Schools' use of expulsion and racial/ethnic differences in skipping school due to feeling unsafe among us public high school students

Racial disparities in skipping school due to feeling unsafe have persisted for the past 30 years. Since 1995, Black students have been two times more likely to skip school compared to White students. School discipline is a well-documented driver of racial and ethnic educational disparities. Black students are also two to three times more likely to be expelled from school as compared to White students (despite research indicating that actual (mis)behavior is the same across all racial/ethnic groups). Addressing racial and ethnic disparities in feeling unsafe at school aligns with goals from the CDC and Healthy People 2030 to measure and confront the impact of racial discrimination on health and disparities, and yet, research that has explored the association between school expulsion and health disparities is lacking. Our objective was to examine whether schools’ use of expulsion as a disciplinary action is associated with students skipping school due to feeling unsafe, overall, and by race/ethnicity. Student-level health behavior data from the 2019 national Youth Risk Behavior Survey, a nationally representative sample of U.S. high school students, was merged with school-level disciplinary data from the 2017–2018 Civil Rights Data Collection, a dataset of all U.S. pre-K-12 public schools. The final dataset included 126 high schools and 12,779 students. Student-level univariate statistics were calculated using SUDAAN version 11.0.1. School-level univariate and bivariate statistics were conducted using SAS version 9.4. Finally, multilevel logistic regression models were estimated using PROC GLIMMIX within SAS version 9.4. Weighted random-intercept multilevel logistic regression models were built using a sequential modeling process. Population-average and race/ethnicity-stratified models were created to examine the association between school expulsion of ≥1 student and a student skipping school due to feeling unsafe. Overall, 9.1% of students skipped school due to feeling unsafe. The prevalence of feeling unsafe was higher among Black (8.5%) and Hispanic/Latino (11.4%) compared to White (7.1%) students. Almost half (48.4%) of all schools expelled ≥1 student in the school year. Students had increased odds of skipping school due to feeling unsafe if they attended a school that expelled ≥1 student (aOR=1.21, 1.19-1.23). Black (aOR=1.44 95% CI 1.41-1.47) and Hispanic/Latino (aOR=1.48, 95% CI 1.45-1.50) students had higher odds of skipping school due to feeling unsafe compared to White students. Using nationally representative data, this paper establishes the link between schools’ use of expulsions and students skipping school due to feeling unsafe. Any expulsion—its adverse association with student health and disproportionate impact by race/ethnicity—demands action by CDC as a public health problem. Through public health surveillance, CDC can continue to identify and monitor school-level policies and practices that impact students’ feeling of safety at school and drive racial/ethnic disparities. Through public health practice, CDC can expand programming in schools to confront and dismantle racism. Finally, schools can provide anti-racist training and professional development for staff, review and rewrite policies using an anti-racist lens, and collaborate with students and their families to cultivate a school environment that is safe and supportive for all students.