Social and environmental adversity predict poor mental health in a Milwaukee, WI community sample

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-03-27 DOI:10.1016/j.socscimed.2025.118015

C.W. Tomas , S. Timmer-Murillo , K. Vine , J. Krukowski , S. Purdle , J. Janusiak , J.R. Mantsch , L. Torres , J. Harris , T.A. deRoon-Cassini

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引用次数: 0

Abstract

Racism functions as a system of continued devaluation, disempowerment, and inequitable allotment driven by racial hierarchy. Operating at multiple levels – individual, interpersonal, community, and societal – racism perpetuates significant mental and physical health disparities. Though evidence evinces the impact of racism across domains, few studies have assessed factors rooted in structural racism simultaneously and how they relate together to predict outcomes. The current study examines how racism impacts the mental health (MH) of Black Americans adults across multiple levels. Risk and protective factors were analyzed to understand the collective impact of racism in this population. Black adults (N = 400) in Milwaukee, WI completed a battery of surveys assessing demographic, mental health, behavioral health, physical/built environment, sociocultural environment, healthcare, and neighborhood context. Bivariate analyses, exploratory factor analyses (EFA), and general linear modeling were conducted, with anxiety, depression, and post-traumatic stress symptoms (PTSS) as outcomes. Participants (M = 43.8 years; 86.1 % earning <$40,000 annually) exhibited elevated depression, anxiety, and PTSD risk. All three mental health outcomes were positively correlated with alcohol/drug use, pain, exposure to violence, housing insecurity, racism-related vigilance, ethnic discrimination, and everyday discrimination while neighborhood social cohesion was negatively correlated. Depression was negatively correlated with social support (p < .05). EFA produced three factor clusters: Social & Environmental Adversity (SEA), Psychosocial Resilience (PR), and Substance Use (SU). SEA and SU were strongly and positively related to all MH outcomes (p < .001) but PR was not. Socioecological frameworks provide a more comprehensive method to evaluate the impact of racism and identify and address mental health disparities. In the current study, results showed that social and environmental factors predicted poor mental health and highlight a need to understand these factors collectively to inform intervention.

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社会和环境逆境预测在密尔沃基，WI社区样本不良心理健康

种族主义是一种由种族等级驱动的持续贬值、剥夺权力和不公平分配的制度。种族主义在个人、人际、社区和社会等多个层面上运作，使重大的身心健康差距永久化。尽管有证据表明种族主义的影响是跨领域的，但很少有研究同时评估植根于结构性种族主义的因素，以及它们如何相互关联以预测结果。目前的研究考察了种族主义是如何在多个层面上影响美国黑人成年人的心理健康的。分析了风险和保护因素，以了解种族主义在这一人群中的集体影响。威斯康星州密尔沃基市的黑人成年人（N = 400）完成了一系列调查，评估人口统计、心理健康、行为健康、物理/建筑环境、社会文化环境、医疗保健和社区环境。以焦虑、抑郁和创伤后应激症状（PTSS）为结局，进行双变量分析、探索性因素分析（EFA）和一般线性建模。参与者(M = 43.8岁；86.1%（年收入4万美元）表现出抑郁、焦虑和创伤后应激障碍的风险升高。所有三项心理健康结果与酒精/药物使用、疼痛、暴力暴露、住房不安全、种族主义相关警惕性、种族歧视和日常歧视呈正相关，而社区社会凝聚力呈负相关。抑郁与社会支持呈负相关(p <；. 05)。全民教育产生了三个因素集群：社会；环境逆境（SEA），社会心理弹性（PR）和物质使用（SU）。SEA和SU与所有MH结果呈显著正相关(p <；.001)，但PR不是。社会生态框架提供了一种更全面的方法来评估种族主义的影响，并确定和解决心理健康差异。在目前的研究中，结果表明，社会和环境因素预示着不良的心理健康，并强调需要了解这些因素，以告知干预措施。

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.