Disparities in mental health and health services utilization are crucial public health and social justice concerns. Prior research has established differences in mental and physical health between different subsets of the US population, including differences between ethnic groups and between people who differ in sexual orientation. These disparities may be linked to experiences of prejudice, discrimination, and stigmatization that are common in the lives of both racial/ethnic minorities and lesbian, gay, and bisexual people (i.e., sexual minorities) and that may be even greater among individuals who are also immigrants to the US. The proposed two-study, two-year research project is guided by a conceptual model of minority stress that identifies potential causes, moderators, and mediators, some that derive from interactions with the "dominant" culture and some from associations with similarly stigmatized individuals, that impact the mental health of sexual minority immigrants. Specifically, in Study 1 a large and representative public health dataset of California residents will be used to test predictions about disparities in mental health and health services utilization as a function of gender, ethnicity, sexual orientation, immigrant status, and combinations of these characteristics. In addition, a complementary research approach, interviews, will be utilized in Study 2 to learn about sources of and experiences with minority stress directly from sexual minority immigrants (specifically Asian and Latino), as well as about their coping resources and activities. For Study 1, and based on minority stress frameworks, poorer health and less utilization are expected for stigmatized individuals, but especially among individuals who possess multiple stigmatizing characteristics. Analyses of the Study 2 first-person accounts will focus on identifying themes across and between participants in order to explicate minority stress theoretical constructs, write items of future research, and to provide context for understanding the Study 1 findings. Thus, the specific aims of this project include assessing health disparities 1) as a function of gender and ethnic, sexual minority, and immigrant statuses separately, and 2) as a function of combined multiple minority characteristics. 3) In addition, subjective experiences related to the possible moderators and mechanisms identified in the proposed conceptual model linking stigmatizing characteristics to poorer health among sexual minority immigrants will be explored. The project is original and timely in focusing on a hidden group of individuals who face unique health risks. It also has the potential to advance scientific knowledge of health disparities, minority stress, and health and well-being, and the results could potentially be used to inform policies, practices, and community programming focused on meeting the needs of disadvantaged and vulnerable populations.
Health disparities may be linked to experiences of prejudice, discrimination, and stigmatization that are common in the lives of both racial/ethnic minorities and lesbian, gay, and bisexual people and that may be even greater among immigrants. The proposed research uses complementary quantitative and qualitative research approaches in focusing on health disparities and differences in mental health and health services utilization as a function of gender, ethnicity, immigrant status, sexual orientation, and combinations of these potentially stigmatizing characteristics. Project results will advance scientific knowledge of health disparities, minority stress, and health and well-being, and potentially could be used to inform policies, practices, and community programming focused on meeting the needs of disadvantaged and vulnerable populations.