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Study objective: To investigate cultural identity as a risk factor for mental health problems among adolescents. Design: A cross sectional school based population survey. Mental health problems were measured using the strengths and difficulties questionnaire. Pupils were classified into one of four cultural identity types on the basis of friendship and clothing choices. Setting: East London. Participants: 2623 adolescents (aged 11-14) from a representative sample of 28 schools in east London. Results: In comparison with marginalised adolescents who chose friends from neither their own or other cultures, fewer mental health problems were found among adolescents making culturally integrated friendship choices (friends from own and other cultures: OR = 0.6, 0.4 to 0.9), boys making integrated friendship choices (OR = 0.45, 0.22 to 0.91), and specifically among Bangladeshi pupils with integrated friendship choices (OR = 0.15, 0.04 to 0.55). Conclusion: As measures of cultural identity, integrated friendship choices overall, and specifically for boys and Bangladeshi pupils, are associated with lower levels of adolescent mental health problems.

Original publication




Journal article


Journal of Epidemiology and Community Health

Publication Date





296 - 302