Latino Adolescent Health and Emotional Well-Being: The Role of Social Determinants

Background: Nearly 95% of the US health expenditures are directed toward medical care, despite evidence suggesting that almost half of population health is accounted for by social determinants of health (SDOH). SDOH are non-biological social, economic, and physical conditions that affect physical and emotional health status and that disproportionately impact racial and ethnic minority youth. Limited data are available regarding SDOH for Latino adolescents. The current study evaluated the relationship of SDOH and self-reported physical health, health behaviors, and emotional health for Latino adolescents.

Methods: Data were drawn from the baseline (1998-2000) and 15-year follow up (2014-2017) waves of the Fragile Families and Child Well-being Study, a nationally representative study of primarily single mothers and their newborns in large US cities. Data were collected through in-home and telephone interviews. Inclusion criteria were all youth with Latina mothers (N = 748) who participated in the 15-year follow up. Dependent variables included youth’s self-reported health, measured on a 5-point Likert scale (1 = poor; 5 = excellent); health behaviors, which measured eating habits and physical activity (range = 18-47; 47 indicated most positive behaviors), and emotional well-being (range = 36-112; 112 indicated highest well-being). Predictors included demographic data and SDOH, including neighborhood closeness and safety, socioemotional well-being, belongingness and interactions at school, and income per household member. Ordinal regression analysis was conducted to assess predictors of self-rated health. Multiple regression analyses were performed to evaluate predictors of health behaviors and emotional well-being.

Results: Mean scores were 3.93 for self-reported health, 24 for health behaviors, and 43 for emotional well-being. For self-reported health, the overall model (p = .000) accounted for 17.1% of variance in the dependent variable. Predictors included neighborhood safety, school belonging, socioemotional well-being, and relationship with mom. Relationship with mom was the greatest predictor, increasing odds of reporting a higher level of health by .20. For health behaviors, the overall model was significant (F = 10.625, p = .000). Mother’s age, sense of belonging at school, socioemotional well-being, and relationship with mom each emerged as predictors. School belonging was the strongest predictor with those reporting higher belonging having .33 greater likelihood of healthier behaviors. For emotional well-being, the overall model was also significant (F = 32.76, p = .000). Predictors included mom’s age, closeness of neighbors, neighborhood safety, school belonging, socioemotional well-being, and relationship with mom.

Conclusion: Findings build upon existing research with other populations to suggest that SDOH are meaningful for Latino adolescent health and emotional well-being. Specifically, a strong relationship with mother, positive neighborhood characteristics, and a sense of belonging at school may be valuable protective factors for both physical and mental health status. Latino youth can experience health disparities and incidents (e.g., discrimination) that elevate risks of poorer physical and emotional health. This study raises awareness for social work practice with Latino youth and the relevance for future research to examine factors that contribute to building positive family relationships, school belonging, and neighborhood closeness and safety