The independent and joint effect of socioeconomic status and Multiracial status on the prevalence and frequency of substance use and depression among U.S. adolescents.

Aim: While the United States is becoming increasingly Multiracial, much is still unknown about the behavioral health of these growing new generations of Multiracial Americans. To narrow this research gap, this study investigated the prevalence/frequency of substance use and major depressive episodes [MDE] among non-Hispanic Multiracial [NHM] adolescents compared to their non-Hispanic White [NHW] counterparts and whether racial differences vary by socioeconomic status.

Methods: We analyzed data from the 2015-2019 National Survey on Drug Use and Health (N = 3,645 NHM and 34,776 NHW adolescents aged 12-17). Average Marginal Effects derived from logistic regression and negative binomial regression were used to examine (1) differences in six outcomes (past-month use of alcohol, cannabis, or drugs other than cannabis [DOTC], past-year MDE, and the frequency of alcohol and cannabis use among past-month users) by Multiracial status; (2) the moderation effect of family income on these associations.

Results: Compared to high-income NHW adolescents, high-income NHM adolescents reported significantly higher prevalence of past-month cannabis and DOTC use, and past-year MDE. No racial differences were observed at other income levels. Furthermore, moderation analyses indicated that the effect of Multiracial status on MDE was larger in the highest income group compared to the lowest income group.

Conclusion: Our findings suggested that NHM adolescents, particularly those from high income families, exhibit increased prevalence of drug use and depression than NHW adolescents. As the US becomes more diverse, there is a need to further examine the social and structural factors driving the identified racial differences.