Mediation of Latinx health status disparities during the COVID-19 pandemic by social determinants of health.

IF 3.6 2区医学 Q1 PSYCHIATRY

Social Psychiatry and Psychiatric Epidemiology Pub Date : 2025-05-05 DOI:10.1007/s00127-025-02890-8

Jorge I Ramírez García, Veronica Oro, Elizabeth L Budd, Anne Marie Mauricio, Stephanie De Anda, Ellen H McWhirter, Leslie D Leve, David S DeGarmo

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引用次数: 0

Abstract

Purpose: The hypothesis that health status disparities exist because of high levels of social disadvantages, the Social Determinants of Health - Health Disparities (SDOH-HD) hypothesis by Ramírez García [1], was investigated among adults (N = 1,833) attending SARS-CoV-2 testing events at 71 community sites.

Methods: A Multilevel Structural Equation Model (CFI = 1.0, SRMRs ≤ 0.03), with cross-sectional self-reported data, operationalized health status with latent individual level and latent community site level variables. At the individual level, health variables met full or partial metric equivalence between participants who answered the survey in Spanish versus in English (CFIs = 0.99, SRMRs ≤ 0.03).

Results: Consistent with the SDOH-HD, high food insecurity and/or low levels of education among Latinxs putatively mediated (abs = 0.01 to 0.08, ps < 0.05) worse individual level general health (Within Level Model R² = 0.10, p <.05) or worse individual level psychological distress (Within Level Model R² = 0.11, p <.05) compared to non-Latinx Whites. However, three SDOH - unemployment, housing instability, and discrimination - did not support the SDOH-HD. Community site level SDOH - social vulnerability, and minority status indices - were not significantly related to site level health status, but site level psychological distress was lower in rural than in urban sites (γ = - 0.39, p <.05).

Conclusion: Taken together, the results delineate that equitable implementation of food security and education interventions may mitigate health status Latinx disparities. The SDOH-HD was partially supported, underscoring the need to investigate further these and additional SDOH-HD pathways.

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健康社会决定因素对COVID-19大流行期间拉丁裔健康状况差异的影响

目的：通过Ramírez García[1]对71个社区站点参加SARS-CoV-2检测活动的成年人（N = 1,833）进行健康状况差异的社会决定因素-健康差异（SDOH-HD）假设，研究健康状况差异的存在是因为社会弱势程度高。方法：采用多层结构方程模型（CFI = 1.0, SRMRs≤0.03），采用横断面自我报告数据，将健康状况与潜在的个体水平和潜在的社区水平变量进行操作。在个体水平上，用西班牙语回答问卷的参与者与用英语回答问卷的参与者之间的健康变量满足完全或部分度量等价（CFIs = 0.99, SRMRs≤0.03）。结果：与SDOH-HD一致，拉丁美洲人的高度粮食不安全和/或低教育水平是推定介导的（abs = 0.01至0.08,ps2 = 0.10, p2 = 0.11, p）。结论：综上所述，结果描述了公平实施粮食安全和教育干预可能减轻拉丁美洲人健康状况的差异。SDOH-HD得到了部分支持，强调了进一步研究这些和其他SDOH-HD途径的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Psychiatry and Psychiatric Epidemiology 医学-精神病学

CiteScore

8.50

自引率

2.30%

发文量

184

审稿时长

3-6 weeks

期刊介绍： Social Psychiatry and Psychiatric Epidemiology is intended to provide a medium for the prompt publication of scientific contributions concerned with all aspects of the epidemiology of psychiatric disorders - social, biological and genetic. In addition, the journal has a particular focus on the effects of social conditions upon behaviour and the relationship between psychiatric disorders and the social environment. Contributions may be of a clinical nature provided they relate to social issues, or they may deal with specialised investigations in the fields of social psychology, sociology, anthropology, epidemiology, health service research, health economies or public mental health. We will publish papers on cross-cultural and trans-cultural themes. We do not publish case studies or small case series. While we will publish studies of reliability and validity of new instruments of interest to our readership, we will not publish articles reporting on the performance of established instruments in translation. Both original work and review articles may be submitted.