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 种族和民族差异的流行物质使用以及情绪和焦虑问题， 青少年正在发生变化，引发了对不平等加剧的担忧。而非西班牙裔白色青少年 历史上，与大多数种族化的人相比， 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，过量， 和自杀风险的年轻队列的黑人，亚洲和西班牙裔青少年和年轻人。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 鉴于资源的分配。要解决这些新出现的差距，就需要评估地理和 变化的时间来源，以便建议干预和预防工作。在本补充中， R 01-DA 048853为了支持健康公平性研究，我们要求额外的资金来增加两个分析目标， 我们的项目都以以前未开发的方式利用监测未来数据，其科学目标是 以不重复的方式适当地符合受资助的目标。事实上，我们资助的目标研究时间趋势， 对青少年药物使用和心理健康的时间趋势的解释，但迄今为止还没有关注 这些趋势中的种族/族裔差异，或新出现的差距的潜在结构性驱动因素。监测 鉴于样本量超过530，000，Future是适合实现当前目标的理想数据源 青年;可靠的心理健康和物质使用措施，以及州一级的差异。我们开始 调查在2008年，因为它是心理健康症状的增加和出现的拐点 物质使用的差异。目前，我们可以进行分析，直到2020年，并将延长评估 在可能的情况下，纳入对COVID-19是否扩大了现有不平等的评估 因此，我们计划：目标1）检查种族/民族（包括种族/民族亚组，如波多黎各人和 古巴青年）作为2008-2020年青少年年龄期队列效应的效应测量修正因子 酒精，大麻，其他药物使用，尼古丁和大麻的vaping，心理健康及其共同发生; 目的2）通过种族/民族评估年龄-时期-队列效应的州与州异质性，并通过 国家一级对历史遗产、政策、态度和社会方面的结构性种族主义的综合衡量 种族化的少数民族。在COVID-19的背景下，这些分析越来越重要 大流行; COVID-19对少数民族社区影响的健康差异可能会放大日益扩大的差异 在青少年物质使用，心理健康，以及他们的共同出现。由于2020年、2021年及以后的MTF数据是 评估流行病对青少年健康和健康差距的后果 将为针对青年的干预和预防工作提供必要的数据。

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.