Impact of Racism on Trajectories of Substance Use, Mental Health and Legal System Contact from Adolescence to Young Adulthood

BIDS Faculty Affiliate Erin M. Kerrison, with colleagues from UCSF and Brown University, were awarded a 5-year (May 2022 – Feb 2027) $3.7M National Institute on Drug Abuse (NIDA) grant to investigate The Impact of Racism on Trajectories of Substance Use, Mental Health and Legal System Contact from Adolescence to Young Adulthood

Racial and ethnic minoritized youth with prior juvenile justice system contact experience significant health and legal inequities that persist into adulthood, but the impact of structural factors on these inequities is unknown. To advance understanding of structural racism and discrimination (SRD) and its influence on public health and legal inequities, Kerrison and the research team will leverage an existing statewide longitudinal dataset from a project called “EPICC,” which was informed by Ecodevelopmental Theory and followed 401 youth and an involved caregiver (55% ethnoracial minoritized youth) for two years starting from the time of first-ever youth contact with the juvenile legal system. Data are available on the longitudinal trajectories of substance use, psychiatric symptoms, HIV/STI risk behaviors, and recidivism, as well as the multiple contributing risk and protective influences (individual, family and extrafamilial) on youth trajectories.

For this new study – Project EPICC-2 – Kerrison and team will follow up with 300 previously-enrolled youth and caregivers to conduct once-annual followup assessments and life-course interviews. The new research will expand the Ecodevelopmental Framework to study the longitudinal impact of structural racism and discrimination (SRD) on trajectories of ethnoracial minoritized youth’s substance use, psychiatric, sexual and reproductive health, and legal outcomes during adolescence and into young adulthood. 

Using statewide administrative data, the team will expand on the original study to include substance use and psychiatric services utilization to understand more about the direct influence of structural racism and discrimination on justice-impacted young adult healthcare services access and equity. Annual life-course interviews with a stratified random subsample of 50 young adults and 50 caregivers will provide a more nuanced qualitative and contextual understanding of the impact of structural racism on adolescent, young adult and family experiences and trajectories. 

EPICC-2 will leverage an existing longitudinal dataset, pre-existing relationships with a large sample of justice-impacted families, an ecodevelopmental and intersectional (race, ethnicity, sex, gender, socioeconomic status) framework, an intergenerational approach, and an accomplished multidisciplinary study team to answer critically important questions in the field of adolescent and young adult health disparities.

This award (May 2022 – Feb 2027) was made as part of a funding call entitled Understanding and Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities issued by of the National Institutes of Health (NIH).