Adolescent Voices on Global Racisms: Lived Experiences, Health Impacts and Demands Across Six Countries

Introduction: Although the mechanisms of racism may be globally consistent, both these mechanisms and their context-specific expressions require further investigation. Comparing perceptions and experiences of minoritised adolescents across countries helps reveal how racism manifests in different contexts. This multi-country study investigates how adolescents understand, experience, and demand action against the racisms that shape their health and lives. Methods: We conducted semi-structured interviews with 93 adolescents from minoritised groups across Brazil, Peru, South Korea, Sri Lanka, Uganda, and the UK, using culturally adapted vignettes. Using inductive thematic analysis, country-based and external coders applied a co-developed cross-country codebook, achieving high inter-rater reliability, and identified seven key themes. Results: Participants' narratives showed how appearance, language, and socioeconomic status functioned as social markers through which racism reproduced inequities in education, healthcare, and economic opportunity. Across contexts, racism imposed psychological strain, through social exclusion combined with pressure to succeed. This affected adolescent health, contributing to emotional distress, low self-esteem, and uncertainty, while shaping help-seeking, institutional trust, and exposure to material conditions that worsened physical health. Experiences varied: ethnic diversity in the UK offered perceived protection from interpersonal discrimination; economic security in South Korea helped render a minoritised identity an asset; while spatial segregation in Brazil, Peru, Sri Lanka, and Uganda reduced external threat but intensified structural disadvantage. Adolescents called for stronger support networks, anti-racist education, accountability, improved opportunities, and broader justice in workplaces and online spaces. Conclusion: Our findings underscore that addressing racism's impacts on adolescent health requires a health justice approach. This must recognise racism as a public health crisis, confront racialised structural inequities, promote resource access, and engage adolescents in policy development.