ideation in the AFR-like participants. Second, our results are primarily derived from EHR. Marginalized racial and ethnic populations receive less engagement in EHR (e.g., fewer number of EHR actions performed within a patient’s EHR per hour) compared to those who are non-Hispanic White 68, leading to a potentially biased assessment of externalizing. Lastly, in line with the “social push” model 69 of gene-environment interaction, the null association could reflect the increased relevance of adverse social conditions amongst AFR-like participants (e.g., racism, discrimination)56–58, who are predominantly African-American. Importantly, these are not mutually exclusive explanations.
