Abstract
Socioenvironmental factors, such as chronic exposure to stress and lack of resources, may play a role in explaining ethnic differences in health. Past studies have focused on the impact of socioeconomic stress (SES) on health in adolescents using individual measures of SES such as parental income, occupation, and/or education. The impact of school and community variables on cardiovascular risk factors in adolescents has not been well studied.The primary goal of this study was to assess the impact of school socioenvironmental factors on cardiovascular risk factors in a sample of 15,885 multiethnic 10 th graders, consisting primarily of understudied ethnic minority groups from 36 public high schools in Miami-Dade County, using a multi-level modeling approach. Ethnic and gender differences in cardiovascular risk factors and health behaviors were also described.The main finding of this study was that school socioenvironmental factors had an impact on body mass index (BMI) and systolic blood pressure (SBP) in adolescents. Multiple indicators of socioenvironmental stress negatively impacted BMI and accounted for a large proportion of the variance in a hierarchical linear regression model. High enrollment of students in limited English proficiency classes impacted SBP, suggesting that low acculturation had a positive effect on SBP. Other important findings were the ethnic and gender differences that emerged in cardiovascular risk factors and health behaviors. Overall, African Americans, Caribbean Blacks, and Black Hispanics had higher rates of cardiovascular risk factors and poorer health behaviors than White non-Hispanics, White Hispanics, and Asians.The results of this study suggest that interventions to improve adolescent health should not only be made at the individual-level, but also in the school. The community and government should be aware of the impact of school environment on adolescent health. Availability of healthy foods, higher quality physical education, reduced class size, and improved school atmosphere are some of the many interventions that could be considered in the school.