We examine associations between social determinants and mental health and assess how the associations vary by race/ethnicity using a large, diverse sample of older adults.
Method:
A retrospective study of 444,057 older adults responding to the Medicare Health Outcomes Survey in 2015–2017 was conducted. Using a multilevel linear regression, we examined the associations between the self-reported number of unhealthy days due to mental health and social determinants, stratified by race/ethnicity.
Results:
Health factors were most strongly associated with unhealthy days across all racial/ethnic groups. Strength of other factors varied by race/ethnicity. Social/economic factors had stronger associations among Whites, Asians, and multiracial individuals, while such factors were not significant for American Indians/Alaska Natives and Native Hawaiians/Other Pacific Islanders.
Discussion:
We found varying degrees of associations between social determinants and poor mental health by racial/ethnic groups. These results suggest that homogeneous interventions may not meet the mental health needs of all.
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