Identifying Structural Vulnerability Latent Classes Associated with the Health Outcomes of Latino Immigrant Men in Baltimore

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Recent public health events have highlighted the disproportionate burden communities of color face in the U.S. as a result of chronic health disparities. Foreign-born immigrant Latino men (LM) have been found to be particularly likely to engage in risky behaviors (substance use, sexual risks) and less likely to seek out health care services when compared to Latina immigrant women. A growing body of research has documented the impact immigration-related stressors have on the mental health and substance use of LM. However, there is a gap in knowledge of how psychosocial vulnerability, in the form of a complex dynamic between racial discrimination, stigma, violence victimization and social isolation, contribute to health disparities. Guided by structural vulnerability theory, we will use a sequential explanatory mixed methods approach to first conduct latent class analyses to identify psychosocial vulnerability subgroups of LM (N=300) and associations with health outcomes. Next, we will develop deeper etiological understanding of identified latent classes by qualitatively characterizing subgroups based on the lived experience of participants (n=40). Specifically, this study aims to 1. Identify distinct psychosocial vulnerability (racial discrimination stigma, v iolence, social isolation) latent classes (e.g., hypothesized high, moderate, low classes) among LM in Baltimore; 2. Examine the individual (socio-demographics, legal status, English proficiency), and socio-contextual determinants (social support, family contact, living and working conditions) associated with each psychosocial vulnerability latent class (e.g., high, moderate, low), and their associations with health outcomes (drug and alcohol related problems, infection risk, mental health); and 3. Qualitatively characterize the influence socio-cultural contextual factors have on the distinct psychosocial vulnerability latent classes identified in Aims 1 & 2. The proposed study will advance scientific knowledge by elucidating the lived psychosocial and health effects of systemic oppression among a vulnerable and significantly underserved group of immigrant men. Successful completion of this R21 project has high promise to inform and test novel targeted public health prevention interventions to reduce health disparity burdens among LM in a future R01 application.