Intersectional discrimination and mental health inequalities: a qualitative study of young women’s experiences in Scotland
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SUBMITTER: Tinner L
PROVIDER: S-EPMC10903064 | biostudies-literature | 2024 Jan
REPOSITORIES: biostudies-literature
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Project description:IntroductionGendered racism against Asian American women has become an increasing public health threat in recent years. Although intersectional discrimination (i.e., co-occurring race- and gender-based discrimination) against Asian American women is not new, research on this topic is lacking. The present scoping review sought to explore how Asian American women report experiences of intersectional discrimination through a systematic examination of the current literature. We included studies that explicitly or implicitly discuss intersectional discrimination. We also aimed to identify indicators of psychological wellbeing and coping associated with these experiences.MethodsFollowing PRISMA Guidelines for Systematic Scoping Reviews, database searches were conducted for peer-reviewed articles. A total of 1,476 studies were title- and abstract-screened by two independent reviewers. Then, 148 articles were full-text screened for eligibility.ResultsA final sample of 23 studies was identified (15 qualitative and 8 quantitative). Only nine of the included studies explicitly used an intersectional framework. Results from qualitative studies revealed that Asian American women experience intersectional discrimination through fetishization, the ascription of passivity, invalidation through lack of representation and pervasive white beauty ideals, and workplace tokenization and scrutiny. Study findings suggested that Asian American women experience these forms of intersectional discrimination across multiple levels of influence (i.e., internalized, interpersonal, institutional, structural). Findings from both qualitative and quantitative studies also indicated how discrimination, whether explicitly or implicitly intersectional, contributes to adverse mental health outcomes such as body shame, disordered eating, depression, and suicidality. Studies also touched on common coping mechanisms employed by Asian American women when facing or anticipating discrimination, such as avoidance, shifting, proactive coping, and leaning on networks of support. There was a lack of studies using quantitative assessments of intersectional discrimination. Also, most studies did not include disaggregated data by ethnicity, age, sexual identity, religion, socioeconomic status, immigration status, or skin color, all of which are likely to shape their experiences.DiscussionOur scoping review highlights how the marginalization of Asian American women is an urgent threat to their mental wellbeing. These findings are discussed to inform future research, interventions, and policy changes that prevent racialized and gendered violence against Asian American women.
| S-EPMC10008964 | biostudies-literature
Project description:BackgroundPhysical intimate partner violence (IPV) risk looms large for younger women in Bangladesh. We are, however, yet to know the association between their intersectional social locations and IPV across communities. Drawing on intersectionality theory's tenet that interacting systems of power, oppressions, and privileges work together, we hypothesized that (1) younger, lower educated or poor women's physical IPV experiences will be exacerbated in disadvantaged communities; and conversely, (2) younger, higher educated or nonpoor women's physical IPV experiences will be ameliorated in advantaged communities.MethodsWe applied intercategorical intersectionality analyses using multilevel logistic regression models in 15,421 currently married women across 911 communities from a national, cross-sectional survey in 2015. To test the hypotheses, women's probabilities of currently experiencing physical IPV among intersectional social groups were compared. These comparisons were made, at first, within each type of disadvantaged (e.g., younger or poor) and advantaged (e.g., older or nonpoor) communities; and then, between different types of communities.ResultsWhile our specific hypotheses were not supported, we found significant within community differences, suggesting that younger, lower educated or poor women were bearing the brunt of IPV in almost every community (probabilities ranged from 34.0-37.1%). Younger, poor compared to older, nonpoor women had significantly higher IPV probabilities (the minimum difference = 12.7, 95% CI, 2.8, 22.6) in all communities. Similar trend was observed between younger, lower educated compared to older, higher educated women in all except communities that were poor. Interestingly, younger women's advantage of higher education and material resources compared to their lower educated or poor counterparts was observed only in advantaged communities. However, these within community differences did not vary between disadvantaged and advantaged communities (difference-in-differences ranged from - 0.9%, (95% CI, - 8.5, 6.7) to - 8.6%, (95% CI, - 17.6, 0.5).ConclusionsUsing intersectionality theory made visible the IPV precarity of younger, lower educated or poor women across communities. Future research might examine the structures and processes that put them at these precarious locations to ameliorate their socio-economic-educational inequalities and reduce IPV in all communities. For testing hypotheses using intersectionality theory, this study might advance scholarship on physical IPV in Bangladesh and quantitative intersectionality globally.
| S-EPMC8756647 | biostudies-literature
Project description:ObjectivesDiscrimination poses a threat to the mental health of university students, especially those affected by social inequality, yet understanding its intersectional impact remains limited. This study examines the intersection of social inequalities with perceived discrimination to explore differences in mental health among students in Germany.MethodsData from the cross-sectional project "Survey on study conditions and mental health of university students" (n = 14,592) were analysed using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA). Depressive symptoms, cognitive stress symptoms, and exhaustion were examined across 48 intersectional strata based on gender, first academic generation, family care tasks, and perceived discrimination.ResultsThe MAIHDA analysis revealed substantial between strata variance, with most of it explained by additive rather than intersectional interaction effects. Perceived discrimination, diverse or female gender, first academic generation, and family care tasks (for exhaustion only) were associated with worse mental health outcomes.ConclusionThe profound associations between perceived discrimination and the mental health among university students call for urgent attention and intervention within university settings. Adopting an intersectional lens is key to identifying and addressing inequalities.
| S-EPMC11775900 | biostudies-literature
Project description:ObjectiveGuided by role theory and the intersectionality framework, this study assesses whether social role volume, role type, and role configuration influence the mental health of Non-Latina White, African American, Afro-Caribbean, Mexican, Cuban, Puerto Rican, Chinese, Filipina, and Vietnamese American women.BackgroundContemporary shifts in the primary roles (i.e., worker, spouse, parent) women occupy and in the ethnic composition of the U.S. necessitate a re-examination of how roles impact U.S. women's mental health. Moreover, family member and friend roles are relatively understudied.MethodDrawing data from the nationally representative Collaborative Psychiatric Epidemiology Surveys (CPES) (N=7370), ordinary least squares (OLS) regression analysis is used to assess the relationship between role volume, role type, role configuration, and mental health for women across nine ethnic groups. We report ethnicity-stratified models.ResultsOn one hand, role accumulation was psychologically beneficial for Non-Latina White, African American, Puerto Rican, and Chinese women. On the other hand, the psychological benefits of social roles diminished after accumulating three social roles for Cuban, Mexican, and Filipina women. The psychological influence of specific roles and role configurations for women was dependent on ethnicity.ConclusionThis study demonstrates the powerful impact of ethnicity on social role engagement as well as the influence of such roles on women's psychological health.
| S-EPMC9555067 | biostudies-literature
Project description:PurposeMental health inequalities across social identities/positions during the COVID-19 pandemic have been mostly reported independently from each other or in a limited way (e.g., at the intersection between age and sex or gender). We aim to provide an inclusive socio-demographic mapping of different mental health measures in the population using quantitative methods that are consistent with an intersectional perspective.MethodsData included 8,588 participants from two British cohorts (born in 1990 and 2000-2002, respectively), collected in February/March 2021 (during the third UK nationwide lockdown). Measures of anxiety and depressive symptomatology, loneliness, and life satisfaction were analysed using Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) models.ResultsWe found evidence of large mental health inequalities across intersectional strata. Large proportions of those inequalities were accounted for by the additive effects of the variables used to define the intersections, with some of the largest gaps associated with sexual orientation (with sexual minority groups showing substantially worse outcomes). Additional inequalities were found by cohort/generation, birth sex, racial/ethnic groups, and socioeconomic position. Intersectional effects were observed mostly in intersections defined by combinations of privileged and marginalised social identities/positions (e.g., lower-than-expected life satisfaction in South Asian men in their thirties from a sexual minority and a disadvantaged childhood social class).ConclusionWe found substantial inequalities largely cutting across intersectional strata defined by multiple co-constituting social identities/positions. The large gaps found by sexual orientation extend the existing evidence that sexual minority groups were disproportionately affected by the pandemic. Study implications and limitations are discussed.
| S-EPMC9872068 | biostudies-literature
Project description:The concept of intersectionality has gradually been introduced to health inequality research, adding depth and breadth to the way inequalities in health are approached. We conducted a scoping review with the purpose to systematically map, describe and analyze the literature about intersectional inequalities in mental health. For eligibility, the study had to analyze and report inequality defined by combinations of socioeconomic position, gender, race/ethnicity, sexual orientation or religion. The mental health outcome had to be measured as self-reported symptoms assessed through validated scales, or disorders assessed through diagnostic interviews. The search strategy was applied in two databases and the screening process yielded 20 studies. The interaction of intersectional positions showed no consistent patterns in mental health across studies, but both synergistic and antagonistic effects were observed. In most studies an absolute measure of inequality was used and few studies analyzed factors potentially explaining the intersectional inequalities. Taken together, the findings of this review highlight the value of assessing intersectional inequalities across population groups for priority setting and action on mental health inequalities.
| S-EPMC6657170 | biostudies-literature
Project description:Disability is a key social identity or social category that is associated with significant social disadvantage. For men, having a disability can be discordant with their masculine identity. Self-reliance is one component of masculinity that is known to be important to men with disabilities, however it is also known to be associated with adverse mental health outcomes in the broader adult male population. Intersectionality approaches offer a means of examining the way that the effect of self-reliance on mental health might vary between those with and without a disability. Among a sample of 12,052 men aged 18-55 years from the Ten-to-Men study, we used effect measure modification (EMM) to examine the way that self-reliance modifies the relationship between disability and depressive symptoms. Disability was assessed using the Washington Group Short Set of questions, which capture functional limitations. Results showed that men with disabilities who reported higher conformity to self-reliance norms had much worse mental health than non-disabled men with low conformity to self-reliance, as measured in terms of depressive symptoms (PRR: 9.40, 95%CI 7.88, 11.22, p-value<0.001). We found evidence of positive EMM of depressive symptoms by conformity to self-reliance on the additive scale (RERI: 2.84, 95%CI 1.26, 4.42, p-value<0.001). These results provide evidence that high conformity to self-reliance norms exerts a particularly damaging effect on the mental health of men with disabilities. Given that men with disabilities are more likely to rely on help and support from others, these results provide important insights for the delivery of services to men with disability.
| S-EPMC6700447 | biostudies-literature
Project description:The 2011 India Human Development Survey found that in about a quarter of Indian households, women are expected to have their meals after men have finished eating. This study investigates whether this form of gender discrimination is associated with worse mental health outcomes for women. Our primary data source is a new, state-representative mobile phone survey of women ages 18-65 in Bihar, Jharkhand, and Maharashtra in 2018. We measure mental health using questions from the World Health Organization's Self-Reporting Questionnaire. We find that, for women in these states, eating last is correlated with worse mental health, even after accounting for differences in socioeconomic status. We discuss two possible mechanisms for this relationship: eating last may be associated with worse mental health because it is associated with worse physical health, or eating last may be associated with poor mental health because it is associated with less autonomy, or both.
| S-EPMC7924788 | biostudies-literature
Project description:BackgroundApproximately one in five women will experience mental health difficulties in the perinatal period. However, for a large group of women, symptoms of adverse perinatal mental health remain undetected and untreated. This is even more so for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.AimsTo explore minority ethnic women's experiences of access to and engagement with perinatal mental health care.MethodsSemi-structured interviews were conducted with 18 women who had been diagnosed with perinatal mental health difficulties and who were supported in the community by a specialist perinatal mental health service in South London, United Kingdom. Women who self-identified as being from a minority ethnic group were purposefully selected. Data were transcribed verbatim, uploaded into NVivo for management and analysis, which was conducted using reflective thematic analysis.ResultsThree distinct overarching themes were identified, each with two or three subthemes: 'Expectations and Experiences of Womanhood as an Ethnic Minority' (Shame and Guilt in Motherhood; Women as Caregivers; Perceived to Be Strong and Often Dismissed), 'Family and Community Influences' (Blind Faith in the Medical Profession; Family and Community Beliefs about Mental Health and Care; Intergenerational Trauma and Family Dynamics) and 'Cultural Understanding, Empowerment, and Validation' (The Importance of Understanding Cultural Differences; The Power of Validation, Reassurance, and Support).ConclusionWomen of ethnic minority background identified barriers to accessing and engaging with perinatal mental health support on an individual, familial, community and societal level. Perinatal mental health services should be aware ethnic minority women might present with mental health difficulties in different ways and embrace principles of cultural humility and co-production to fully meet these women's perinatal mental health needs.
| S-EPMC9116695 | biostudies-literature
Project description:BackgroundPerinatal mental health problems are prevalent, affecting up to 20% of women However, only 17-25% receive formal support during the perinatal period. In this qualitative study, we sought to examine women's experiences with peer support for mental health problems during the perinatal period.MethodsSemi-structured interviews and focus groups were conducted with twenty-five mothers from the UK who had utilised peer support for a perinatal mental health problem. Data was analysed using thematic analysis.ResultsSeven major themes were identified in women's help seeking process and experience of peer support. These included; perinatal specific precipitating factors that contributed to their mental health problems, barriers in the form of unhelpful professional responses, feelings of isolation, acceptance of the problem and need to actively re-seek support, finding support either through luck or peer assistance.ConclusionPeer support showed promise as an effective means to reduce perinatal mental health difficulties; either as a form of formal support or as an adjunct to formal support. The results highlight ways to improve perinatal women's access to mental health support through peer-based mechanisms.
| S-EPMC9450402 | biostudies-literature