Higher school wealth has been shown to protect low-income adolescents from depression; however, there is limited information on which school contextual factors mediate this association. This study examines several potential mediators among poor minority youth and whether they differ by sex and race/ethnicity.
This cross-sectional study uses Moving to Opportunity data. Participants included primarily black and Hispanic adolescents aged 12-19 years from poor families in 5 metropolitan areas. School poverty was measured by % of students receiving free or reduced lunch (FRL) and categorized into quartiles. A dichotomous measure of lifetime depression was defined using a 6-item questionnaire (UM-CIDI). Logistic regression analysis was performed to assess the association of depression and school poverty, adjusting for individual (age, race, gender, cigarette, alcohol, and marijuana use), peer (drug use), family (maternal depression, education, employment, and household income, paternal involvement), location, and intervention group with and without adjusting for neighborhood poverty. Next, this association was examined adjusting for school mediators including school racial composition, perceived discrimination in school, gang presence in school or neighborhood, teacher interest, school safety, cheating, student disruptions, and unfair discipline. Finally, we assessed whether there were differences by sex and race/ethnicity. Analyses were limited to black and Hispanic adolescents attending school (N=1879).
Two thirds of adolescents were black, with an even distribution of sex and age. Median household income was $13,000, and 70% of households had incomes below the federal poverty line. The median of students on FRL was 69% (quartile range 47-80%). 6.0% of black and 5.7% of Hispanic adolescents reported depression. In adjusted logistic regression analyses without school mediators, higher school poverty was associated with increased odds of depression. With the school mediators included, the association persisted but was not statistically significant. The association between school poverty and depression was stronger among black than Hispanic adolescents which persisted with school mediators in the model. The association was mediated to a larger extent by school factors among girls than boys.
1School poverty quartile OR (95% CI) of depression stratified by sex and race/ethnicity with incremental adjustment of neighborhood poverty (nhood) and school mediators (school)
Increased school poverty is associated with adolescent depression and mediated by several school characteristics. School poverty is associated with a higher risk of depression among black than Hispanic youth. Perhaps resources should be targeted at screening black adolescents for depression in poor school districts.
© 2006 Society for Adolescent Medicine. Published by Elsevier Inc. All rights reserved.