Taking an Intersectional Approach to Define Latent Classes of Socioeconomic Status, Ethnicity and Migration Status for Psychiatric Epidemiological Research

Overview

Journal Epidemiol Psychiatr Sci

Publisher Cambridge University Press

Specialties Psychiatry
Public Health

Date 2017 Apr 10

PMID 28390448

Citations 23

Authors

L Goodwin

B Gazard

L Aschan

S MacCrimmon

M Hotopf

S L Hatch

Affiliations

Soon will be listed here.

Abstract

Aims: Inequalities in mental health are well documented using individual social statuses such as socioeconomic status (SES), ethnicity and migration status. However, few studies have taken an intersectional approach to investigate inequalities in mental health using latent class analysis (LCA). This study will examine the association between multiple indicator classes of social identity with common mental disorder (CMD).

Methods: Data on CMD symptoms were assessed in a diverse inner London sample of 1052 participants in the second wave of the South East London Community Health study. LCA was used to define classes of social identity using multiple indicators of SES, ethnicity and migration status. Adjusted associations between CMD and both individual indicators and multiple indicators of social identity are presented.

Results: LCA identified six groups that were differentiated by varying levels of privilege and disadvantage based on multiple SES indicators. This intersectional approach highlighted nuanced differences in odds of CMD, with the economically inactive group with multiple levels of disadvantage most likely to have a CMD. Adding ethnicity and migration status further differentiated between groups. The migrant, economically inactive and White British, economically inactive classes both had increased odds of CMD.

Conclusions: This is the first study to examine the intersections of SES, ethnicity and migration status with CMD using LCA. Results showed that both the migrant, economically inactive and the White British, economically inactive classes had a similarly high prevalence of CMD. Findings suggest that LCA is a useful methodology for investigating health inequalities by intersectional identities.

Citing Articles

The non-linear correlation between the severity of alcohol consumption and depressive symptoms in the Chinese Wa ethnic minority.

Liu J, Feng X, Liu Y, Xiao L, Tong R, Wang Y Front Public Health. 2024; 12:1430840.

PMID: 39540101 PMC: 11557407. DOI: 10.3389/fpubh.2024.1430840.

Disparities in Receipt of Early Intervention Services by Toddlers with Autism Diagnoses: an Intersectional Latent Class Analysis of Demographic Factors.

Portillo N, Thammathorn L, Buitrago L, Carter A, Sheldrick R, Eisenhower A J Autism Dev Disord. 2024; .

PMID: 39466583 DOI: 10.1007/s10803-024-06613-x.

Mental health vulnerability in multicultural families: Risk factors among homogenous country.

Kim E, Park M Glob Ment Health (Camb). 2024; 11:e101.

PMID: 39464549 PMC: 11504928. DOI: 10.1017/gmh.2024.108.

A mixed methods PAR study investigating social capital as a resource for Black and other racially minoritised communities in the UK: A study protocol.

Gnan G, Asif Z, Campbell S, Dyer J, Ehsan A, Hoffmann K PLoS One. 2023; 18(12):e0296125.

PMID: 38128005 PMC: 10734924. DOI: 10.1371/journal.pone.0296125.

Post-migration living difficulties and poor mental health associated with increased interpretation bias for threat.

Vikhanova A, Tibber M, Mareschal I Q J Exp Psychol (Hove). 2023; 77(6):1154-1168.

PMID: 37477179 PMC: 11103921. DOI: 10.1177/17470218231191442.

References

Geyer S, Hemstrom O, Peter R, Vagero D . Education, income, and occupational class cannot be used interchangeably in social epidemiology. Empirical evidence against a common practice. J Epidemiol Community Health. 2006; 60(9):804-10. PMC: 2566032. DOI: 10.1136/jech.2005.041319. View

Fryers T, Melzer D, Jenkins R . Social inequalities and the common mental disorders: a systematic review of the evidence. Soc Psychiatry Psychiatr Epidemiol. 2003; 38(5):229-37. DOI: 10.1007/s00127-003-0627-2. View

Ford E, Clark C, McManus S, Harris J, Jenkins R, Bebbington P . Common mental disorders, unemployment and welfare benefits in England. Public Health. 2010; 124(12):675-81. DOI: 10.1016/j.puhe.2010.08.019. View

Weich S, Nazroo J, Sproston K, McManus S, Blanchard M, Erens B . Common mental disorders and ethnicity in England: the EMPIRIC study. Psychol Med. 2005; 34(8):1543-51. DOI: 10.1017/s0033291704002715. View

Rosenfield S . Triple jeopardy? Mental health at the intersection of gender, race, and class. Soc Sci Med. 2012; 74(11):1791-801. DOI: 10.1016/j.socscimed.2011.11.010. View

Bauer G . Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity. Soc Sci Med. 2014; 110:10-7. DOI: 10.1016/j.socscimed.2014.03.022. View

Gazard B, Frissa S, Nellums L, Hotopf M, Hatch S . Challenges in researching migration status, health and health service use: an intersectional analysis of a South London community. Ethn Health. 2014; 20(6):564-93. PMC: 4566875. DOI: 10.1080/13557858.2014.961410. View

Das-Munshi J, Becares L, Dewey M, Stansfeld S, Prince M . Understanding the effect of ethnic density on mental health: multi-level investigation of survey data from England. BMJ. 2010; 341:c5367. PMC: 2962884. DOI: 10.1136/bmj.c5367. View

Fuller-Rowell T, Evans G, Ong A . Poverty and health: the mediating role of perceived discrimination. Psychol Sci. 2012; 23(7):734-9. DOI: 10.1177/0956797612439720. View

10.

McFadden E, Luben R, Bingham S, Wareham N, Kinmonth A, Khaw K . Self-rated health does not explain the socioeconomic differential in mortality: a prospective study in the EPIC-Norfolk cohort. J Epidemiol Community Health. 2009; 63(4):329-31. DOI: 10.1136/jech.2008.078139. View

11.

Smith N, Kelly Y, Nazroo J . Intergenerational continuities of ethnic inequalities in general health in England. J Epidemiol Community Health. 2008; 63(3):253-8. DOI: 10.1136/jech.2008.077495. View

12.

Casey M, Thiede Call K, Klingner J . Are rural residents less likely to obtain recommended preventive healthcare services?. Am J Prev Med. 2001; 21(3):182-8. DOI: 10.1016/s0749-3797(01)00349-x. View

13.

Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M . Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003; 157(2):98-112. DOI: 10.1093/aje/kwf182. View

14.

Ibrahim A, Kelly S, Adams C, Glazebrook C . A systematic review of studies of depression prevalence in university students. J Psychiatr Res. 2012; 47(3):391-400. DOI: 10.1016/j.jpsychires.2012.11.015. View

15.

Denise E . Multiple disadvantaged statuses and health: the role of multiple forms of discrimination. J Health Soc Behav. 2014; 55(1):3-19. DOI: 10.1177/0022146514521215. View

16.

Galea S, Freudenberg N, Vlahov D . Cities and population health. Soc Sci Med. 2004; 60(5):1017-33. PMC: 7117054. DOI: 10.1016/j.socscimed.2004.06.036. View

17.

Psaki S, Seidman J, Miller M, Gottlieb M, Bhutta Z, Ahmed T . Measuring socioeconomic status in multicountry studies: results from the eight-country MAL-ED study. Popul Health Metr. 2014; 12(1):8. PMC: 4234146. DOI: 10.1186/1478-7954-12-8. View

18.

Hatch S, Frissa S, Verdecchia M, Stewart R, Fear N, Reichenberg A . Identifying socio-demographic and socioeconomic determinants of health inequalities in a diverse London community: the South East London Community Health (SELCoH) study. BMC Public Health. 2011; 11:861. PMC: 3227613. DOI: 10.1186/1471-2458-11-861. View

19.

Butterworth P, Leach L, McManus S, Stansfeld S . Common mental disorders, unemployment and psychosocial job quality: is a poor job better than no job at all?. Psychol Med. 2012; 43(8):1763-72. DOI: 10.1017/S0033291712002577. View

20.

Karlsen S, Nazroo J . Relation between racial discrimination, social class, and health among ethnic minority groups. Am J Public Health. 2002; 92(4):624-31. PMC: 1447128. DOI: 10.2105/ajph.92.4.624. View