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

项目摘要 女性被诊断患有抑郁症和焦虑症的可能性大约是男性的两倍， 自COVID-19大流行以来不断增加。健康方面的性别差异延伸到身体健康， 虽然妇女的寿命比男子长，但妇女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妇女的精神和身体 健康受到结构性社会不平等和基于性别的歧视的影响， 骚扰这项拟议的研究分析了大型和有目的的多样化NIH All of Us数据集， 了解这些性别健康差异，考虑到种族/民族的交叉身份， 性取向All of Us数据集包括全面的客观和主观指标， 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，描述了基于性别的歧视与以下方面有关的途径： 妇女的健康。具体而言，我们试图研究是否（a）。女性控制感和社会支持 缓和基于性别的歧视经历与心理健康之间的关联， 抑郁和焦虑，（B.）健康行为（即，吸烟、饮酒、物质使用）介导 基于性别的歧视与心理健康之间的关联;以及（c.）如果所提出的模型起作用 身体健康也是如此，考虑到身体健康和心理健康之间的相关性。第二个目标是 探讨拟议模式是否考虑到妇女的心理健康， 交叉身份拟议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调节的中介分析与模型比较 approach.鉴于边缘化群体妇女面临的社会不平等的差异，我们力求 了解模型提出的主持人和调解人是否对子组起类似的作用（即， 种族/民族和性别认同），以便更好地了解心理健康与 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，解决具有多重身份的妇女的身心健康问题。 重要的是，在模型中检查的解释机制都是可修改的（社会支持，感觉 控制，健康行为），并代表未来干预的关键点。手册和会议 专题介绍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.