Study provides insight about development, mental health of underserved ethnically diverse children

Reviewed by Emily Henderson, B.Sc.Mar 16 2021

A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports on the young adult assessment of the now 20-year longitudinal Boricua Youth Study (BYS), a large cohort that brings much needed insight about development and mental health of children from diverse ethnic background growing up in disadvantaged contexts.

The present article, with its companion report on prevalence of conditions and associated factors, provides an update on the study's fourth wave, which follows-up two probability-based population samples of children of Puerto Rican heritage. Unique to the study is its two-site design, which allows for comparison of a single ethnic group in two contexts: one in which the group is an ethnic minority living in an disadvantaged area (South Bronx, NY); and another where though challenges are many, children do not grow up being part of an ethnic minority group (San Juan, Puerto Rico).

The BYS provides a unique opportunity to understand developmental processes relevant to young adults who are not easily included in clinical, school, internet or telephone-based studies. By focusing on an underserved ethnic group (Puerto Ricans), whose risk for future psychiatric disorders has been well documented in the USA, we add relevant information to a rich tradition of population-based longitudinal studies that have informed our knowledge of developmental psychopathology."

Cristiane Duarte, PhD, MPH,  Lead Author, Ruane Professor at the Division of Child and Adolescent Psychiatry, Columbia University, New York

Children have been followed since the year 2000, when the original 2,491 participants were between the ages of 5 to 13 years old. Young adults were re-assessed on average 11.3 years after the last study contact, with retention of more than 80 percent of the original sample. The current article presents the cohort composition during young adulthood as it pertains to survival, mobility, parental involvement and other parameters that are crucial to the understanding of developmental psychopathology processes but are not frequently captured by more selective studies.

Hoping to help advance the field, the paper also provides detailed descriptions of methods and measures used, plus strategies utilized to engage and retain a low-income ethnically diverse cohort. The main aim of the first three waves of the study, initiated by Drs. Bird and Canino at the turn of the 21st century was to investigate development, specifically related to antisocial behaviors at the two study sites.

Co-author Glorisa Canino, PhD, Professor at the Department of Psychiatry, University of Puerto Rico, Puerto Rico, said: "The study included the ascertainment of a wide array of putative risk factors that could be related to differences across contexts. After the completion of the first three waves, the question remained as to whether similar patterns observed in childhood would persist into late adolescence and early adulthood."

The risks threatening the positive development of Puerto Rican youth and other diverse racial/ethnic youth, living in disadvantaged contexts, are now likely being compounded by number of relevant factors. These include the disproportionate impact of COVID-19 on underserved racial/ethnic minorities; a prolonged economic depression; and a recent major natural disaster (Hurricane Maria) together with the long-term experiences of discrimination and structural racism that have afflicted these same families for centuries.

The BYS gathers data from childhood through young adulthood on areas such as family relationships, cultural stress and psychiatric disorders, with the addition of domains specific to late adolescence and young adulthood (e.g., sexual risk behaviors, substance use, and financial independence). As such, the study is poised to answer questions that are important to the lived experiences of this ethnic group as they might pertain to mental health and has the capacity to assess the role of context and gender in these associations.

"This study is distinctive and even more relevant today as we unpack the role of minority status in the development of Latinx youth," said co-author Margarita Alegria, PhD Professor, Harvard University. "This represents a unique opportunity to identify assets and risks of Latinx youths' mental health as they transition to emerging adults."

Of note, currently Hector Bird, MD, study co-author states, "The retention of over 80 percent of a sample of children, now young adults, seen more than ten years after the last encounter, has been remarkable. We sincerely hope that the current readers and those of years to come will benefit from the results of this work both in informing epidemiologic methodology as well as from the implications of the findings for the mental health of Puerto Rican and other ethnic groups."