., G. P. Knight, K. H. Zeiders, J. Y. Tein, M. W. Roosa, N. A. Gonzales, and D. Saenz. 2010. Discrimination and adjustment for Mexican American adolescents: A prospective examination of the benefits of culturally related values. Journal of Research on Adolescence 20(4):893-915.
Berry, J. W. 2005. Acculturation: Living successfully in two cultures. International Journal of Intercultural Relations 29:697-712.
Boykin, A. W. 1986. The triple quandary and the schooling of Afro-American children. The School Achievement of Minority Children: New Perspectives 57-92.
Brody, G. H., M. K. Lei, D. H. Chae, T. Yu, S. M. Kogan, and S. R. Beach. 2014. Perceived discrimination among African American adolescents and allostatic load: A longitudinal analysis with buffering effects. Child Development 85(3):989-1002.
Burnam, M. A., R. L. Hough, M. Karno, J. I. Escobar, and C. A. Telles. 1987. Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles. Journal of Health and Social Behavior 28(1):89-102.
Caughy, M., P. J. O’Campo, and C. Muntaner. 2004. Experiences of racism among African American parents and the mental health of their preschool-aged children. American Journal of Public Health 94:2118-2124.
Clark, R. 2000. Perceptions of interethnic group racism predict increased vascular reactivity to a laboratory challenge in college women. Annals of Behavioral Medicine 22(3):214-222.
Cross, W. E., and T. B. Cross. 2008. Theory, research, and models. In Handbook of race, racism, and the developing child, edited by S. M. Quintana and C. McKown. Hoboken, NJ: Wiley. Pp. 154-181.
Cuéllar, I. 2000. Acculturation and mental health: Ecological transactional relations of adjustment. In Handbook of multicultural mental health: Assessment and treatment of diverse populations, edited by I. Cuéllar and F. A. Paniagua. San Diego, CA: Academic Press. Pp. 45-62.
Cuéllar, I., B. Nyberg, R. E. Maldonado, and R. E. Roberts. 1997. Ethnic identity and acculturation in a young adult Mexican-origin population. Journal of Community Psychology 25(6):535-549.
Dumka, L. E., N. A. Gonzales, D. D. Bonds, and R. E. Millsap. 2009. Academic success of Mexican origin adolescent boys and girls: The role of mothers’ and fathers’ parenting and cultural orientation. Sex Roles 60(7-8):588-599.
Earnshaw, V. A., L. Rosenthal, J. B. Lewis, E. C. Stasko, J. N. Tobin, T. T. Lewis, A. E. Reid, and J. R. Ickovics. 2013. Maternal experiences with everyday discrimination and infant birth weight: A test of mediators and moderators among young, urban women of color. Annals of Behavioral Medicine 45(1):13-23.
Farver, J. M., Y. Xu, B. R. Bhadha, S. Narang, and E. Lieber. 2007. Ethnic identity, acculturation, parenting beliefs, and adolescent adjustment: A comparison of Asian Indian and European American families. Merrill-Palmer Quarterly 53(2):184-215.
Fritz, M. V., D. Chin, and V. DeMarinis. 2008. Stressors, anxiety, acculturation, and North American students. International Journal of Intercultural Relations 32:244-259.
García Coll, C., G. Lamberty, R. Jenkins, H. P. McAdoo, K. Crnic, B. H. Wasik, and H. Vázquez García. 1996. An integrative model for the study of developmental competencies in minority children. Child Development 67(5):1891-1914.
Gomez, J., R. Miranda, and L. Polanco. 2011. Acculturative stress, perceived discrimination, and vulnerability to suicide attempts among emerging adults. Journal of Youth and Adolescence 40(11):1465-1476.
Greene, M. L., N. Way, and K. Pahl. 2006. Trajectories of perceived adult and peer discrimination among black, Latino, and Asian American adolescents: Patterns and psychological correlates. Developmental Psychology 42(2):218-236.
Harrell, J. P., S. Hall, and J. Taliaferro. 2003. Physiological responses to racism and discrimination: An assessment of the evidence. American Journal of Public Health 93(2):243-248.
Harris-Britt, A., C. R. Valrie, B. Kurtz-Costes, and S. J. Rowley. 2007. Perceived discrimination and self-esteem in African American youth: Racial socialization as a protective factor. Journal of Research on Adolescence 17:669-682.
Heilemann, M. V., K. A. Lee, and F. S. Kury. 2002. Strengths and vulnerabilities of women of Mexican descent in relation to depressive symptoms. Nursing Research 51(3):175-182.
Hill, N. E. 2011. Undermining partnerships between African-American families and schools: Legacies of discrimination and inequalities. In African American children’s mental health, Vol. 1, edited by N. E. Hill, T. L. Mann, and H. E. Fitzgerald. Santa Barbara, CA: Praeger. Pp. 199-230.
Hilmert, C. J., T. P. Dominguez, C. D. Schetter, S. K. Srinivas, L. M. Glynn, C. J. Hobel, and C. A. Sandman. 2014. Lifetime racism and blood pressure changes during pregnancy: Implications for fetal growth. Health Psychology 33(1):43-51.
Hughes, D., J. Rodriguez, E. P. Smith, D. J. Johnson, H. C. Stevenson, and P. Spicer. 2006. Parents’ ethnic-racial socialization practices: A review of research and directions for future study. Developmental Psychology 42(5):747-770.
Hughes, D., D. Witherspoon, D. Rivas-Drake, and N. West-Bey. 2009. Received ethnic-racial socialization messages and youths’ academic and behavioral outcomes: Examining the mediating role of ethnic identity and self-esteem. Cultural Diversity and Ethnic Minority Psychology 15(2):112.
Hunter, B. 2009. Indigenous social exclusion: Insights and challenges for the concept of social inclusion. Family Matters 82:52-61.
Ida, A. K., and C. A. Christie-Mizell. 2012. Racial group identity, psychosocial resources, and depressive symptoms: Exploring ethnic heterogeneity among African Americans. Sociological Focus 45:41-62.
Kalibatseva, Z., and F. T. L. Leong. 2011. Depression among Asian Americans: Review and recommendations. Depression Research and Treatment 9.
Karlamangla, A. S., B. H. Singer, and T. E. Seeman. 2006a. Reduction in allostatic load in older adults is associated with lower all-cause mortality risk: Macarthur studies of successful aging. Psychosomatic Medicine 68(3):500-507.
Karlamangla, A., K. Zhou, D. Reuben, G. Greendale, and A. Moore. 2006b. Longitudinal trajectories of heavy drinking in adults in the United States of America. Addiction 101(1):91-99.
Karlamangla, A. S., S. S. Merkin, E. M. Crimmins, and T. E. Seeman. 2010. Socioeconomic and ethnic disparities in cardiovascular risk in the United States, 2001-2006. Annals of Epidemiology 20(8):617-628.
Krieger, N., and S. Sidney. 1997. Prevalence and health implications of anti-gay discrimination: A study of black and white women and men in the CARDIA cohort. International Journal of Health Services 27:157-176.
Kyung-Hee, C., J. Paul, G. Ayala, R. Boylan, and S. E. Rregorich. 2013. Experiences of discrimination and their impact on the mental health among African American, Asian and Pacific Islanders, and Latino men who have sex with men. American Journal of Public Health 103:868-874.
LaFromboise, T. D., K. Albright, and A. Harris. 2010. Patterns of hopelessness among American Indian adolescents: Relationships by levels of acculturation and residence. Cultural Diversity and Ethnic Minority Psychology 16(1):68-76.
Lee, S., H. S. Juon, G. Martinez, C. E. Hsu, E. S. Robinson, J. Bawa, and G. X. Ma. 2009. Model minority at risk: Expressed needs of mental health by Asian American young adults. Journal of Community Health 34(2):144-152.
Lopez, M. H., R. Morin, and P. Taylor. 2010. Illegal immigration backlash worries, divides Latinos. Washington, DC: Pew Hispanic Center. http://www.pewhispanic.org/files/reports/128.pdf (accessed October 1, 2014).
Luthar, S. S. 2006. Resilience in development: A synthesis of research across five decades. In Developmental psychopathology, Vol. 3, 2nd ed., edited by D. Cicchetti and D. J. Cohen. Hoboken, NJ: Wiley. Pp. 739-795.
Martin, M. J., B. McCarthy, R. D. Conger, F. X. Gibbons, R. L. Simons, C. E. Cutrona, and G. H. Brody. 2011. The enduring significance of racism: Discrimination and delinquency among black American youth. Journal of Research on Adolescence 21(3):662-676.
Mays, V. M., and S. D. Cochran. 2001. Mental health correlated of perceived discrimination among lesbian, gay, and bisexual adults in the U.S. American Journal of Public Health 91:1869-1876.
McCabe, S. E., W. B. Bostwick, T. L. Hughes, B. T. West, and C. J. Boyd. 2010. The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. American Journal of Public Health 100:1946-1952.
Meyer, I. H. 1995. Minority stress and mental health in gay men. Journal of Health and Social Behavior 36:38-56.
Neblett, E. W., D. Rivas-Drake, and A. J. Umaña-Taylor. 2012. The promise of racial and ethnic protective factors in promoting ethnic minority youth development. Child Development Perspectives 6(3):295-303.
NRC (National Research Council). 2013. Reforming juvenile justice: A developmental approach. Washington, DC: The National Academies Press.
Ogden, J. 2012. Health psychology: A textbook. New York: McGraw-Hill International.
Padilla, A. M. 2002. Hispanic psychology: A 25-year retrospective look. In Online readings in psychology and culture (Unit 3, Ch. 3), edited by W. J. Lonner, D. L. Dinnel, S. A. Hayes, and D. N. Sattler. Bellingham: Western Washington University.
Pew Research Center. 2013a. After Boston, little change in views of Islam and violence. Washington, DC: Pew Research Center.
Pew Research Center. 2013b. For African Americans, discrimination is not dead. Washington, DC: Pew Research Center. http://www.pewresearch.org/fact-tank/2013/06/28/for-african-americans-discrimination-is-not-dead (accessed September 26, 2014).
Priest, N., Y. Paradies, B. Trenerry, M. Truong, S. Karlsen, and Y. Kelly. 2013. A systematic review of studies examining the relationship between reported racism and health and wellbeing for children and young people. Social Science & Medicine 95:115-127.
Schmitt, M. S., N. R. Branscombe, T. Postmes, and A. Barcia. 2014. The consequences of perceived discrimination for psychological well-being: A meta-analytic review. Psychological Bulletin 140:921-948.
Seaton, E. K., C. H. Caldwell, R. M. Sellers, and J. S. Jackson. 2008. The prevalence of perceived discrimination among African American and Caribbean black youth. Developmental Psychology 44:1288-1297.
Seaton, E. K., E. W. Neblett, R. D. Upton, W. P. Hammond, and R. M. Sellers. 2011. The moderating capacity of racial identity between perceived discrimination and psychological well-being over time among African American youth. Child Development 82(6):1850-1867.
Sellers, R. M., N. Copeland-Linder, P. P. Martin, and R. H. Lewis. 2006. Racial identity matters: The relationship between racial discrimination and psychological functioning in African American adolescents. Journal of Research on Adolescence 16(2):187-216.
Simons, R. L., V. Murry, V. McLoyd, K. H. Lin, C. Cutrona, and R. D. Conger. 2002. Discrimination, crime, ethnic identity, and parenting as correlates of depressive symptoms among African American children: A multilevel analysis. Development and Psychology 14:371-393.
Stein, G. L., L. M. Gonzalez, and N. Huq. 2012. Cultural stressors and the hopelessness model of depressive symptoms in Latino adolescents. Journal of Youth and Adolescence 41(10):1339-1349.
Stock, M. L., F. X. Gibbons, M. Gerrard, A. E. Houlihan, C. Y. Weng, F. O. Lorenz, and R. L. Simons. 2013. Racial identification, racial composition, and substance use vulnerability among African American adolescents and young adults. Health Psychology 32(3):237.
U.S. Department of Education and National Center for Education Statistics. 2014. The condition of education 2014 (NCES 2014-083). http://nces.ed.gov/pubs2014/2014083.pdf (accessed October 1, 2014).
Viruell-Fuentes, E. A., P. Y. Miranda, and S. Abdulrahim. 2012. More than culture: Structural racism, intersectionality theory, and immigrant health. Social Science & Medicine 75(12):2099-2106.
Wagner, J. A., C. Y. Osborn, E. A. Mendenhall, L. M. Budris, S. Belay, and H. A. Tennen. 2011. Beliefs about racism and health among African American women with diabetes: A qualitative study. Journal of the National Medical Association 103(3):224.
Williams, D., and R. Williams-Morris. 2000. Racism and mental health: The African American experience. Ethnicity and Health 5(3-4):243-268.
Williams, D. R., H. W. Neighbors, and J. S. Jackson. 2003. Racial/ethnic discrimination and health: Findings from community studies. American Journal of Public Health 93(2): 200-208.
Wills, T. A., V. M. Murry, G. H. Brody, F. X. Gibbons, M. Gerrard, C. Walker, and M. G. Ainette. 2007. Ethnic pride and self-control related to protective and risk factors: Test of the theoretical model for the strong African American families program. Health Psychology 26(1):50-59.
Yasui, M., and T. J. Dishion. 2007. The ethnic context of child and adolescent problem behavior: Implications for child and family interventions. Clinical Child and Family Psychology Review 10(2):137-179.