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Mental Health

Association between skin tone and mental health status in the National Longitudinal Survey of Youth 1997 cohort Sarah Garcia* Sarah Garcia Patricia Louie Anjum Hajat

Background: While the relationship between race and mental health has been studied extensively, skin tone also contributes to social stratification and experiences of colorism can result in poor mental health. We evaluated the association between skin tone, a proxy for colorism, and mental health status, and if race and ethnicity modified the association.

Methods: We used data from the National Longitudinal Survey of Youth 1997 (N=3,089). Mental health was measured in the 2010 wave with the Mental Health Inventory (MHI-5) which asks about mental health factors in the past month. Scores ranged from 0-15 with higher scores indicating better mental health status. Interviewers identified skin tone in 2010 ranging from 0-10, with 0 as the lightest skin tone and 10 the darkest. Skin tone was combined into three groups: light (0-2), medium (3-4), dark (5-10). Poisson regression analysis was used to compute prevalence ratios (PR).

Results: Median MHI-5 score was 11 (IQR=9-13). The association between skin tone and mental health was null (medium vs light PR=1.00, 95%CI=0.98,1.02; dark vs light PR=1.01, 95%CI=0.99,1.03). However, race and ethnicity appeared to modify this association (Wald test p-value=0.04). Prevalence of a one-unit higher MHI-5 score was higher among White non-Hispanic individuals with medium skin tone (PR=1.03, 95%CI=1.00,1.05) than dark skin tone (PR=0.96, 95%CI=0.85,1.10) when groups were compared to light skin tone. Hispanic individuals of another race with medium skin tone (PR=0.95, 95%CI=0.91,1.00) had lower prevalence than dark skin tone (PR=1.01, 95%CI=0.93,1.09). Black non-Hispanic individuals with medium and dark skin tones had lower prevalence (PR=0.95, 95%CI=0.86,1.05; PR=0.98, 95%CI=0.89,1.07).

Conclusion: Although PR were approximately the same across skin tones, the association between skin tone and mental health is stronger for some groups. Specifically, Black non-Hispanic individuals with darker skin tones had poorer mental health status.