As adolescent substance use declines, internalizing symptoms increase: identifying high-risk substance using groups and the role of social media, parental supervision, and unsupervised time

摘要 物质使用情况以及情绪和焦虑问题的种族和民族差异 青少年正在转变，这引发了人们对日益加剧的不平等的担忧。而非西班牙裔白人青少年 从历史上看，与大多数种族歧视的人相比，他们面临着更高的物质使用和心理健康问题的风险 少数群体，我们和其他人最近发表的证据表明，大麻使用率上升，吸毒过量， 黑人、亚裔和西班牙裔青少年和年轻人的年轻队列中的自杀风险。这些 美国各州之间的差异差异很大，这是一个对政策和干预至关重要的地理实体 在资源分配的情况下。解决这些新出现的差距需要评估地理和 时间变异来源，以便建议干预和预防努力。在本附录中， R01-DA048853为了支持关于健康公平的研究，我们要求额外拨款，以增加两个分析目标，以 我们的项目都以以前未开发的方式利用了监测未来的数据，其科学目标是 以一种非重复的方式适当地与资助目标相匹配。事实上，我们资助的目标是研究时间趋势和 对青少年中物质使用和心理健康的时间趋势的解释，但迄今尚未集中于 这些趋势中的种族/族裔差异，或新出现的差异的潜在结构性驱动因素。监控 考虑到样本大小超过53万，Future是适合实现当前目标的理想数据源 青年；可靠的精神健康和物质使用措施，以及国家一级的差异。我们开始我们的提案 2008年调查认为，这是心理健康症状增加和出现的拐点 物质使用方面的差异。目前，我们可以进行分析到2020年，并将延长评估 在未来几年可能的情况下，包括对新冠肺炎是否放大了现有的不平等的评估 因此，我们计划：目标1)审查种族/族裔(包括种族/族裔亚群，如波多黎各人和 古巴青年)作为2008-2020年青少年年龄-时期-队列效应的影响衡量指标 酒精、大麻、其他毒品的使用、尼古丁和大麻的蒸发、精神健康及其共同出现； 目的2)按种族/族裔评估年龄段队列效应的州与州之间的异质性，并通过 历史遗产、政策、态度和社会中结构性种族主义的国家级综合衡量标准 种族主义少数群体的定位。在新冠肺炎的背景下，这些分析变得越来越重要 大流行病；新冠肺炎对少数族裔社区影响的健康差距可能扩大差距 在青少年药物使用、心理健康及其共同出现方面。根据2020年、2021年及以后的MTF数据 收集并发布，评估大流行对青少年健康和健康差距的影响 将为针对青年的干预和预防工作提供基本数据。

Abstract Racial and ethnic differences in the prevalence of substance use as well as mood and anxiety problems among adolescents are shifting, prompting concern for rising inequality. While non-Hispanic white adolescents historically were at increased risk of substance use and mental health problems compared with most racialized minority groups, we and others have published recent evidence indicating rising rates of cannabis use, overdose, and suicide risk among young cohorts of Black, Asian, and Hispanic adolescents and young adults. These differences are widely variable across US states, a geographic entity that is critical for policy and intervention given allocation of resources. Addressing these emerging disparities requires assessment of the geographic and temporal sources of variation in order to recommend intervention and prevention efforts. In this supplement to R01-DA048853 to support research on health equity, we request additional funding to add two analytic aims to our project that both utilize the Monitoring the Future data in previously untapped ways, with scientific goals that fit appropriately with funded aims in a non-duplicative way. Indeed, our funded aims examine time trends and explanations for time trends in substance use and mental health among youth, but have not to date focused on racial/ethnic differences in those trends, or potential structural drivers of emergent disparities. Monitoring the Future is an ideal data source suited to accomplish the present aims, given the sample size of more than 530,000 youth; reliable mental health and substance use measures, and state-level variation. We begin our proposed investigation in 2008 as it is the inflection point for the increase in mental health symptoms and the emergence of disparities in substance use. Currently, we can conduct analyses through 2020, and will extend assessments into future years when possible to include assessment of whether COVID-19 has amplified existing inequalities Therefore we plan to: Aim 1) Examine race/ethnicity (including race/ethnic subgroups such Puerto Rican and Cuban youth) as effect measure modifiers of age-period-cohort effects among adolescents from 2008-2020 in alcohol, cannabis, other drug use, and vaping of nicotine and cannabis, mental health, and their co-occurrence; Aim 2) Assess state-to-state heterogeneity in age-period-cohort effects, by race/ethnicity, and moderation by state-level aggregated measures of structural racism in historical legacies, policies, attitudes, and social positioning of racialized minorities. These analyses are increasingly critical in the context of the COVID-19 pandemic; health disparities in the effects of COVID-19 on minority communities may amplify growing disparities in youth substance use, mental health, and their co-occurrence. As MTF data from 2020, 2021 and beyond are collected and released, assessing the consequences of the pandemic on adolescent health and health disparities will provide essential data for targeting intervention and prevention efforts to youth.