Am J Epidemiol. 2023 Oct 10;192(10):1624-1636. doi: 10.1093/aje/kwad152.
Understanding social determinants that shape pertinent developmental shifts during emerging adulthood (i.e., ages 18-25 years) and their associations with psychological health requires a nuanced approach. In our exploratory study, we investigated how multiple social identities and lived experiences generated by systems of marginalization and power (e.g., racism, classism, sexism) intersect in connection to the mental-emotional well-being of emerging adults (EAs). Eating and Activity Over Time (EAT, 2010-2018) data were collected from 1,568 EAs (mean age = 22.2 (standard deviation, 2.0) years) recruited initially in 2010 from Minneapolis/St. Paul schools. Conditional inference tree analyses were employed to treat "social location" and systems of marginalization and power as interdependent social factors influencing EAs' mental-emotional well-being outcomes: depressive symptoms, stress, self-esteem, and self-compassion. Conditional inference tree analyses identified EAs' subgroups with differing mean levels of mental-emotional well-being outcomes, distinguished primarily by marginalized social experiences (e.g., discrimination, financial difficulties) rather than social identities themselves. The relative positioning of EAs' experiences of social marginalization (e.g., discrimination) to their social identities (e.g., race/ethnicity) suggests that the social experiences generated by systems of privilege and oppression (e.g., racism) are more adjacent social determinants of mental-emotional well-being than the social identities used in public health research to proxy the oppressive systems that give them social meaning.
理解塑造成年早期（即 18-25 岁）相关发展转变的社会决定因素及其与心理健康的关系需要一种细致入微的方法。在我们的探索性研究中，我们调查了边缘化和权力系统（例如种族主义、阶级主义、性别歧视）产生的多种社会身份和生活经历如何相互交织，与成年早期（EAs）的心理-情感健康相关。饮食和活动随时间变化（EAT，2010-2018）数据来自 1568 名 EAs（平均年龄为 22.2（标准差 2.0）岁），他们最初于 2010 年从明尼阿波利斯/圣保罗的学校招募。条件推理树分析用于将“社会地位”和边缘化和权力系统视为相互依存的社会因素，影响 EAs 的心理-情感健康结果：抑郁症状、压力、自尊和自我同情。条件推理树分析确定了 EAs 的亚组，他们的心理-情感健康结果存在不同的平均水平，主要区别在于边缘化的社会经历（例如歧视、经济困难）而不是社会身份本身。EAs 边缘化社会经历（例如歧视）与社会身份（例如种族/民族）的相对定位表明，特权和压迫系统（例如种族主义）产生的社会经历是心理-情感健康的更接近的社会决定因素，而不是公共卫生研究中用于代理赋予他们社会意义的压迫系统的社会身份。
