Presentation Title: Health Consequences of Weight- and Race-Based Bullying Among Urban Adolescents

Abstract: Background: Discrimination has been associated with a wide variety of adverse mental and physical health outcomes, and may play a key role in driving persistent socioeconomic and racial/ethnic health disparities in the U.S. The majority of research in this domain has been conducted with adults, but increasing research and theory suggest the importance of taking a life course perspective to fully understand the association between discrimination and health. Among younger age groups, stigma-based bullying may be a particularly important and prevalent form of discrimination with adverse health consequences. Stigma-based bullying is bullying based on a socially devalued characteristic (e.g., race, weight, gender, class, sexual orientation, etc.). Thus, the current investigation aimed to (1) investigate the associations of experiencing weight- and race-based bullying with changes in physical health outcomes across two years and (2) examine mental health as a potential mediator of those associations among predominantly Black and Latino, socioeconomically disadvantaged, urban adolescents.

Methods: In a longitudinal cohort study, surveys and physical health assessments were conducted with 644 New Haven, Connecticut middle school students in grades 5-6 in 2009 and grades 7-8 in 2011. Reflecting school district demographics, the sample included mostly Black and Latino, socioeconomically disadvantaged, urban adolescents. Specifically, this investigation tested the hypothesis that greater experiences with weight- and race-based bullying would each have unique associations with adverse health changes (i.e., increases in systolic and diastolic blood pressure and body mass index, and decreases in self-reported health) across the two year study period, through the mechanism of experiencing more negative emotional symptoms. We conducted regression analyses, using Baron and Kenny’s (1986) four steps for testing mediation, to test the hypothesized mediated relationships. Weight- and race-based bullying were the predictor variables, emotional symptoms was the mediator, and systolic and diastolic blood pressure, body mass index, and self-rated health during Wave 2 were the outcome variables. We controlled for clustering at the school level, race/ethnicity, age, sex, free or reduced-price lunch eligibility, fitness tests, frequency of healthy and unhealthy eating, systolic and diastolic blood pressure, body mass index, and overall self-rated health during Wave 1, as well as change in height from Wave 1 to Wave 2.

Results: As hypothesized, weight- and race-based bullying each were significantly indirectly associated with increased systolic blood pressure, diastolic blood pressure, and body mass index, as well as decreased overall self-rated health, through the mechanism of more negative emotional symptoms. Only weight-based bullying had a direct association with decreased overall self-rated health.

Discussion: Results support the importance of taking a life course perspective to understand the adverse mental and physical health consequences of discrimination, and suggest important avenues for future research to examine mechanisms and longitudinal associations of discrimination and stigma-based bullying with health outcomes. Results indicate that stigma-based bullying, a form of discrimination experienced early in life, may be part of a larger life-long cycle contributing to health disparities. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects.

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