Intersectional Racial, Gender, and Socioeconomic Discrimination and Youth Alcohol and Cannabis Use: A Latent Class Analysis Among Black and White Adolescents.

Banks D.; Howerton I.; Grimes L.; Bucholz K. · Journal of racial and ethnic health disparities · 2026

**Background & Methods** This secondary analysis of a statewide family study examined discrimination patterns and their association with substance use among 1,052 Black and White adolescents (ages 13-19; 53.0% Black; 51.1% female). Latent class analysis identified distinct discrimination profiles across four settings using 12 dichotomous indicators, with stratified multinomial regressions assessing associations between class membership and alcohol/cannabis use. **Key Findings** • Black youth demonstrated four distinct discrimination classes: no discrimination (75.8%), racial discrimination in public (12.6%), racial law enforcement discrimination (7.8%), and multiple attribute/setting discrimination (3.8%), whereas White youth showed only two classes (no discrimination 89.6% vs. moderate school discrimination 10.4%), revealing significant racial differences in discrimination experiences. • Among Black adolescents, racial discrimination in public settings was associated with increased alcohol use; law enforcement discrimination was linked to both alcohol and cannabis use; and multiple attribute/setting discrimination was specifically associated with cannabis use. • Among White adolescents, moderate school discrimination was associated with cannabis use but not alcohol use, suggesting differential vulnerability patterns and discrimination impacts based on race and type of exposure. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This study employs a robust person-centered latent class analysis approach with adequate sample size (n=1,052) and demographic adjustments for confounding. However, limitations include secondary data analysis with potential measurement constraints, cross-sectional design precluding causal inference regarding discrimination-substance use directionality, reliance on self-reported discrimination and substance use data subject to recall bias, and lack of examination of potential mediating mechanisms. The authors acknowledge the need for future longitudinal research to establish temporal relationships and identify specific intervention targets. The stratified analysis by race strengthens findings by recognizing intersectional patterns but limits generalizability beyond the studied population. Overall evidence quality is moderate, suitable for hypothesis generation and guiding future prospective research.

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