Ethnicity & Health最新文献

{"title":"Socioeconomic factors and mental health among young Asian adults in the United States.","authors":"Juliann Li Verdugo, Todd Nobles, Jerald R Herting, Jane J Lee, David T Takeuchi","doi":"10.1080/13557858.2025.2600274","DOIUrl":"10.1080/13557858.2025.2600274","url":null,"abstract":"<p><strong>Objectives: </strong>Rates of anxiety and depression have risen among Asian adults in the U.S., and sociodemographic factors such as immigration, financial hardship, and parental education are associated with different health outcomes. However, less is known about mental health by these indicators. While many affective disorders present between young adulthood (ages 18-29), research on this developmental period among Asian adults is scant. Since more than half of all Asian Americans are enrolled in some form of higher education during this age range, colleges and universities are meaningful settings to investigate social factors associated with mental health outcomes among young Asian adults.</p><p><strong>Design: </strong>Secondary data were analyzed examining a large sample of young Asian students (n = 8,669) who participated in the 2022-2023 Healthy Minds Study (HMS), which is a national survey evaluating mental health among enrollees in higher education. Multivariable logistic regressions were conducted to evaluate differences in anxiety and depression by citizenship status, financial hardship, and highest level of parental education obtained, adjusting for age, ethnic subgroup, sexual orientation, and sex.</p><p><strong>Results: </strong>The mean age of respondents was 21.3 years (SD = 2.9) and most participants identified as female (70%, n = 6,064). Roughly one quarter of participants (27%, n = 2,365) reported not holding U.S. citizenship. Depression and anxiety were high among the sample overall, with symptoms being greater for those with more financial hardship. Regarding immigrant status, U.S. citizens had higher odds of meeting criteria for both clinical depression and anxiety compared to those without U.S. citizenship. Mixed findings were found regarding parental education and affective symptoms.</p><p><strong>Conclusion: </strong>Findings support the need to prioritize social determinants of health such as basic needs and financial resources in mental health service delivery for Asian communities in the U.S. More research is also needed to better understand how to assess and promote mental wellbeing among diverse young Asian immigrants.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"39-59"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applying the PEN-3 cultural model to explore and improve cancer survivorship in Black and Latinx people in the US.","authors":"Candidus Nwakasi, Darlingtina Esiaka, Korijna Valenti, Neke Nsor, Collins Airhihenbuwa","doi":"10.1080/13557858.2025.2575345","DOIUrl":"10.1080/13557858.2025.2575345","url":null,"abstract":"<p><strong>Background: </strong>Culture is important as it influences how survivors navigate micro (e.g. interpersonal relationships, social networks) and macro systems (e.g. healthcare system, society) in their everyday lives. This study applied a sociocultural lens, using the PEN-3 cultural model, to explore experiences of Black and Latinx cancer survivors and their families with the aim of identifying recommendations to improve cancer survivorship experience.</p><p><strong>Methods: </strong>We used qualitative descriptive design. A total of 17 (4 men and 13 women) cancer survivors 50 years or older (Mean age = 63.9 years) were interviewed using a semi-structured interview guide. Afterwards, we conducted six focus group discussions (three Latinx and three Black groups) with a total of 33 caregivers of cancer survivors (Mean age = 63 years). All interviews were audio recorded, transcribed verbatim, and analyzed using a hybrid of inductive-deductive thematic analysis.</p><p><strong>Results: </strong>Three themes were identified from the analysis: Two of the themes were labeled using the PEN-3 cultural model categories; (1) relationships and expectations influencing survivorship experience, (2) cultural empowerment and cancer survivorship. The third theme represents the improvement recommendations provided by the participants; (3) recommendations for improving survivorship.</p><p><strong>Discussion: </strong>The findings of this study will add to a body of knowledge on using a cultural lens to deepen our understanding cancer survivorship inequities and may inform culturally tailored cancer survivorship interventions in Black and Latinx communities.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"913-931"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superwoman schema and perceived stress among Black women: a latent profile analysis.","authors":"Tamara Nelson, Linda A Oshin, Naysha N Shahid, Ramya Ramadurai","doi":"10.1080/13557858.2025.2553185","DOIUrl":"10.1080/13557858.2025.2553185","url":null,"abstract":"<p><p>Understanding how Superwoman Schema (SWS) dimensions cluster may be key to exploring how this phenomenon varies among Black women. In this study, we identified profiles of Superwoman Schema in a sample of 167 Black women (M_age = 22). We also determined if distinct profiles of Superwoman Schema dimensions predicted perceived stress. Using latent profile analysis, we detected a 4-class solution: Guarded Caregivers (high emotional suppression, resistance to vulnerability, and obligation to help others); Authentically Unburdened (lowest average on all SWS dimensions); Reluctant Superwoman (mid-range adherence to SWS dimensions with a strong sense of the obligation to help others); and Resilient Caregivers (high desire to present strength and a strong sense of the obligation to help others). The Guarded Caregiver profile had the highest perceived stress scores compared to all other profiles. There were no significant differences between profile groups and sociodemographics. Findings suggest that Black women who are high in adherence to emotional suppression, resistance to vulnerability, and obligatory helping may be more likely to experience elevated stress. Thus, interventions to reduce stress should promote emotional expression, foster help-seeking behaviors, and challenge the need for self-sacrifice at the expense of personal well-being.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"898-912"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity in adverse childhood experiences and heart disease among U.S. Black Women and Men.","authors":"Ryan D Talbert, Raja Staggers-Hakim, Jolaade Kalinowski","doi":"10.1080/13557858.2025.2575341","DOIUrl":"10.1080/13557858.2025.2575341","url":null,"abstract":"<p><strong>Objectives: </strong>Exposure to adverse childhood experiences (ACE) accounts for up to 1.9 million heart disease cases. This study extends research by examining the association between heart disease and four-forms of ACE heterogeneity (i.e. counts, scores, clusters, and individually) among Black men and women.</p><p><strong>Design: </strong>Data come from the 2019-2022 Behavioral Risk Factor Surveillance System's ACE supplement (n = 30,746). Latent class analysis of eleven ACEs - verbal, physical, or sexual abuse; experiencing divorced parents, rape, or sexual coercion; or living in a household with domestic violence, imprisonment, drug use, alcohol abuse, or mental illness - identified seven-classes. Multiple gender-stratified binary logistic regressions estimated adjusted odds of heart disease based on ACE counts, scores, individual events, and the seven-classes, which reflected: (1) domestic violence and alcohol abuse, (2) sexual violence, (3) abusive parents, (4) universal ACEs, (5) non-sexual ACEs, (6) few ACEs, and (7) household imprisonment/substance abuse.</p><p><strong>Results: </strong>Odds of heart disease were higher for women and men with more ACE exposures (i.e. counts and universal-ACEs classification), and when exposed specifically to sexual violence, household drug use, and mental illness. Exceeding the threshold of two-plus ACEs increased odds of heart disease for women but not men. Women's and men's odds of heart disease were higher when experiencing physical/verbal abuse and household imprisonment, respectively.</p><p><strong>Conclusion: </strong>ACE heterogeneity factors into heart disease patterns for Black men and women with important implications for intersectional screening, intervention, and the advancement of health equity.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"983-999"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How community engaged practices are applied in interventions promoting human papillomavirus (HPV) vaccination for culturally and linguistically diverse (CALD) children and adolescents: a systematic review.","authors":"Kathleen Prokopovich, Annette Braunack-Mayer, Lyn Phillipson","doi":"10.1080/13557858.2025.2573914","DOIUrl":"10.1080/13557858.2025.2573914","url":null,"abstract":"<p><strong>Background: </strong>Effective vaccines for human papillomavirus (HPV) are readily available but culturally and linguistically diverse (CALD) communities experience vaccination disparities. Whilst community engaged (CE) practices are recommended, we know little about this practice in local settings.</p><p><strong>Aim: </strong>We aim to compare CE practices within HPV vaccination interventions targeting CALD children aged 9-17 years and identify how CE elements are linked to outcomes.</p><p><strong>Method: </strong>Included interventions targeted vaccine eligible CALD children, their parents/caregivers, or health professionals servicing CALD populations. We searched six databases for studies published between 2006 and April 2024. We critically appraised included studies, and data was synthesised based on a CE health framework.</p><p><strong>Results: </strong>We screened 3798 articles to identify 22 studies. Interventions were based in the United States (USA) and targeted nine different CALD communities. CE practice varied across interventions. All CE practices improved vaccine knowledge, but only multi-component, peer-led/delivered CE practice improved series completion. We note several confounders and analysis limitations.</p><p><strong>Discussion: </strong>Most CE approaches were initiated by health services rather than the local community. All interventions were limited by study bias and reporting details. We experienced difficulties linking CE practice to intervention outcomes, highlighting tensions between health service driven CE and community empowered CE practices.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"954-982"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'<i>If I Were White</i>': a qualitative analysis of the experiences of minoritized ethnic groups with systemic autoimmune rheumatic diseases in the United Kingdom.","authors":"Sydnae A Taylor, Mandeep Ubhi, Shaista Tayabali, Rakesh Narendra Modi, Arvind Kaul, Abigail Taiwo, Kaira Naidu, Martha A Piper, Muna Abdullah, Wendy Diment, Elaine Dunbar, James Cantwell, David D'cruz, Melanie Sloan","doi":"10.1080/13557858.2025.2575343","DOIUrl":"10.1080/13557858.2025.2575343","url":null,"abstract":"<p><strong>Background: </strong>In the United Kingdom (UK), individuals of minoritized ethnic groups report poorer healthcare experiences and face disparities in health outcomes and access to healthcare services relative to their White counterparts. While it has been demonstrated that sociodemographic characteristics play important roles in the risk of developing rheumatic diseases, disease progression, and treatment journeys, there is limited understanding of the experiences of minoritized ethnic groups in the UK. This study aimed to investigate how the social and structural processes associated with ethnicity affect the medical experiences of people with systemic autoimmune rheumatic diseases in the UK.</p><p><strong>Design: </strong>Qualitative data were collected between 2023 and 2025 through semi-structured interviews with <i>N</i> = 29 (36% South Asian, 86% female) patients and <i>N</i> = 16 (81% White, 50% female) clinicians. Analysis was thematic and involved immersion in the data, coding using NVivo, and discussion of themes with a multidisciplinary team including patient partners.</p><p><strong>Results: </strong>Interviews generated three main themes: (1) subtle and systemic racism in care and society, (2) racialized medical and behavioural stereotyping, and (3) socio-cultural factors impacting doctor-patient communication and rapport building. Throughout each theme, participant recommendations for improving care were raised.</p><p><strong>Conclusions: </strong>Our study demonstrated that the socio-structural processes related to ethnicity, namely racism, social deprivation, stereotyping and institutional bias, impact the medical experiences of SARDs patients in multitudinous ways. Some patients reported systemic and interpersonal racism, racialized stereotyping, and mistrust in care, while others listed factors that they considered were protective against discrimination, such as education and location. Socio-cultural factors, including language barriers and variations in clinician understandings of patient experiences, further impact doctor-patient interactions.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"932-953"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of healthcare utilization by older refugees in the United States: a modified Andersen Behavioral Model approach.","authors":"Muna Saleh, Hyojin Im, Kyeongmo Kim, Denise Burnette","doi":"10.1080/13557858.2025.2573919","DOIUrl":"10.1080/13557858.2025.2573919","url":null,"abstract":"<p><strong>Background and objectives: </strong>The global rise in aging populations intersects with increasing rates of forced displacement and chronic illness, prompting an urgent need to integrate older refugees into national healthcare systems. Health service use is a key means of decreasing health disparities and improving health equity, particularly among individuals with chronic illness. Yet little is known about the factors that shape healthcare use among older refugees in the US. This study uses nationally representative data to examine primary care visits among older refugees resettled between 2015 and 2019.</p><p><strong>Design and methods: </strong>Using data from the 2020 Annual Survey of Refugees, we applied Andersen's Modified Behavioral Model of Health Service Use to examine the association of migration-related predisposing, enabling, and need factors with having a routine physical exam during the past year. Migration-specific variables included post-migration stressors, ethnic density, and arrival cohort. We conducted hierarchical logistic regression to evaluate the relative influence of each factor category, entering predisposing factors first, followed by enabling and need factors.</p><p><strong>Results and discussion: </strong>Primary care use was significantly associated with race, religion, insurance coverage, education, and English proficiency. Muslim identity was a strong predictor, and Asian and Black refugees were more likely than White refugees to have had a physical exam. Both higher education and lower English proficiency were linked to increased use of primary care.</p><p><strong>Implications: </strong>Findings highlight key determinants of healthcare utilization and suggest a need for targeted interventions to improve older refugees' use of health services. Notably, need-based health variables were not significantly linked to exam completion. Expanding insurance, education, culturally responsive care, and community-based interventions could enhance access. Future research should incorporate administrative health data and qualitative methods to address survey limitations and explore within-group differences in healthcare utilization.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"881-897"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rooted in identity: racial centrality buffers the effects of chronic stress on suicide outcomes among Black Americans.","authors":"Sean Darling-Hammond, Ángela Gutiérrez, Cindy Le, Christy Bryana Atangana, Courtney Thomas Tobin","doi":"10.1080/13557858.2025.2552210","DOIUrl":"10.1080/13557858.2025.2552210","url":null,"abstract":"<p><strong>Objectives: </strong>Black Americans have experienced a rapid rise in suicidal ideation, plans, and attempts, yet little research has examined whether chronic stress, a well-established driver of mental health disparities, contributes to these suicide outcomes. Chronic stress refers to the persistent, cumulative burdens of daily life shaped by structural racism, making it particularly harmful for Black Americans. Social stress theory emphasizes the importance of psychosocial resources in mitigating the effects of chronic stress. Racial centrality is a culturally grounded measure of racial identity that is related to myriad mental health outcomes. We review data from 627 Black adults in the Nashville Stress and Health Study to ascertain relationships between chronic stress, racial centrality, and suicide outcomes among Black Americans and evaluate whether racial centrality might serve as a buffer against suicide.</p><p><strong>Design: </strong>An analysis of variance test (ANOVA) explored whether racial centrality was related to chronic stress. Weighted logistic regressions predicted suicide outcomes as a function of chronic stress, racial centrality, and the interaction of the two.</p><p><strong>Results: </strong>Racial centrality was negatively associated with chronic stress. Suicide outcomes were predicted by chronic stress. Racial centrality served as a buffer, negatively moderating the relationship between chronic stress and suicide.</p><p><strong>Conclusion: </strong>These findings underscore chronic stress as a critical, understudied risk factor for Black suicide outcomes and highlight racial centrality as a culturally meaningful protective factor with implications for identity-affirming prevention strategies.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"845-862"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The determinants of psychological distress and wellbeing among people of African descent living in Western Australia: evidence from a statewide health and wellbeing survey.","authors":"Emmanuel Badu, Fadzai Chikwava, Gemma Crawford, Roanna Lobo, Marshall Makate, Yun Zhao","doi":"10.1080/13557858.2025.2573918","DOIUrl":"10.1080/13557858.2025.2573918","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, there are renewed efforts to improve mental health and wellbeing of migrants. However, lack of policy relevant research including subgroup analysis to understand the determinants of migrants' mental health and funding availability is impeding the roll out of effective interventions. This study examined factors associated with psychological distress and wellbeing among people of African descent living in Western Australia (WA).</p><p><strong>Methods: </strong>The study involved analysis of cross-sectional survey data sourced from the WA Health and Wellbeing Surveillance System from 2007 to 2021. Bivariable and multivariable logistic regression models, adjusted for survey design, were fitted to examine factors associated with psychological distress and wellbeing among the African population in WA.</p><p><strong>Results: </strong>The multivariable analysis showed, living with a disability or long-term illness (OR = 4.25 95% CI 2.11-8.54) or living with other family member with a disability (OR = 2.18 95% CI 1.21, 3.91), and experiences of 2 (OR = 3.82 95% CI 1.85, 7.90) or 3 or more stressful events (OR = 6.60 95% CI 3.42, 12.75) were strongly associated with psychological distress. Poor emotional wellbeing was strongly associated with never married status (OR = 1.80 95% CI 1.05, 3.09), living with a disability or long-term illness (OR = 2.60 95% CI 1.44, 4.70) or living with other family member with a disability (OR = 2.10 95% CI 1.31, 3.38), experiences of stressful events [1 stressful event, OR = 1.93 95% CI 1.28, 2.93; 2 stressful events, OR = 2.18 95% CI 1.29, 3.68; 3 or more stressful events, OR = 8.32 95% CI 5.10, 13.59], and being unemployed (OR = 1.60 95% CI 1.01, 2.54).</p><p><strong>Conclusion: </strong>Among people of African descent living in WA, psychological distress was associated with disability or long-term illness, and stressful major life events. Emotional wellbeing was associated with marital status, disability or long-term illness, stressful major events and employment status. These findings provide support for tailored mental health initiatives for migrant communities in WA.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"863-880"},"PeriodicalIF":2.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimorbidity and depression severity among Black populations in the United States: an intersectionality approach.","authors":"Bosede O Adejugbe, Jacob W Mobolaji","doi":"10.1080/13557858.2025.2544115","DOIUrl":"10.1080/13557858.2025.2544115","url":null,"abstract":"<p><strong>Objectives: </strong>Multimorbidity, otherwise referred to as multiple chronic conditions (MCCs), is defined as the presence of two or more chronic conditions and has been linked to an increased risk of depression in many parts of the world. Disadvantaged social identities potentially play an important role in shaping this association. However, these associations are poorly understood in situations of multiple disadvantaged social identities, especially among Black populations in the United States of America. This study examined the association between multimorbidity and depression severity among Black populations in the United States using the intersectionality approach.</p><p><strong>Design: </strong>This study utilized IPUMS-NHIS datasets from 2009 to 2019. A weighted sample of 5,745 respondents aged 18 years and above was extracted from the data and analyzed using multinomial logistic regression models.</p><p><strong>Results: </strong>The study found that although multimorbid individuals had a higher risk of severe depression (RRR = 1.93; <i>p</i> < 0.001; 95% CI:1.58-2.35), there are variations by individual's social identities. The risk was higher among Black Americans (RRR = 2.40; <i>p</i> < 0.001; 95% C.I = 1.89-3.07) with MCCs compared to Black immigrants; and among females (RRR = 2.73; <i>p</i> < 0.001; 95% C.I = 2.11-3.54) and unemployed (RRR = 2.69; <i>p</i> < 0.001; 95% C.I = 2.07-3.51) compared to their male and employed counterparts, respectively. Those with multiple disadvantaged social identities yet had MCCs, especially, unemployed Black American females (RRR = 3.43; <i>p</i> < 0.001; 95% C.I = 2.54-4.63) and males who were unemployed (RRR = 2.02; <i>p</i> < 0.05; 95% C.I = 1.42-2.87) had elevated risk of experiencing severe depression compared to those who had no MCCs and Black immigrants.</p><p><strong>Conclusion: </strong>The findings suggest the need to focus attention on the complex effects of multiple disadvantaged social identities in shaping mental health outcomes, particularly among individuals experiencing chronic health conditions.</p>","PeriodicalId":51038,"journal":{"name":"Ethnicity & Health","volume":" ","pages":"787-805"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}