The Impact of Individual- and Neighborhood-Level Social Connectedness on Mental Health in Black Adults

项目总结/摘要 美国黑人成年人的心理健康不平等是显而易见的。2020年，上年流行 根据DSM诊断的任何精神疾病在黑人成年人中占17%（超过700万人）。在 从这个角度来看，这个数字比伊利诺伊州芝加哥、德克萨斯州休斯顿和费城的人口总和还要多 宾夕法尼亚州黑人成年人往往被诊断出患有更严重的心理健康状况，持续时间更长， 会产生削弱社会的后果。社会结构和环境压力因素，如种族 歧视、警察暴力和持续的贫困是心理健康状况不佳的充分证据 在黑人中。社会联系与心理健康的改善直接相关， 一些健康风险因素的负面影响，如社会隔离。然而，关于社会联系的研究 黑人成年人的心理健康仍然有限。这种工作的缺乏反映了知识上的严重差距 关于一个心理社会保护因素，这可能是显着的，以减少不良的心理健康结果， 黑人成年人为了解决这一差距，我们将使用居住在威斯康星州密尔沃基的黑人成年人的定量数据， 参加了美国中年（MIDUS）研究（n=1489，跨波组合），并收集 来自黑人成年人的定性数据，以将定量结果置于背景中并制定潜在的干预措施 战略布局具体来说，我们将开发和评估一个多维社会的测量属性， 从MIDUS中评估的现有项目构建的连通性指标（例如，社会融合， 宗教/教会为基础的社会支持和社会凝聚力）（目的1a）。然后我们将测试 邻里和个人水平的社会联系与三种心理健康结果（例如，凯斯勒-6 心理困扰、MASQ一般困扰-抑郁症状和DSM-III-R重度抑郁症）（AIM 1 b）。为了更好地了解社会联系如何影响心理健康，我们将估计 社会孤立和孤独介导了社会联系与心理健康之间的联系 (AIM 2a）并量化社会联系缓冲种族之间联系的程度 歧视和心理健康结果（AIM 2b）。最后，我们会与社会各持份者合作， 进行焦点小组讨论，将定量研究结果置于情境中，并使用6SQuID模型的前两个步骤， 制定潜在的干预战略和目标，以解决黑人中持续存在的心理健康不平等问题 成人（AIM 3）。影响：调查支持多层面 社会联系和心理健康是促进健康公平的重要一步。这项研究发现， 将提供一个强有力的证据基础，为基于社区的干预措施提供信息，以改变和利用社会 作为减少种族健康不平等的更大战略的一部分。这些发现 将刺激更长期的研究，为“所有政策中的社会”框架提供更多证据， 社会关系的基本机制和过程如何影响健康、疾病、恢复和幸福。

Project Summary/Abstract Mental health inequities among Black adults in the United States are stark. In 2020, the prevalence of past-year any mental illness based on a DSM diagnosis was 17% among Black adults (over 7 million people). In perspective, that number is more than the combined populations of Chicago IL, Houston TX, and Philadelphia PA. Black adults tend to be diagnosed with mental health conditions that are more severe, persist longer, and have debilitating social consequences. Socio-structural and environmental stressors such as racial discrimination, police brutality, and persistent poverty are well-documented predictors of poor mental health among Black people. Social connectedness is directly associated with improved mental health and buffers the negative impact of several health risk factors such as social isolation. Yet, research on social connectedness and mental health among Black adults remains limited. This paucity of work reflects a critical gap in knowledge regarding a psychosocial protective factor that may be salient to reducing poor mental health outcomes among Black adults. To address this gap, we will use quantitative data from Black adults residing in Milwaukee, WI who participated in the Midlife in the United States (MIDUS) study (n=1489 combined across waves) and collect qualitative data from Black adults to contextualize the quantitative findings and develop potential intervention strategies. Specifically, we will develop and assess the measurement properties of a multidimensional social connectedness indicator constructed from existing items assessed in MIDUS (e.g., social integration, religious/church-based social support, and social cohesion) (AIM 1a). Then we will test the associations between neighborhood- and individual-level social connectedness with three mental health outcomes (e.g., Kessler-6 psychological distress, MASQ general distress-depressive symptoms, and DSM-III-R major depression) (AIM 1b). To better understand how social connectedness influences mental health, we will estimate the degree to which social isolation and loneliness mediate the association between social connectedness and mental health (AIM 2a) and quantify the extent to which social connectedness buffers associations between racial discrimination and mental health outcomes (AIM 2b). Lastly, in partnership with community stakeholders, we will conduct focus groups to contextualize the quantitative findings and use the first two steps of 6SQuID model to develop potential intervention strategies and targets to address persistent mental health inequities among Black adults (AIM 3). Impact: Investigating the mechanisms undergirding the associations between multidimensional social connectedness and mental health is an important step toward advancing health equity. This study findings will provide a strong evidence-base to inform community-based interventions to modify and leverage social connectedness among Black people as part of a larger strategy to reduce racial health inequities. The findings will stimulate longer term research to generate more evidence for a “social in all policies” framework to illuminate how underlying mechanisms and processes of social relationships affect health, illness, recovery, and well-being.