Abstract: Social Injustice Is Bad for Your Health: Exploring How Discrimination Contributes to Experiences of Depression for Marginalized Women and Trans People in Ontario, Canada (Society for Social Work and Research 22nd Annual Conference - Achieving Equal Opportunity, Equity, and Justice)

Schedule:

Saturday, January 13, 2018: 4:44 PM

Liberty BR Salon J (ML 4) (Marriott Marquis Washington DC)

* noted as presenting author

Charmaine Williams, PhD, Associate Professor, University of Toronto, Toronto, ON, Canada

Deone Curling, PhD, Therapist, Women's Health in Women's Hands Community Health Centre, Toronto, ON, Canada

Leah Steele, PhD, Clinical Scientist, St. Michael's Hospital, Toronto, ON, Canada

Margaret Gibson, Lecturer, York University, Toronto, ON, Canada

Andrea Daley, PhD, Associate Professor, York University, Toronto, ON, Canada

Datejie Green, M.ES, Doctoral student, York University, Toronto, ON, Canada

Lori Ross, PhD, Associate Professor, University of Toronto, Toronto, ON, Canada

Background & Purpose

This study explored how experiences of race, gender, sexuality, class and their intersections are associated with depression and unmet need for mental health care in a population of women and trans people in Ontario, Canada. Previous research suggests women and trans people are at higher risk for depression, and individuals who are marginalized on the basis of race, sexuality and social class may face further risks. This research was directed at empirical exploration of how intersecting identities and intersecting experiences of marginalization are implicated in increased risk for depression.

Methods

Data were collected using a cross-sectional survey design. The survey collected demographic information, information about mental health and use of mental health care services, and data for the Everyday Discrimination Scale and the PHQ-9 Questionnaire for Depression. The survey could be completed online or on paper. A convenience community sample of adult women and trans people (n=704) was recruited trough online networks and community agencies. Through deliberate outreach to diverse populations, we recruited a sample that identified as 34.8% racial minority, 58.9% sexual minority, 27.4% gender minority and 60.4% living with a household income of less than $40,000 CDN per year. Survey data were entered into SPSS for analysis. Bivariate and regression analyses were used to explore group differences in depression and discrimination experiences, and predictors of depression and unmet need for mental health care.

Results

Analyses revealed that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet needs for mental health care. Everyday discrimination was the strongest predictor of both depression and unmet need for mental health care. Use of interaction terms to model intersecting identities and exclusion contributed to explained variance in both outcome variables, beyond that predicted by main effects of race, gender, sexuality or lower income. The results suggest lower income and intersection of race with other marginalized identities are associated with more depression and unmet need for mental health care; however, discrimination is the factor that contributes the most to those vulnerabilities.

Implications

This study demonstrated that race, gender, class and sexuality all corresponded to significant differences in exposure to discrimination, experiences of depression and unmet need for mental health care. Intersectionality theory adds to both our empirical and conceptual understandings of how depression is experienced by marginalized women and trans people, calling attention to the higher risks and barriers that are experienced by those living with intersecting marginalized identities and the significant role played by everyday discrimination. The findings add to the evidence base by demonstrating that risks marginalized populations face for poorer mental health are linked to exposure to social injustice and lack of access to equitable social services and resources. Both exposure to discrimination and institutional barriers to receiving adequate healthcare are areas where social work is positioned to work toward equity for marginalized populations.