Examining the Associations between Women's Experiences with Gender-Based Discrimination and their Mental and Physical Health: An Intersectional Analysis

项目摘要 女性被诊断为抑郁症和焦虑症的可能性大约是男性的两倍。 自新冠肺炎大流行以来，这一比例不断上升。按性别划分的健康差距延伸到身体健康， 虽然女性的寿命比男性长，但女性的残疾和发病率更高。研究人员和 健康从业者最近呼吁更好地了解女性的心理和身体状况 健康受到结构性社会不平等和基于性别歧视的经历的影响 骚扰。拟议的研究分析了NIH所有人的大量和有目的的多样化数据集，以 了解这些性别健康差异，考虑到种族/族裔和 性取向。我们所有人数据集由全面的客观和主观测量组成 健康和健康的社会决定因素。拟议的项目有两个主要目标。第一个目标是测试一个 一种新的心理社会模型，描述了性别歧视与 妇女健康。具体地说，我们试图检查(A)女性的控制感和社会支持 缓和基于性别歧视的经历与心理健康之间的联系 抑郁和焦虑，(B)健康行为(如吸烟、饮酒、使用药物)是否会影响 基于性别的歧视与心理健康之间的联系；和(C)如果所提出的模型起作用 同样，身体健康也是如此，允许身体健康和精神健康之间的相关性。第二个目标是 探讨拟议的模型是否考虑到女性的心理健康 相互交叉的身份。拟议的项目涉及复杂的数据分析方法，包括 一般线性建模方法和多组协调中介分析与模型比较 接近。鉴于边缘化群体妇女所面临的社会不平等的差异，我们寻求 理解模型建议的主持人和调解人对于子组是否起到类似的作用(即， 种族/民族和性认同)，以便更好地了解心理健康是如何关联的 基于性别的歧视。拟议研究的结果将直接为预防和 采取干预措施，解决身份交错的妇女的身心健康问题。 重要的是，模型中考察的解释机制都是可修改的(社会支持、 控制、健康行为)，并代表未来干预措施的关键点。稿件和会议 发言将传播拟议分析的结果。

Project Summary Women are approximately twice as likely as men to be diagnosed with depression and anxiety, with rates increasing since the COVID-19 pandemic. Gendered health disparities extend to physical health such that while women live longer than men, women have higher levels of disability and morbidity. Researchers and health practitioners have recently called for a greater understanding of how women's mental and physical health are impacted by structural social inequality and experiences with gender-based discrimination and harassment. The proposed study analyzes the large and purposefully diverse NIH All of Us dataset to understand these gender health disparities, taking into account intersecting identities of race/ethnicity and sexual orientation. The All of Us dataset consists of comprehensive objective and subjective measures of health and social determinants of health. The proposed project has two primary aims. The first aim is to test a novel psychosocial model that describes pathways through which gender-based discrimination is related to women's health. Specifically, we seek to examine whether (a.) women's sense of control and social support moderate the association between experiences with gender-based discrimination and mental health of depression and anxiety, (b.) whether health behaviors (i.e., smoking, alcohol use, substance use) mediate the association between gender-based discrimination and mental health; and (c.) if the proposed model functions similarly for physical health, allowing for a correlation between physical and mental health. The second aim is to explore whether the proposed model accounts for women's mental health taking into account their intersecting identities. The proposed project involves sophisticated data analytic approaches, including a general linear modeling approach and multiple groups moderated mediation analyses with a model comparison approach. Given the differences in societal inequalities faced by women from marginalized groups, we seek to understand if the models' proposed moderators and mediators function similarly for subgroups (i.e., race/ethnicity and sexual identity) in order to achieve greater understanding of how mental health is associated with gender-based discrimination. Results from the proposed study will directly inform prevention and intervention efforts to address physical and mental health among women with intersecting identities. Importantly, explanatory mechanisms examined in the model are all modifiable (social support, sense of control, health behaviors) and represent key points for future interventions. Manuscripts and conference presentations will disseminate the results of the proposed analyses.