Mayorga Nubia A, Smit Tanya, Salwa Aniqua, Buitron Victor, Garza Monica, Ochoa-Perez Melissa, Lemaire Chad, Zvolensky Michael J
Department of Psychology, University of Houston, 3695 Cullen Blvd., Room 126, Houston, TX, 77204, USA.
Department of Psychology, Florida International University, Miami, FL, USA.
J Racial Ethn Health Disparities. 2024 Sep 17. doi: 10.1007/s40615-024-02146-2.
There is a growing recognition that Social Determinants of Health (SDoH) can inform some sources of physical and mental health disparities among the Latinx population. The current study sought to expand previous research by exploring the singular and interactive influence of financial strain and subjective social status-two common and clinically important SDoH factors-on pain intensity, pain disability, general depression, social anxiety, and anxious arousal. The current sample consisted of 155 Latinx adults (81.3% female; M = 40.02 years, SD = 10.61) presenting for care at a Federally Qualified Health Center (FQHC). Multivariate results demonstrated that financial strain was statistically significantly associated with greater pain intensity, pain disability, general depression, and anxious arousal, but not social anxiety. Further, lower subjective social status was related to greater general depression, social anxiety, and anxious arousal but not with higher levels of pain indices. An interactive effect was found wherein the combination of higher levels of financial strain and low levels of subjective social status was related to general depression and anxious arousal. This is the first study to empirically evaluate the main and interactive effects of financial strain and subjective social status regarding numerous physical and mental health symptoms. These findings clarify how two prevalent SDoH factors influence health outcomes. Specifically, the results suggest that a multi-risk conceptualization can advance a fine-grained understanding of Latinx health disparities by showing differential associations between SDoH factors and clinical outcomes that are frequently the source of health inequities in the Latinx population.
人们越来越认识到，健康的社会决定因素（SDoH）可以解释拉丁裔人群身心健康差异的一些根源。当前的研究试图通过探索经济压力和主观社会地位这两个常见且在临床上重要的SDoH因素对疼痛强度、疼痛残疾、一般性抑郁、社交焦虑和焦虑唤醒的单一及交互影响，来扩展先前的研究。当前样本包括155名在联邦合格健康中心（FQHC）就诊的拉丁裔成年人（81.3%为女性；平均年龄M = 40.02岁，标准差SD = 10.61）。多变量结果表明，经济压力在统计学上与更高的疼痛强度、疼痛残疾、一般性抑郁和焦虑唤醒显著相关，但与社交焦虑无关。此外，较低的主观社会地位与更高的一般性抑郁、社交焦虑和焦虑唤醒相关，但与更高水平的疼痛指数无关。发现了一种交互作用，即较高水平的经济压力和较低水平的主观社会地位相结合与一般性抑郁和焦虑唤醒有关。这是第一项实证评估经济压力和主观社会地位对多种身心健康症状的主要和交互影响的研究。这些发现阐明了两个普遍存在的SDoH因素如何影响健康结果。具体而言，结果表明，多风险概念化可以通过展示SDoH因素与临床结果之间的差异关联，推进对拉丁裔健康差异的细粒度理解，而这些临床结果往往是拉丁裔人群健康不平等的根源。
