Multiple jeopardy, national wealth and perceived discrimination: Subjective health of intersecting minority groups across 28 countries

Objective: Belonging to social minority groups is detrimental for health outcomes, yet it is still unclear how multiple social minority statuses combine in their effect on health and whether perceived discrimination explains this link. Moreover, the moderating role of the societal context on the multiple social minority status-health link has never been tested. The current study employs a comprehensive conceptual framework to better understand the patterns of association between health outcomes and multiple social minority statuses. Methods and measures: Using data from the European Social Survey (N = 53,161 from 28 countries) and multi-level structural equation modelling, the study examines whether older age, female gender and ethnic minority status have additive, exacerbation or inurement effects on subjective health, whether perceived discrimination mediates these relations, and whether national wealth moderates the associations. Results: Old age and female gender, but not ethnicity, were related to adverse health outcomes, especially in poorer countries. Belonging to two, but not three, social minority groups exacerbated health outcomes. Perceived discrimination explained some of the (multiple) social minority status-health links, whereas an ethnicity-related health risk was fully mediated by perceived discrimination. Conclusion: Supporting the idea of intersectionality, different combinations of social minority statuses differ in health outcomes as well as the underlying mechanisms.