Youth Gang Membership and Physical Health: Illuminating Disparities and Informing Health Promotion Efforts

Background and Purpose: Gang-involved youth are at greater risk for substance use, poor mental health, and adverse sexual health. Although they report lower health satisfaction than their non-gang peers (Li et al., 2002) and poorer health in early adulthood (Connolly & Jackson, 2019), research on differences in health promoting behaviors (e.g., physical activity, healthy diet, sleep) and indicators of physical health (e.g., asthma, disability) between gang and non-gang youth is virtually nonexistent in the current literature. Given the importance of health promoting behaviors during adolescence for later health (Burdette et al., 2017), research is needed to better understand whether physical health disparities exist for gang-involved youth. This study examined gang and non-gang differences in prevalence of health promoting behaviors and indicators of physical health, including whether observed associations were robust to demographic characteristics. We add to the dearth of research on youth gangs and physical health to create a more comprehensive portrait of the health challenges and needs of this population. Implications include building awareness of disparities and informing research and practice efforts geared toward health promotion within this population.

Methods: Data come from a state-representative survey of students in the 8^th, 10^th, and 12^th grades (n=11,331). The sample was ethnoracially diverse, 51% female, and 15 years old on average. Approximately 7% self-identified as gang involved. Measures included indicators of diet and nutrition, physical activity, sleep, asthma diagnosis, physical and learning disabilities, and healthcare access. Chi-square and independent samples t-tests (including effect sizes) assessed gang and non-gang differences in physical health behaviors and indicators. Regression models tested whether significant differences remained after accounting for youth demographic characteristics (race/ethnicity, sex, age, poverty indicators, and living situation).

Results: Gang-involved youth reported significantly lower health promoting behaviors and worse indicators of health compared to their non-gang peers. Specifically, gang-involved youth reported lower breakfast and greater snack food consumption, more screen time, fewer hours of sleep per night, lower likelihood of having seen a doctor or dentist, greater likelihood of having a physical, emotional, and/or learning disability, and greater likelihood of having received an asthma diagnosis. Gang-involved youth did, however, report greater fruit and vegetable consumption and strength training. The effect of gang membership on indicators of physical health remained even after accounting for demographic characteristics, except for screen time, asthma diagnosis, and doctor/dentist visits.

Conclusions and Implications: This study is among the first to test for differences in prevalence of health promoting behaviors and indicators of physical health for gang and non-gang youth. Our findings illuminated disparities across indicators indicative of physical health trajectories for gang-involved youth, suggesting these youth may be at heightened risk of adverse physical health over the short- and long-term. Research and practice with gang-involved youth typically centers delinquency and legal system intervention with limited attention to health and well-being. Addressing health disparities will require alternative approaches. Strategies for addressing physical health disparities in the youth gang population, including what will be needed in order to develop culturally relevant health promotion efforts for this population, will be discussed.