Black children are more likely to experience behavioral problems and consume alcohol when they attend racially segregated schools, according to a new University of California at San Francisco (UCSF) study published in Pediatrics.

Black girls attending segregated schools were more likely to drink alcohol compared with Black boys attending such schools.

“Schooling can influence one’s life course and attending segregated schools is commonplace for Black children, but research on its relationship to their health is scarce,” first author Guangyi Wang, PhD, a research analyst with the UCSF Philip R. Lee Institute for Health Policy Studies, said in a UCSF article .

This research is one of the first to suggest a relationship between increased school segregation and the health and well-being of Black children.

Researchers studied data on 1,248 Black children ages 5 to 17 who lived in school districts under court-ordered desegregation in 1991. That same year, the Supreme Court issued rulings that allowed schools to disregard the 1954 Brown v. Board of Education decision that deemed segregated schools unconstitutional. Since then, the proportion of highly segregated schools, defined as schools where 10% or less of the students are white, rose from 5.7% to 18.6%.

Researchers measured children’s well-being and segregation levels through 2014. Segregation was measured using the Black-White dissimilarity index, which shows the percentage of Black or white students who would need to switch schools to achieve a uniform racial distribution. The values of this index range from 0 to 1; the higher the value the more segregated the school district is.

Researchers found that every 0.2 increase in the dissimilarity index was linked to a 31% increase in behavioral problems and a 62% increase in the probability of drinking.

The results are in keeping with previous studies relating racial, economic and social marginalization with child behavioral problems, according to the authors. Children living in stressful family situations or neighborhoods are less likely to manage mental and emotional challenges, which can lead to unhealthy coping mechanisms, such as drinking.

Structural racism is at the core of these issues, according to the study authors.

“With the Black-White child health gap enduring, our findings show that school integration and support for Black children who attend segregated schools may help to reduce health inequities,” said Wang.

“Black people experienced some benefits after schools were first integrated,” said senior author Rita Hamad, MD, PhD, an associate professor in residence in the UCSF Department of Family and Community Medicine. “Now that schools are segregated again, kids are missing out on the benefits of integration. We need structural interventions to address segregation and its consequences so we can ensure more Black children have a better chance at a healthier future.”

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