SOCIAL DETERMINANTS OF HEALTH AND RACIAL AND ETHNIC MINORITY AND AI/AN MENTAL HEALTH
The relationship between social determinants of health (SDOH) and health disparities and inequities is complex and multilayered. SDOH are the conditions in which people are born, grow, learn, work, play, live, and age, and the wider set of structural factors shaping the conditions of daily life. Health disparities are the preventable differences in burden of disease, injury, violence, and opportunities to achieve optimal health experienced by socially disadvantaged groups. Health disparities are often the result of or exacerbated by intersecting SDOH factors.
Racial and ethnic minority and American Indian/Alaska Native (AI/AN) populations experience a range of mental health disparities including higher rates of attempted suicide in adolescents and lower treatment rates for mental disorders like depression in adults. Facing racial discrimination, living through a natural disaster, experiencing poverty, and having limited access to mental health care services are all examples of SDOH factors that can worsen mental health disparities for racial and ethnic minority and AI/AN people.
SDOH can be grouped into five domains. Click on the headings below to learn about the five SDOH domains and the role they play in mental health outcomes for racial and ethnic minority and AI/AN populations, as well as suggested reading curated by the OMH Knowledge Center librarians. The resources in this list are available to read and download for free. For more resources on the health of racial and ethnic minority populations, please visit the OMH Knowledge Center online catalog.
ECONOMIC STABILITY
Economic stability refers to having a steady income and enough resources to meet basic needs such as food, housing, health care, and transportation. People with economic stability are more likely to have good health outcomes, while those who are struggling financially are more likely to experience increased stress and mental health problems.
- Associations Between Depression and Diabetes Among Latinx Patients from Low-Income Households in New Mexico. Erhardt, E., Murray-Krezan, C., Regino, L., Perez, D., Bearer, E. L., et al. Social Science & Medicine, v. 320 (March): Art. 115713, 2023.
- The Economic Burden of Mental Health Inequities in the United States Report. Satcher Health Leadership Institute, satcherinstitute.org, 2022.
- Economic and Psychosocial Impact of COVID-19 in the Hispanic Community Health Study/Study of Latinos. Isasi, C. R., Gallo, L. C., Cai, J., Gellman, M. D., Xie, W., et al. Health Equity, v. 7, #1 (March 27), pp. 206–215, 2023.
- Household Food Insufficiency, Financial Strain, Work-Family Spillover and Depressive Symptoms in the Working Class: The Work, Family, and Health Network Study. Okechukwu, C. A., El Ayadi, A. M., Tamers, S. L., Sabbath, E. L., and Berkman, L. American Journal of Public Health, v. 102, #1 (January), pp. 126–133, 2012.
- Unconditional Cash Transfers and Mental Health Symptoms Among Parents with Low Incomes: Evidence from the 2021 Child Tax Credit. Kovski, N., Pilkauskas, N. V., Michelmore, K., and Shaefer, H. L. SSM – Population Health, v. 22 (June): Art. 101420, 2023.
EDUCATION ACCESS AND QUALITY
Access to educational resources and quality education plays a significant role in health. Education equips individuals with the knowledge and skills to understand health information and make informed decisions about their health and the healthcare system.
- Adolescent Feelings on COVID-19 Distance Learning Support: Associations with Mental Health, Social-Emotional Health, Substance Use, and Delinquency. Kwaning, K., Ullah, A., Biely, C., Jackson, N., Dosanjh, K. K., et al. Journal of Adolescent Health, v. 72, #5 (May), pp. 682-687, 2023.
- Lessons from Black Colleges on Mental Health and Wellbeing: Practical Approaches for Historically Black Colleges and Universities to Support Student Belonging and Mental Health. Active Minds, activeminds.org, 2023.
- Measuring the Lifetime Costs of Serious Mental Illness and the Mitigating Effects of Educational Attainment. Seabury, S. A., Axeen, S., Pauley, G., Tysinger, B., Schlosser, D., et al. Health Affairs, v. 38, #4 (April) pp. 652–659, 2019.
- A Roadmap to Equitable School Mental Health Screening. Moore, S., Long, A. C. J., Coyle, S., Cooper, J. M., Mayworm, A. M., et al. Journal of School Psychology, v. 96 (February), pp. 57–74, 2023.
- A Trauma- and Justice, Equity, Diversity, and Inclusion (JEDI)-Informed Approach to Suicide Prevention in School: Black Boys’ Lives Matter. Marraccini, M. E., Lindsay, C. A., Griffin, D., Greene, M. J., Simmons, K. T., et al. School Psychology Review, v. 52, #3 (January 28), pp. 292–315, 2023.
HEALTH CARE ACCESS AND QUALITY
Health care access and quality of care is a fundamental social determinant of health. Geographic proximity, affordability, and availability of health care providers all influence how easily people can get the care they need. Approximately 10% of the U.S. population does not have health insurance, which can prevent individuals from seeking out mental health care services. Difficulty navigating the healthcare system and lack of culturally and linguistically appropriate care providers can also affect access to quality mental health care.
- Access to Virtual Mental Healthcare and Support for Refugee and Immigrant Groups: A Scoping Review. Hynie, M., Oda, A., Calaresu, M., Kuo, B. C. H., Ives, N., et al. Journal of Immigrant and Minority Health, v. 25, #5 (July 5), pp. 1171–1195, 2023.
- Investigating the Potential Double-Edged Score of Immigration-Related Stress, Discrimination, and Mental Health Access. Andrews, A. R., Escobar, K., Gonzalez, S. M. E., Reyes, S., and Acosta, L. M. International Journal of Environmental Research and Public Health, v. 21, #3 (March 20), p. 373, 2024.
- Mental Health Care Access Among Arab Immigrants in the United States: Application of Public Arena Model. Shaimaa, E., and Bialous, S. Community Mental Health Journal, v. 60, #2 (February), pp. 376–384, 2024.
- Racial and Ethnic Disparities in Access to Community-Based Perinatal Mental Health Programs: Results from a Cross-Sectional Survey. Rokicki, S., Patel, M., Suplee, P. D., & D'Oria, R. BMC Public Health, v. 24, #1 (April 20): Art. 1094, 2024.
- Structural Racism and Health: Assessing the Mediating Role of Community Mental Distress and Health Care Access in the Association Between Mass Incarceration and Adverse Birth Outcomes. Larrabee Sonderlund, A., Williams, N. J., Charifson, M., Ortiz, R., Sealy-Jefferson, S., et al. SSM – Population Health, v. 24 (December): Art. 101529, 2023.
NEIGHBORHOOD AND BUILT ENVIRONMENT
Neighborhoods play a key role in good mental health. Where you live can significantly impact your physical and mental health. Unfortunately, racial and ethnic minority populations and low-income residents are more likely to live in neighborhoods with higher health risks.
- Examining Place-Based Neighborhood Factors in a Multisite Peer-Led Healthy Lifestyle Effectiveness Trial for People with Serious Mental Illness. Salvo, D., Resendiz, E., Stefancic, A., and Cabassa, L. J. International Journal of Environmental Research and Public Health, v. 20, #9 (May): Art. 5679, 2023.
- Exploring the Association Between Structural Racism and Mental Health: Geospatial and Machine Learning Analysis. Mohebbi, F., Forati, A. M., Torres, L., deRoon-Cassini, T. A., Harris, J., et al. JMIR Public Health and Surveillance, v. 10 (May 3): Art. e52691, 2024.
- The Impact of Residential Greenness on Psychological Distress Among Hurricane Katrina Survivors. Burrows, K., Fong, K. C., Lowe, S. R., Fussell, E., and Bell, M. L. PLoS One, v. 18, #5 (May 11): Art. e0285510, 2023.
- Overcrowded Housing Reduces COVID-19 Mitigation Measures and Lowers Emotional Health Among San Diego Refugees from September to November of 2020. Hassani, A., Omaleki, V., Erikat, J., Frost, E., Streuli, S., et al. PLoS One, v. 18, #6 (June 20): Art. e0286993, 2023.
- Perceived Neighborhood Environment Walkability and Health-Related Quality of Life Among Predominantly Black and Latino Adults in New York City. Zhu, J., Kodali, H., Wyka, K. E., and Huang, T. T. BMC Public Health, v. 23 (January 18): Art. 127, 2023.
SOCIAL AND COMMUNITY CONTEXT
Social connections matter. Relationships with family, friends, and community provide support, reduce stress, and influence healthy behaviors. Strong social connections and a sense of belonging within a community foster well-being. Discrimination, unsafe neighborhoods, and lack of resources can hinder getting the social support needed for good physical and mental health.
- "Abrazame Que Ayuda" (Hug Me, It Helps): Social Support and the Effect of Perceived Discrimination on Depression Among US- and Foreign-Born Latinxs in the USA. Garcini, L. M., Chen, M. A., Brown, R., LeRoy, A. S., Cano, M. A., et al. Journal of Racial and Ethnic Health Disparities, v. 7, #3 (June), pp. 481–487, 2020.
- Acculturative Stress and Depressive Symptoms Among Chinese Immigrants: The Role of Gender and Social Support. Fang, C. Y., Handorf, E. A., Rao, A. D., Siu, P. T., and Tseng, M. Journal of Racial and Ethnic Health Disparities, v. 8, #5 (October), pp. 1130–1138, 2021.
- Demographic, Social, and Mental Health Aspects of American Indian and Alaska Native Adolescents in Hawai'i. Munnelly, S. M., Hishinuma, E. S., Lee, M., Smith, M. D., and McCarthy, K. American Indian and Alaska Native Mental Health Research, v. 25, #2, pp. 20–53, 2018.
- Relationships Among Organ Damage, Social Support, and Depression in African American Women with Systemic Lupus Erythematosus. Jordan, J., Thompson, N. J., Dunlop-Thomas, C., Lim, S. S., and Drenkard, C. Lupus, v. 28, #2 (February), pp. 253–260, 2019.
- Social Support and Self-Coping of Depressed African-American Cancer Patients. Gary, F., Li, R., Zhu, H., Zhang, A. Y., and Killion, C. Journal of the National Black Nurses Association (JNBNA), v. 27, #2 (December), pp. 11–19, 2016.