Abstract：
BACKGROUND:The theory of fundamental causes explains why health disparities persist over time, even as risk factors, mechanisms, and diseases change. Using an intersectional framework, we evaluated multifactorial discrimination as a fundamental cause of mental health disparities. METHODS:Using baseline data from the Project STRIDE: Stress, Identity, and Mental Health study, we examined the health effects of discrimination among individuals who self-identified as lesbian, gay, or bisexual. We used logistic and linear regression to assess whether multifactorial discrimination met the four criteria designating a fundamental cause, namely that the cause: 1) influences multiple health outcomes, 2) affects multiple risk factors, 3) involves access to resources that can be leveraged to reduce consequences of disease, and 4) reproduces itself in varied contexts through changing mechanisms. RESULTS:Multifactorial discrimination predicted high depression scores, psychological well-being, and substance use disorder diagnosis. Discrimination was positively associated with risk factors for high depression scores: chronic strain and total number of stressful life events. Discrimination was associated with significantly lower levels of mastery and self-esteem, protective factors for depressive symptomatology. Even after controlling for risk factors, discrimination remained a significant predictor for high depression scores. Among subjects with low depression scores, multifactorial discrimination also predicted anxiety and aggregate mental health scores. CONCLUSIONS:Multifactorial discrimination should be considered a fundamental cause of mental health inequities and may be an important cause of broad health disparities among populations with intersecting social identities.
journal_name
Int J Equity Healthjournal_title
International journal for equity in healthauthors
Khan M,Ilcisin M,Saxton Kdoi
10.1186/s12939-017-0532-zsubject
Has Abstractpub_date
2017-03-04 00:00:00pages
43issue
1issn
1475-9276pii
10.1186/s12939-017-0532-zjournal_volume
16pub_type
杂志文章abstract：BACKGROUND:Despite recent progress in improving access to maternal health services, the utilization of these services remains inequitable among women in developing countries, and rural women are particularly disadvantaged. This study sought to measure i) disparities in the rates of institutional births between rural an...
journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-019-1025-z
更新日期：2019-08-09 00:00:00
abstract：INTRODUCTION:Many countries from the European region, which moved from a government financed and provided health system to social health insurance, would have had the risk of moving away from universal health coverage if they had followed a "traditional" approach. The Eastern European high-income countries studied in t...
journal_title：International journal for equity in health
pub_type： 杂志文章
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abstract：BACKGROUND:Street-level workers play a key role in public health policies in Africa, as they are often the ones to ensure their implementation. In Burkina Faso, the State formulated two different user-fee exemption policies for indigents, one for deliveries (2007), and one for primary healthcare (2009). The objective o...
journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-017-0717-5
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journal_title：International journal for equity in health
pub_type： 杂志文章,随机对照试验
doi：10.1186/s12939-017-0643-6
更新日期：2017-08-30 00:00:00
abstract：INTRODUCTION:Health care financing reforms in both China and Vietnam have resulted in greater financial difficulties in accessing health care, especially for the rural poor. Both countries have been developing rural health insurance for decades. This study aims to evaluate and compare equity in access to health care in...
journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/1475-9276-11-10
更新日期：2012-02-29 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/1475-9276-7-26
更新日期：2008-12-18 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-020-01339-5
更新日期：2020-12-09 00:00:00
abstract：BACKGROUND:China had proposed the unification of equity and efficiency since the launch of the new round of health system reform in 2009. And the central government gave priority to the development of primary health care (PHC) whilst ensuring its availability and improving its efficiency. This study aimed to evaluate t...
journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-018-0851-8
更新日期：2018-09-12 00:00:00
abstract：INTRODUCTION:Vietnam has succeeded in reducing maternal mortality in the last decades. Analysis of survey data however indicate that large inequities exist between different segments of the population. We have analyzed utilization of antenatal care and skilled birth attendance among Vietnamese women of reproductive age...
journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/1475-9276-11-24
更新日期：2012-05-15 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-018-0776-2
更新日期：2018-05-18 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-015-0252-1
更新日期：2015-11-20 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-020-01284-3
更新日期：2020-09-21 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-015-0154-2
更新日期：2015-02-27 00:00:00
abstract：BACKGROUND:The provision of insecticide-treated nets (ITNs) is widely accepted in Burkina Faso thanks to large-scale national distribution campaigns. However, household also use other methods of prevention. Thus far, there is little knowledge about the expenditures of these malaria prevention methods, particularly in c...
journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-014-0108-0
更新日期：2014-11-07 00:00:00
abstract：BACKGROUND:In 2004, The Kenyan government removed user fees in public dispensaries and health centers and replaced them with registration charges of 10 and 20 Kenyan shillings (2004 $US 0.13 and $0.25), respectively. This was termed the 10/20 policy. We examined the effect of this policy on the coverage, timing, source...
journal_title：International journal for equity in health
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-019-0978-2
更新日期：2019-06-03 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/s12939-017-0701-0
更新日期：2017-11-28 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/1475-9276-10-21
更新日期：2011-05-25 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/1475-9276-12-22
更新日期：2013-04-02 00:00:00
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journal_title：International journal for equity in health
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journal_title：International journal for equity in health
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journal_title：International journal for equity in health
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journal_title：International journal for equity in health
pub_type： 杂志文章
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更新日期：2012-09-18 00:00:00
abstract：BACKGROUND:Aggregate urban health statistics mask inequalities. We described maternity care in vulnerable slum communities in Mumbai, and examined differences in care and outcomes between more and less deprived groups. METHODS:We collected information through a birth surveillance system covering a population of over 2...
journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/1475-9276-8-21
更新日期：2009-06-05 00:00:00
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journal_title：International journal for equity in health
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更新日期：2014-08-09 00:00:00
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journal_title：International journal for equity in health
pub_type： 杂志文章
doi：10.1186/1475-9276-12-11
更新日期：2013-01-24 00:00:00
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journal_title：International journal for equity in health
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doi：10.1186/1475-9276-12-34
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journal_title：International journal for equity in health
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更新日期：2019-09-05 00:00:00
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journal_title：International journal for equity in health
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abstract：BACKGROUND:In 2003, Médecins Sans Frontières, the provincial government, and the provincial health authority began a community project to guarantee financial access to primary health care in Karuzi province, Burundi. The project used a community-based assessment to provide exemption cards for indigent households and a ...
journal_title：International journal for equity in health
pub_type： 杂志文章
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更新日期：2009-10-24 00:00:00
