Longitudinal evidence on the association between air pollution and blood pressure (BP) in adolescence is scarce. We explored this association in an ethnically diverse cohort of schoolchildren. Sex-stratified, linear random-effects modelling was used to examine how modelled residential exposure to annual average nitrogen dioxide (NO₂), particulate matter (PM_2.5, PM₁₀) and ozone (O₃), measures in μg/m³, associated with blood pressure. Estimates were based on 3,284 adolescents; 80% from ethnic minority groups, recruited from 51 schools, and followed up from 11–13 to 14–16 years old. Ethnic minorities were exposed to higher modelled annual average concentrations of pollution at residential postcode level than their White UK peers. A two-pollutant model (NO₂ & PM_2.5), adjusted for ethnicity, age, anthropometry, and pubertal status, highlighted associations with systolic, but not diastolic BP. A μg/m³ increase in NO₂ was associated with a 0.30 mmHg (95% CI 0.18 to 0.40) decrease in systolic BP for girls and 0.19 mmHg (95% CI 0.07 to 0.31) decrease in systolic BP for boys. In contrast, a 1 μg/m³ increase in PM_2.5 was associated with 1.34 mmHg (95% CI 0.85 to 1.82) increase in systolic BP for girls and 0.57 mmHg (95% CI 0.04 to 1.03) increase in systolic BP for boys. Associations did not vary by ethnicity, body size or socio-economic advantage. Associations were robust to adjustments for noise levels and lung function at 11–13 years. In summary, higher ambient levels of NO₂ were associated with lower and PM_2.5 with higher systolic BP across adolescence, with stronger associations for girls.

Studies, predominantly from the US, suggest that positive parenting, social support, academic achievement, and ethnic identity may buffer the impact of racism on health behaviours, including smoking, but little is known about how such effects might operate for ethnically diverse young people in the United Kingdom. We use the Determinants of young Adult Social well-being and Health (DASH), the largest UK longitudinal study of ethnically diverse young people, to address the following questions: a) Is racism associated with smoking? b) Does the relationship between racism and smoking vary by gender and by ethnicity? (c) Do religious involvement, parenting style and relationship with parents modify any observed relationship? and d) What are the qualitative experiences of racism and how might family or religion buffer the impact? The cohort was recruited from 51 London schools. 6643 were seen at 11-13y and 4785 seen again at 14-16y. 665 participated in pilot follow-up at 21-23y, 42 in qualitative interviews. Self-report questionnaires included lifestyles, socio-economic and psychosocial factors. Mixed-effect models examined the associations between racism and smoking. Smoking prevalence increased from adolescence to age 21-23y, although ethnic minorities remained less likely to smoke. Racism was an independent longitudinal correlate of ever smoking throughout adolescence (odds ratio 1.77, 95% Confidence Interval 1.45–2.17) and from early adolescence to early 20s (1.90, 95% CI 1.25–2.90). Smoking initiation in late adolescence was associated with cumulative exposure to racism (1.77, 95% CI 1.23–2.54). Parent-child relationships and place of worship attendance were independent longitudinal correlates that were protective of smoking. Qualitative narratives explored how parenting, religion and cultural identity buffered the adverse impact of racism. Racism was associated with smoking behaviour from early adolescence to early adulthood, regardless of gender, ethnicity or socio-economic circumstances adding to evidence of the need to consider racism as an important social determinant of health across the life course.

There is a paucity of prospective UK studies exploring the role of Adverse Childhood Experiences (ACEs) on adolescent teenage drug use and even less is known about the complex interplay between ACEs and adolescent social, demographic, and economic characteristics. To address these gaps, we use rich longitudinal data from the nationally representative Millennium Cohort Study. Sex-stratified survey logistic regression modelling was applied using data from 9,476 adolescents and their parents to examine associations between ACEs between ages 3 and 14 years and drug use at ages 14 and 17 years. We a) explore the extent to which associations are robust to adjustment for ethnicity, family income, parental social class, and parental education, b) examine whether associations differ by these factors, and c) estimate the proportion of drug use at ages 14 and 17 years attributable to ACEs after controlling for these factors. Half of MCS cohort members had been exposed to at least one ACE and approximately 1 in 11 were exposed to 3+ ACEs. Multivariable analyses suggest that ACEs were associated with a higher likelihood of drug use at age 14 than age 17, especially for girls. No evidence was found that either advantaged socio-economic position or ethnicity acted as a buffer against the negative effects of ACEs in relation to adolescent drug use. Finally, we found that prevention of exposure to sexual violence, bullying and violence within the household (if causal) is more important for girls’ drug use at age 14 than age 17. ACEs are associated with adolescent drug use with potential consequences on wider aspects of young people's lives, regardless of their social, ethnic, or economic background, adding further urgency to the need to reduce the incidence of these negative experiences.

Purpose: No known UK empirical research has investigated prospective associations between ambient air pollutants and conduct problems in adolescence. Ethnic minority children are disproportionately exposed to structural factors that could moderate any observed relationships. This prospective study examined whether exposure to PM_2.5 and NO₂ concentrations is associated with conduct problems in adolescence, and whether racism or ethnicity moderate such associations. Methods: Longitudinal associations between annual mean estimated PM_2.5 and NO₂ concentrations at the residential address and trajectories of conduct problems, and the potential influence of racism and ethnicity were examined school-based sample of 4775 participants (2002–2003 to 2005–2006) in London, using growth curve models. Results: Overall, in the fully adjusted model, exposure to lower concentrations of PM_2.5 and NO₂ was associated with a decrease in conduct problems during adolescence, while exposure to higher concentrations was associated with a flattened trajectory of conduct symptoms. Racism amplified the effect of PM_2.5 (β = 0.05 (95% CI 0.01 to 0.10, p < 0.01)) on adolescent trajectories of conduct problems over time. At higher concentrations of PM_2.5, there was a divergence of trajectories of adolescent conduct problems between ethnic minority groups, with White British and Black Caribbean adolescents experiencing an increase in conduct problems over time. Conclusion: These findings suggest that the intersections between air pollution, ethnicity, and racism are important influences on the development of conduct problems in adolescence.

Introduction: Despite increasing awareness of ethnic inequalities in mental health, UK-based research on the mental health experiences of adolescent migrants remains limited. This gap is particularly notable given the backdrop of rising legal migration and increasingly politicised public narratives surrounding immigration. Drawing on intersectionality theory, this study examines adolescent mental well-being at the intersections of immigration background, racism, socioeconomic disadvantage and gender. Methods: The British Determinants of Adolescent Social Well-being and Health longitudinal study followed up an ethnically diverse sample of 11–13-year-olds in London, UK, between 2002–2003 and 2005–2006. Using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy, we assessed the interplay between immigration background, racism, socioeconomic circumstances and gender using information on 4775 participants. Results: Notable intersectional inequalities involving immigration background, racism, socioeconomic disadvantage and gender were evident, regardless of age and ethnicity. These included UK-born males who reported racism and were least disadvantaged had higher predicted conduct symptom scores than foreign-born males who reported racism and were most disadvantaged. The lowest predicted conduct scores were among foreign-born females who did not report racism and were least disadvantaged (b=1.97, 95% CI 1.85 to 2.08). For hyperactivity, UK-born females who reported racism and were more disadvantaged had significantly higher scores than foreign-born males who did report racism and were more disadvantaged. The lowest hyperactivity scores were among foreign-born males who had not reported racism and were least disadvantaged (b=3.11, 95% CI 2.98 to 3.23). For internalising symptoms, foreign-born males who reported racism and were least disadvantaged had the highest peer relationship scores (b=2.46, 95% CI 2.35 to 2.58). Across all strata, females who reported racism had higher emotional symptom scores than those who did not, regardless of immigration status or socioeconomic circumstances. Conclusions: To fully understand inequalities in migrant adolescent mental well-being, the interplay between racism, socioeconomic disadvantage and gender must be explored.