Health and behavior risks of adolescents with mixed-race identity

Headnote

Objectives. This study compared the health and risk status of adolescents who identify with 1 race with those identifying with more than 1 race.

Methods. Data are derived from self-reports of race, using the National Longitudinal Study of Adolescent Health (Add Health), which provides a large representative national sample of adolescents in grades 7 through 12. Respondents could report more than 1 race.

Results. Mixed-race adolescents showed higher risk when compared with single-race adolescents on general health questions, school experience, smoking and drinking, and other risk variables.

Conclusions. Adolescents who self-identify as more than 1 race are at higher health and behavior risks. The findings are compatible with interpreting the elevated risk of mixed race as associated with stress. (Am J Public Health. 2003;93:1865-1870)

A considerable literature attests to the emotional, health, and behavior risk problems of mixed-race adolescents. The most common explanation for the high-risk status is the struggle with identity formation, leading to lack of self-esteem, social isolation, and problems of family dynamics in mixed-race households.1-6 This literature is not entirely consistent. In some studies no differences are found between mixed-race and single-race children.7-9 This article explores the risk status of self-identified mixed-race compared with single-race adolescents using a large, nationally representative sample.

Most studies are based on clinical reports or reports of mixed-race samples without comparison to single-race groups. It is not surprising that such samples lead to the conclusion of emotional and behavior problems, as clinical samples are self-selected for problems. No national data on adolescents have been reported, except from the sample we used.

In 2000, the Bureau of the Census introduced a new system of reporting race, providing a list of races and asking respondents to check all that apply. Because an adult in the household filled out the census, children and adolescents had their race reported by a household adult. The National Health Interview Survey (NHIS) has been using a check-all-that-apply race classification for data collection for 20 years, but data on the health of those reporting mixed race is only recently being reported.10 In the NHIS, race for adolescents and children is reported by a household adult.

These 2 national sources will provide new data on mixed-race adults and children. However, such data are not suitable...