School racial/ethnic composition, effect modification by caring teacher/staff presence, and mid-/late-life depressive symptoms: findings from the Study of Healthy Aging in African Americans

Am J Epidemiol. 2024 Sep 3;193(9):1253-1260. doi: 10.1093/aje/kwae050.

Abstract

For Black students in the United States, attending schools with a higher proportion of White students is associated with worse mental and physical health outcomes in adolescence/early adulthood. To our knowledge, no prior studies have evaluated the association between school racial/ethnic composition from kindergarten through grade 12 and later-life mental health. In a cohort of Black adults aged ≥50 years in Northern California who retrospectively reported (2017-2020) school racial/ethnic composition for grades 1, 6, 9, and 12, we assessed the association between attending a school with mostly Black students versus not and mid-/late-life depressive symptoms (8-item Patient-Reported Outcomes Measurement Information System (PROMIS) depression score, standardized to the 2000 US adult population) using age-, sex/gender-, southern US birth-, and parental education-adjusted generalized estimating equations, and assessed effect modification by the presence of a caring teacher/staff member. Levels of later-life depressive symptoms were lower among those who attended schools with mostly Black students in grades 1 and 6 (β = -0.12 [95% CI, -0.23 to 0.00] and β = -0.11 [95% CI, -0.22 to 0.00], respectively). In grade 6, this difference was larger for students without an adult at school who cared about them (β = -0.29 [95% CI, -0.51 to -0.07] vs β = -0.04 [95% CI, -0.17 to 0.09]). Among Black Americans, experiencing early schooling with mostly Black students may have later-life mental health benefits; this protective association appears more important for students without the presence of caring teachers/staff. This article is part of a Special Collection on Mental Health.

Keywords: depressive symptoms; effect modification; school racial/ethnic composition.

MeSH terms

  • Adolescent
  • Aged
  • Black or African American* / psychology
  • Black or African American* / statistics & numerical data
  • California / epidemiology
  • Depression* / epidemiology
  • Depression* / ethnology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • School Teachers / psychology
  • School Teachers / statistics & numerical data
  • Schools
  • United States / epidemiology