Early Findings of Mental Health Disparities Research Among Hispanic/Latina Women

Background/Purpose: As the largest ethnic-minority group in the U.S., Hispanics/Latinos are disproportionately impacted by the structural and social conditions that shape health, commonly referred to as social determinants of health (SDoH). In this project, we leveraged the “weathering” framework to concretely link SDoH to health via allostatic load, which comprises the cumulative effects of chronic and repeated exposure to structural stressors (e.g., historical and generational trauma) among historically racialized and marginalized groups. Mental health disorders, such as depression, affect Hispanic/Latino women at twice the rate of men. In addition, previous research indicates heterogeneity in health outcomes across Latino/Hispanic subgroups. These differentials are shaped by fixed (e.g., ethnicity, race, acculturation, and nativity) and dynamic (e.g., employment, education, and healthcare access) factors at all socioecological levels.

Methods: Using the NIH’s All of Us Research Program, we examined the following three specific aims in a sample of Hispanic/Latino women (N=8,002): 1) the relationship between SDoH and mental health (depression and anxiety); 2) associations between SDoH and allostatic load index (ALI); and 3) whether ALI mediates SDoH’s effects on mental health. Our SDoH constructs included sociodemographic information, social context measures, and lived experience measures. For Aim 1, we conducted multiple logistic regressions; in Aim 2, we calculated the ALI by summing the number of relevant biomarkers falling in the sample-specific highest-risk quartile and performed negative binomial logistic regressions. Finally, in Aim 3, we conducted causal mediation analysis to test the mediating role of ALI. For Aims 2 and 3, we also added an interaction term between Hispanic/Latino ethnic group and ALI, to see if and how stress response manifests differently across within-group Hispanic/Latino ethnic origins.

Results: For Aim 1, we found that being U.S.-born, unmarried, using tobacco, and experiencing housing and food insecurity were consistently associated with increased odds of having depression and anxiety disorders. Having health insurance was also associated with higher odds of depression and anxiety, potentially due to better access to diagnostic services (e.g., for participants of the All of Us Research Program). Findings suggested that positive social context was associated with lower odds of depression; and negative lived experiences were associated with higher odds of both depression and anxiety. Results for Aims 2 and 3 are expected to be finished by June 2025, per funding grant’s requirements.

Conclusions and Implications: Our preliminary results were consistent with prior studies of Hispanic/Latino populations. Hispanic/Latino women with fewer sources of social support and experiencing increased precarity are more susceptible to mental health challenges. Since Hispanics/Latinos also make up roughly half of all immigrants in the U.S., this research may have critical implications for immigrant health given immigrants’ vulnerability and resource scarcity. Our analysis in Aims 2 and 3 will deepen our understanding of the specific impact of chronic stress exposure (as measured by ALI) on mental health, and further support advocacy for social work practices that address comprehensive social conditions that affect health.