School suspension predicts trichomoniasis five years later in a matched sample

• Published in: BMC public health Vol. 20; no. 1; p. 88
• Main Author: Rosenbaum, Janet E
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 20.01.2020; BioMed Central; BMC
• Subjects: Administration of criminal justice; Administration of justice; Adolescence; Adolescent health; Adolescents; Adults; Bias; Calipers; Children & youth; Chlamydia; Control theory; Correlation analysis; Crime; Diagnosis; Disease transmission; Diseases; Distribution; Drugs and athletes; Education; Educational attainment; Emerging adulthood; Experiments; Family; Family income; Female; Gonorrhea; Health aspects; Health Surveys; High schools; Humans; Impulsivity; Income; Judicial system; Justice; Longitudinal Studies; Male; Markers; Mediation; Medical research; Prisons; Probation; Propensity scores; Response rates; Risk analysis; Risk Factors; Sampling; School closings; Secondary schools; Sexually transmitted diseases; Sexually Transmitted Diseases - epidemiology; Social networks; Socioeconomic factors; STD; Student Dropouts - statistics & numerical data; Teenagers; Time; Trichomonas Infections - epidemiology; Trichomoniasis; United States - epidemiology; Urine; Variables; Young Adult; Young adults; Youth; United States; Adolescent health; Sexually transmitted diseases; Emerging adulthood; Trichomoniasis; Propensity scores
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-020-8197-8

Young adults who were suspended from school during adolescence are more likely than matched non-suspended youth to be arrested, on probation, or not graduate from high school, which are STI risk factors. This study evaluates whether suspension is a marker for STI risk among young adults who avoid subsequent negative effects. This study evaluated whether suspension predicts a positive test for chlamydia, gonorrhea, or trichomoniasis in a urine sample using matched sampling in the National Longitudinal Study of Adolescent and Adult Health (Add Health), and evaluated potential mediators between suspension and STI status using causal mediation analysis. We used Mahalanobis and exact matched sampling within propensity score calipers to compare 381 youth suspended for the first time in a 1-year period with 980 non-suspended youth. The suspended and non-suspended youth were similar on 67 pre-suspension variables. We evaluated STI outcomes 5 years after suspension. Before matching, suspended youth were more likely to test positive for trichomoniasis and gonorrhea, but not chlamydia, than non-suspended youth. Suspended youth were more likely to test positive for trichomoniasis 5 years after suspension than matched non-suspended youth (OR = 2.87 (1.40, 5.99)). Below-median household income before suspension explained 9% of the suspension-trichomoniasis association (p = 0.02), but criminal justice involvement and educational attainment were not statistically significantly mediators. School suspension is a marker for STI risk. Punishing adolescents for initial deviance may cause them to associate with riskier sexual networks even if they graduate high school and avoid criminal justice system involvement. Suspension may compound disadvantages for youth from below-median-income families, who have fewer resources for recovering from setbacks.