Association of Intersectional Anticipated Discrimination with Mental Health Among Immigrant Latinos.

Introduction: Anticipating discrimination can lead to increased vigilance, which acts as a potential stressor similar to actual discrimination experiences. However, there is limited understanding of how discrimination and anticipated discrimination affect Latinos with intersecting identities, particularly those who are immigrants. Using a cross-sectional survey, we examine the association between intersectional anticipated discrimination and mental health among immigrant Latinos.

Methods: We conducted a cross-sectional survey through the Rapid Acceleration of Diagnostics-Underserved Populations initiative (March 2022-May 2023). Participants were foreign-born adults who self-identified as Latino or Hispanic. The exposure measure used the Intersectional Anticipated Discrimination Scale, and outcomes measures included 2-item screens for anxiety (Generalized Anxiety Disorder screener [GAD-2]) and depression (Patient Health Questionnaire [PHQ-2]) and a 3-item screen for hazardous alcohol consumption (Alcohol Use Disorders Identification Test).

Results: A total of 810 participants completed the survey, of whom 66.7% were uninsured. Among them, 25.2% screened positive for anxiety, 18.1% for depression, and 20.2% for hazardous alcohol consumption. Positive screening for anxiety and depression was associated with higher levels of anticipated discrimination (GAD-2 adjusted odds ratio [AOR] = 1.05, 95% confidence interval [CI]: 1.03, 1.07; PHQ-2 AOR = 1.05, 95% CI: 1.03, 1.07). A dose-response relationship was observed with higher levels of anticipated discrimination and higher PHQ-2 and GAD-2 scores.

Conclusions: Anticipated intersectional discrimination was associated with symptoms of anxiety and depression in immigrant Latinos. Prioritizing culturally competent care that recognizes the heterogeneity of the Latino population, enhancing community support, and implementing targeted policy interventions are imperative steps toward promoting mental health equity among this population.