Using the Race-Based Disparities in Stress and Sleep Model to Identify Targets for Effective School-Based Interventions

Background and Purpose:  The Race-Based Disparities in Stress and Sleep (RBDSS) model links ecological systems theory with psychophysiological stress theories to explain documented racial/ethnic disparities in health, mental health, and academic achievement. The model hypothesizes that a context of institutionalized discrimination at the macro level filters down as racialized stress in mezzo-level contexts such as homes and schools, which then impact individuals’ biological and psychological functioning across domains. The purpose of the current study was to identify elements of the RBDSS model that may offer maximum benefit in addressing racial/ethnic disparities in student mental health and well-being.

Method: 5171 middle- and high-school students from two communities in a southeastern U.S. state completed the School Success Profile (SSP), an assessment of the social environmental context for learning and well-being. Summary scores for the SSP well-being and positive mental health scales were dependent variables for analysis. Hierarchical regressions were conducted to identify the amount of outcome variance contributed by each model element.

Results: The RBDSS model explained 34.4% of total variance in mental health for students of color and 33.7% for White students. The model explained 43.4% of the total variance in general well-being for students of color and 45.3% for White students. Quality sleep was the most impactful predictor of well-being for all students, accounting for 22.6% of variance for students of color and 21.5% among white students. Experiences of peer aggression explained 12% of the variance in well-being for students of color and 14.8% for White students. Family support had the largest impact on mental health for students of color, accounting for 9% of variance, but only 6% of the variance for White students.  School safety and satisfaction had the largest impact on mental health among White students, explaining 10.5% of the variance. These features only explained 3.5% of the variance in mental health for students of color.

Conclusions and Implications: While the RBDSS model recognizes that the influences of model elements may differ for racial/ethnic minority students and White students, the current analysis found that the three elements of sleep, family support, and reduced peer aggression can benefit all students’ well-being and mental health. Because previous research has shown that children of color spend less time sleeping and experience reduced sleep quality compared to their White peers, school-based efforts to promote healthy sleep behaviors may be an overlooked strategy to promote the well-being of diverse student populations. Including content on strengthening supportive relationships within families may be a natural extension of existing school-family outreach that also benefits student mental health. The results also highlight the continued need for school-based efforts to promote positive peer relationships and reduce aggressive behaviors. While promoting healthy sleep, supportive family relationships, and reduced peer aggression may help in particular to narrow racial/ethnic disparities in mental health and well-being, the study demonstrates that students from all backgrounds may benefit such interventions.