Minority Statuses Research Articles

Mental health symptoms and treatment for common mental disorders among sexual minority immigrants in Sweden – a national population-based study

Abstract Background Although sexual minorities are at greater risk of poor mental health, less is known about mental health among dual minority statuses individuals based on sexual orientation and migration status. The current study investigated disparities in mental health symptoms and psychiatric treatment for common mental disorders among Swedish-born and immigrant heterosexuals and sexual minorities. It further explored the role played by interpersonal and social stress in explaining these disparities. Methods Participants (n = 104,652) were drawn from the Swedish Public Health Survey in 2018. Six groups were compared based on sexual orientation (heterosexual, sexual minority) and migration status (Swedish-born, European-born, non-European). The survey was complemented with information on psychiatric treatment from nationwide registries. Odds ratios were calculated using logistic regression. Results Compared to Swedish-born heterosexuals, Swedish-born and non-European sexual minorities had the greatest risk of mental health symptoms (odds ratios [OR]=2.20, 95% confidence intervals [CI]: 1.89-2.57, and OR = 2.10, 95% CI 1.34-3.29, respectively). Swedish-born sexual minorities had greater risk of psychiatric treatment (OR = 2.58, 95% CI 2.20-3.01), while non-European heterosexuals had lower risk (OR = 0.61, 95% CI 0.52-0.72). No differences in psychiatric treatment was found for non-European sexual minorities (OR = 0.82, 95% CI 0.46-1.48). Interpersonal and social stress factors mediated the associations between migration status and mental health symptoms and psychiatric treatment differently depending on sexual orientation. Conclusions No excess risk of mental health symptoms was found among sexual minority immigrants compared to their Swedish-born counterparts. Key message • Non-European sexual minority immigrants’ risk of mental health symptoms was equally high to the risk among Swedish-born sexual minorities, but they received less psychiatric treatment.

The Measurement of Inter-Minority Empathy

ABSTRACT This study introduced the concept of inter-minority empathy, defined as empathy for the experiences of other minorities based on one’s own experience as a minority, derived from interviews with LGBTQ+ allies. In addition, it developed the Inter-Minority Empathy Scale to measure this concept. The scale’s reliability and validity were examined, and hypothesis testing was conducted. In Study 1, the Minority Perception Scale, measuring the degree of awareness of one’s minority situation, and the Inter-Minority Empathy Scale were developed, and their reliability and validity were evaluated and confirmed with 60 graduate students. In Study 2, three hypotheses were formulated and tested using a survey of 150 Japanese undergraduate and graduate students. The affirmative minority experience and interest in other minorities were positively correlated, supporting Hypothesis 1. Furthermore, inter-minority empathy was positively correlated with the individual’s number of minority statuses and with being a visible and easily recognizable minority, supporting Hypotheses 2 and 3, respectively. The lack of positive experiences as minorities did not affect these associations. This concept can be applied not only to LGBTQ+ people but also to other minorities. Developing this concept would allow minority groups to understand the dynamics of discrimination and oppression experienced by other groups.

A - 88 Grandparent Caregivers Interaction with Experiences of Discrimination Effect on Perceptions of Cognitive Control

Abstract Objective This study hypothesized that perceptions of cognitive ability control will differ according to grandparent caregiving status and perceptions of discrimination based on age. Control beliefs mediate the relation between discrimination and executive function. Due to the intersectional nature of grandparents who raise grandchildren and minority statuses compared to non-caregiving grandparents, it is thought that perceptions of age being the main reason of discrimination will differentially affect caregiving grandparents compared to non-caregiving grandparents perceptions of control over cognitive ability. Method Data included 92 caregiving and 407 non-caregiving grandparent participants from the third wave of a longitudinal data collection survey Midlife in the United States study (MIDUS III). MIDUS III included self-administered surveys assessing caregiver status, perceptions of main reasons of discrimination, and perceptions of cognitive control. Result A 2-way ANOVA was performed to analyze the effect of grandparent caregiver status and age discrimination perceptions on perceptions of cognitive ability control. A 2-way ANOVA revealed there was a significant interaction between the effects of grandparent caregiver status and perceptions of aging discrimination (F(1, 498) = 7047, p < 0.001). Conclusions Grandparent caregivers are more likely to have higher perceptions of control over cognitive ability when they do not perceive age as a main reason for discrimination; whereas non-caregiving grandparents have higher perceptions of control over cognitive ability when they do perceive age as a main reason for discrimination. Perceptions of why individuals are discriminated against may interact with personal factors that contribute to perceptions of control in cognitive ability.

Impact of Multiple Minority Statuses: An Examination of Violent Victimization, Police Reporting and Perception of Police Bias

Individuals who identify as belonging to multiple marginalized groups experience disproportionate violent victimization yet are reluctant to inform the police following an incident. Perceptions of the police as biased may influence whether victims report. This study examines low socio-economic and sexual orientation/gender-identity (SOGI) minority statuses on experiencing violent victimization, reporting to the police and perceived police bias as a reason for not reporting. Multivariate logistic regressions were applied to National Crime Victimization Survey data. Low-income, SOGI respondents reported greater odds of experiencing violent victimization but lower odds of reporting to the police. An increase in the odds of perceiving the police as biased was found among victims who did not report. Results suggest greater work to improve the strained relationships between the police and minority communities.

The places we'll go: How have rural residents changed over time?

An increasingly key consideration in Canadian immigration policy is rural settlement patterns. As Canada’s largest census metropolitan areas (CMAs) continue to see increases in overall population, smaller and mid-sized communities face greater challenges in attracting and retaining newcomers as a means of economic and population improvements. As such, it is becoming increasingly important to look at the characteristics of individuals who opt for rural settlement in order to improve the outcomes of future attraction initiatives. While a substantial body of literature looks at the movement of immigrants and native-born Canadians across the country, far fewer look at the characteristics that positively predict rural settlement. This study helps to close the knowledge gap by investigating these characteristics and how they change over a 25-year period, using two identical logistic regression models and a pooled cross-sectional model based on the 1991 and 2016 Canadian Census. Overall, age, lower levels of education and income, as well as non-immigrant and non-visible minority statuses lead to higher propensities for rural living. However, the general trend is a move away from rural settlement in favour of larger cities.

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.

Negative impact of chronic pandemic-specific financial stress on food security among college students

Since the pandemic started, food insecurity has become a more serious issue for U.S. college students. The study goals were to evaluate whether pandemic-specific stress contributes to current food insecurity (as of February–March of 2022) and to determine which student characteristics are associated with food insecurity. We used the 2022 Spring American College Health Association—National College Health Assessment data (n = 620) collected at a public university. We estimated two multiple logistic regression models. The odds of having very low food security (OR = 8.65, 95% CI = 4.84:15.43) and low food security (OR = 2.87, 95% CI = 1.66:4.96) were significantly higher among students whose financial situation had become a lot more stressful as a result of the pandemic (relative to the other students). Sexual and gender minority, relationship, and current tobacco use statuses were associated with very low food security. There is a need for continued efforts to decrease the negative impact of the pandemic on students’ food security.

HIV/AIDS stigma accumulation among people living with HIV: a role of general and relative minority status

The main objective of the study was to investigate the relationship between selected sociodemographic factors (i.e. sexual orientation, gender and AIDS status), and the level of HIV/AIDS stigma among people living with HIV (PLWH). The participants were 663 adults with a medically confirmed diagnosis of HIV infection, undergoing antiretroviral treatment. Their level of HIV/AIDS stigma was assessed with the Berger HIV Stigma Scale, and relevant sociodemographic and clinical data were obtained using a self-report survey. The main effect was revealed only for sexual orientation and total stigma; those with heterosexual orientation declared higher levels of total stigma than those with other sexual orientations. For the subscales, significant results were obtained only for disclosure concerns. Namely, for the interaction of gender and sexual orientation, the highest level of disclosure stigma was declared by heterosexual women, while there was no such relationship for men. This result was further modified when AIDS diagnosis was added to the interaction. There is a cumulative effect of PLWH minority statuses, rather than main effects of each status individually. Thus, each minority status should be analysed from at least two perspectives, general (i.e., compared to the general population) and relative (i.e., compared to the population in question).

Physical and Mental Health Disparities at the Intersection of Sexual and Gender Minority Statuses: Evidence From Population-Level Data

Sexual and gender minorities (SGM) experience detriments across many physical and mental health outcomes compared with heterosexual and cisgender people. But little is known about health outcomes for those who are both gender minorities and sexual minorities. Motivated by theories of double disadvantage and leveraging advancements in data collection and measurement, we examine physical and mental health disparities across sexual and gender minority statuses: cisgender heterosexuals, gender minority heterosexuals, cisgender sexual minorities, and people who are both gender and sexual minorities. Using Gallup's National Health and Well-Being Index (N = 93,144) and the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (N = 543,717), we estimate multivariable logistic regression models to examine how sexual and gender minority statuses are associated with poor/fair self-rated health, functional limitations, and diagnosed depression. Regression models adjusting for sociodemographic characteristics show marked physical and mental health disparities: people who are both gender and sexual minorities report greater odds of poor/fair self-rated health, functional limitations, and depression relative to cisgender heterosexuals and, in some cases, relative to gender minority heterosexuals and cisgender sexual minorities. Our results add to a growing body of research documenting the association between multiple disadvantaged statuses and health and provide novel information on SGM health disparities.

Paying for Nursing Home Quality: An Elusive But Important Goal.

Paying for Nursing Home Quality: An Elusive But Important Goal.

Does the association between Herpes Simplex 2 infection and depressive symptoms vary among different sexual minority statuses and sex groups? Findings from a nationally representative sample

BackgroundHerpes Simplex Virus Type 2 (HSV-2) has been associated with depression, but the relationship has yet to be explored with respect to gender and sexual orientation in a nationally representative sample to help identify individuals at higher risk for depression. MethodsA dataset from National Health and Nutrition Examination Survey 2009–2014 was used in this study. Multivariable logistic regression models were constructed to test effect modification on both the multiplicative and additive scale using a sample of 57,684 subjects. ResultsEffect modification by sexual minority status was not significant on either the multiplicative scale (Ratio of ORs: 0.74, 95 % CI: 0.37–1.50, p = 0.395) or the additive scale (RERI: −0.22, 95%CI: −2.27–1.84, p = 0.833). Meanwhile, biological sex assigned at birth was a significant modifier only on the additive scale (RERI: 0.82, 95 % CI: 0.004–1.64, P = 0.049). Specifically, females (OR: 1.43, 95 % CI: 1.03–1.97, P = 0.032) had greater odds of having depressive symptoms compared with males (OR: 1.20, 95 % CI: 0.69–2.08, p = 0.509) after the HSV-2 infection. LimitationsThe analysis was based on a cross-sectional study; further investigation using longitudinal datasets might be beneficial. ConclusionsSexual minority status did not modify the association between HSV-2 infection and having depressive symptoms. However, biological sex assigned at birth was a modifier only on the additive but not the multiplicative scale. Health workers should be alert for depression symptoms in females with HSV-2 infection.

Understanding Intimate Partner Violence Among Ethnic and Sexual Minorities: Lived Experiences of Queer Women in Norway.

Drawing upon in-depth, semi-structured interviews, this study explored how queer women from ethnic minority backgrounds in Norway understand and experience intimate partner violence (IPV). Based on an intersectional approach, the study highlights and discusses how having multiple minority positions may inform and affect the way participants experience IPV. The analysis shows that participants' experiences of IPV are shaped by their multiple minority statuses in Norwegian society. A discussion is provided that revolves around how being a sexual as well as an ethnic minority generates a significant power imbalance for the participants in their relationships.

Mental Health Among Sexual and Gender Minority Youth Incarcerated in Juvenile Corrections.

This study examined differences by sexual and gender minority (SGM) and incarceration statuses in mental health indicators among youth. Population-based, cross-sectional data are from the 2019 Minnesota Student Survey (N = 72 324) and includes public school students (Mage = 15.49) and youth incarcerated in juvenile correctional facilities (Mage = 15.48). We categorized youth into 4 groups: (1) non-SGM youth in public schools, (2) non-SGM youth in correctional facilities, (3) SGM youth in public schools, and (4) SGM youth in correctional facilities. Multivariable regression models assessed associations among SGM and incarceration statuses and mental health indicators after controlling for sociodemographic characteristics and exposure to adverse childhood experiences. More youth in juvenile correctional facilities identified as SGM (28.8%) compared with youth in public schools (20.4%, P = .002). SGM youth in correctional facilities reported a higher prevalence of suicidal ideation (42.2%), suicide attempt (37.5%), and self-harm (57.8%) compared with all other groups. Depressive symptom severity was similarly elevated among SGM youth in correctional facilities and SGM youth in public schools. SGM youth in correctional facilities, compared with non-SGM youth in public schools, demonstrated elevated odds of suicide ideation (adjusted odds ratio [aOR] = 2.2, 95% confidence interval [95% CI] = 1.3-3.9), suicide attempt (aOR = 6.3, 95% CI = 3.6-10.9), and self-harm (aOR = 3.6, 95% CI = 2.1-6.3). Incarcerated SGM youth disproportionately experience negative mental health indicators. Findings suggest that tailored, intersectional, and responsive mental health interventions are needed to support incarcerated SGM youth.

Race, class, and gender identity: implications for transgender people’s police help seeking

ABSTRACT This study examines various demographic, social, and economic factors related to transgender people’ reluctance to seek police help and appraises the intersectionality among these different factors. The results reveal differences in the degree of reluctance across gender groups, socioeconomic statuses, and racial groups, which suggest that the intersection of multiple minority statuses will increase transgender people’s reluctance to seek help from police. The findings also reveal that transgender people’ past interaction with police is negatively associated with their reluctance to seek police intervention. This study concludes with suggestions that seek to transform law enforcement culture by means of police training and community outreach activities.

Young Adults’ Perceived Impact of COVID-19 Pandemic on Sleep and Other Functioning: Does It Differ for Sexual/Gender and Racial/Ethnic Minorities?

ABSTRACT Objectives Since the beginning of the COVID-19 pandemic, there has been concern that the pandemic and associated mitigation efforts would have a particularly adverse effect on communities that are marginalized. This study examined disparities in the perceived impacts of the pandemic on sleep, mental and physical health, social functioning, and substance use among young adults based on sexual/gender minority (SGM) status and race/ethnicity. Method Participants were 2,411 young adults (mean age = 23.6) surveyed between July 2020-July 2021. A linear regression analysis tested SGM and racial/ethnic group differences on 17 outcomes. Results Most young adults reported little-to-no effect of the pandemic on sleep or other indicators of health and functioning. However, SGM young adults reported more adverse effects than non-SGM young adults on their sleep and most other outcomes. Hispanic young adults reported shorter sleep duration – but less pandemic-related depression, loneliness, and relationship problems – compared to non-Hispanic white young adults. We found no evidence that young adults with multiple minority statuses had especially poor pandemic-related outcomes. Conclusions While most young adults did not perceive much impact of the pandemic, results highlight disparities across certain demographic subgroups that may need to be addressed through targeted interventions and close monitoring for long-term effects.

Sexual Orientation Diversity and Inclusion in the Workplace: A Qualitative Study of LGB Inclusion in a UK Public Sector Organisationientation Diversity and Inclusion in the Workplace: A Qualitative Study of LGB Inclusion in a UK Public Sector Organisation

Inclusion has been identified as a key component of successful approaches to organisational diversity management. To date, the inclusion literature has predominantly used quantitative methodology to study visible forms of diversity such as gender and ethnicity. Invisible forms of diversity, such as sexual orientation diversity, have received limited research attention, despite Lesbian, Gay, and Bisexual (LGB) employees facing significantly higher rates of bullying and discrimination in the workplace than their heterosexual colleagues. The current study uses semi-structured interviews and template analysis to investigate LGB employees’ experiences of workplace inclusion within a UK public sector organisation. Findings demonstrate that LGBs share many experiences of exclusion with other minority groups; however, they are not often regarded as exclusionary or the result of one’s sexual orientation. Such experiences appear to be either overlooked due to membership of other minority groups which hold greater significance, or downplayed due to membership of other majority groups. The main implication of this finding is that quantitative measures of inclusion may not reveal the severity of exclusion in organisations. It is therefore recommended that future research investigating employees’ perceptions of inclusion should consider the validity of findings in relation to inclusion based on invisible characteristics. Finally, the findings detailed in this report lend support for the use of an intersectional research approach, which considers the way in which minority statuses are interconnected and cannot be examined in isolation when investigating individuals’ experiences.

Healthcare Access and Health-Related Cultural Norms in a Community Sample of Black and Latinx Sexual Minority Gender Expansive Women

ABSTRACT Major strides have been made in understanding the impact of intersectionality in everyday life. However, there is a significant gap in the research literature on how individuals with multiple minority statuses must uniquely interact and navigate health services. We carried out an exploratory qualitative study with twenty sexual minority gender expansive women of Latinx and African American descent to explore participants’ access to health services and the impact of cultural factors on their health decisions and behaviors. Participants described long-term challenges with accessing health services that were primarily tied to income and discriminatory treatment on the part of health providers. Participants also shared regular discouragement from family members to engage with U.S./Western medicine and health traditions. Together, participants’ early life experiences and the continued messages from family members, influenced their health behaviors (e.g., delaying care). Implications for future research and health services are discussed.

Epidemiology of binge eating disorder: prevalence, course, comorbidity, and risk factors.

Binge eating disorder (BED) is a new diagnosis in the Fifth Edition of the Diagnostic and Statistic Manual of Mental Disorders (DSM-5) and the Eleventh Revision of the International Classification of Diseases (ICD-11). DSM-5 BED is currently estimated to affect 1.5% of women and 0.3% of men worldwide; a lifetime diagnosis of DSM-5 BED is reported by 0.6-1.8% of women and 0.3-0.7% of men. In adolescence, BED is even more prevalent, but often transient. Many adults with BED report longstanding symptoms; less than half are recognized in healthcare. Commonly co-occurring conditions include obesity, type 2 diabetes, and hypertension. In a nationally representative US-based study, up to 23% of individuals with BED had attempted suicide, and virtually all (94%) reported lifetime mental health symptoms: 70% mood disorders, 68% substance use disorders, 59% anxiety disorders, 49% borderline personality disorder, and 32% posttraumatic stress disorder. Data on mortality are scarce, but the standardized mortality ratio of BED is estimated to be 1.5-1.8. Various minority statuses, deprivation, violence, trauma, and major mental illness may increase the risk of BED. BED is often invisible and overlooked, perhaps due to societal biases. For this reason, prevention, detection, and management of BED are closely linked with social justice and equity.

Racial and ethnic disparities in "stop-and-frisk" experience among young sexual minority men in New York City.

Although racial/ethnic disparities in police contact are well documented, less is known about other dimensions of inequity in policing. Sexual minority groups may face disproportionate police contact. We used data from the P18 Cohort Study (Version 2), a study conducted to measure determinants of inequity in STI/HIV risk among young sexual minority men (YSMM) in New York City, to measure across-time trends, racial/ethnic disparities, and correlates of self-reported stop-and-frisk experience over the cohort follow-up (2014-2019). Over the study period, 43% reported stop-and-frisk with higher levels reported among Black (47%) and Hispanic/Latinx (45%) than White (38%) participants. Stop-and-frisk levels declined over follow-up for each racial/ethnic group. The per capita rates among P18 participants calculated based on self-reported stop-and-frisk were much higher than rates calculated based on New York City Police Department official counts. We stratified respondents' ZIP codes of residence into tertiles of per capita stop rates and observed pronounced disparities in Black versus White stop-and-frisk rates, particularly in neighborhoods with low or moderate levels of stop-and-frisk activity. YSMM facing the greatest economic vulnerability and mental disorder symptoms were most likely to report stop-and-frisk. Among White respondents levels of past year stop-and-frisk were markedly higher among those who reported past 30 day marijuana use (41%) versus those reporting no use (17%) while among Black and Hispanic/Latinx respondents stop-and-frisk levels were comparable among those reporting marijuana use (38%) versus those reporting no use (31%). These findings suggest inequity in policing is observed not only among racial/ethnic but also sexual minority groups and that racial/ethnic YSMM, who are at the intersection of multiple minority statuses, face disproportionate risk. Because the most socially vulnerable experience disproportionate stop-and-frisk risk, we need to reach YSMM with community resources to promote health and wellbeing as an alternative to targeting this group with stressful and stigmatizing police exposure.

An examination of housing interventions among youth experiencing homelessness: an investigation into racial/ethnic and sexual minority status.

The purpose of this study is to explore main and interaction effects of minority and multiple minority statuses on exits from homelessness and the stability of homelessness exits overtime. This study utilized the Homeless Management Information System administrative data of 10922 youth experiencing homelessness collected from a convenience sample of 16 geographically diverse communities across the USA between 2015-17. Using multinomial logistic regression analyses and logistic regression, main effects and interaction effects of racial/ethnic minority identity and sexual/gender minority identity were examined on various homelessness exits (n=9957) and housing sustainability (n=5836). Black youth, relative to White youth, were disproportionately exiting homelessness through incarceration (P<0.001). Black and Latinx youth were less likely to successfully self-resolve their homelessness (both P<0.05). Black heterosexual and Black and Latinx non-heterosexual youth were most frequently lost to the homeless system (all P<0.01). Black youth, relative to White youth, were approximately half as likely to remain stably housed after returning to family (P<0.01). With respect to housing exits and exit stability, Black and Latinx heterosexual youth are consistently at a disadvantage. Homelessness/housing systems and programs need to conduct a deeper investigation into how they implement and develop equitable outreach and engagement practices.