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Taking an intersectional approach to define latent classes of socioeconomic status, ethnicity and migration status for psychiatric epidemiological research

Published online by Cambridge University Press:  10 April 2017

L. Goodwin ,
B. Gazard ,
L. Aschan ,
S. MacCrimmon ,
M. Hotopf  and
S. L. Hatch
L. Goodwin
Affiliation:
King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, 10 Cutcombe Road, London, UK Department of Psychological Sciences, University of Liverpool, Liverpool, UK
B. Gazard*
Affiliation:
King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, 10 Cutcombe Road, London, UK
L. Aschan
Affiliation:
King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, 10 Cutcombe Road, London, UK
S. MacCrimmon
Affiliation:
King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, 10 Cutcombe Road, London, UK
M. Hotopf
Affiliation:
King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, 10 Cutcombe Road, London, UK South London and Maudsley NHS Foundation Trust, London, UK
S. L. Hatch
Affiliation:
King's College London, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, 10 Cutcombe Road, London, UK
*
*Address for correspondence: B. Gazard, Psychological Medicine, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK. (Email: billy.gazard@kcl.ac.uk)
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Abstract

Aims.

Inequalities in mental health are well documented using individual social statuses such as socioeconomic status (SES), ethnicity and migration status. However, few studies have taken an intersectional approach to investigate inequalities in mental health using latent class analysis (LCA). This study will examine the association between multiple indicator classes of social identity with common mental disorder (CMD).

Methods.

Data on CMD symptoms were assessed in a diverse inner London sample of 1052 participants in the second wave of the South East London Community Health study. LCA was used to define classes of social identity using multiple indicators of SES, ethnicity and migration status. Adjusted associations between CMD and both individual indicators and multiple indicators of social identity are presented.

Results.

LCA identified six groups that were differentiated by varying levels of privilege and disadvantage based on multiple SES indicators. This intersectional approach highlighted nuanced differences in odds of CMD, with the economically inactive group with multiple levels of disadvantage most likely to have a CMD. Adding ethnicity and migration status further differentiated between groups. The migrant, economically inactive and White British, economically inactive classes both had increased odds of CMD.

Conclusions.

This is the first study to examine the intersections of SES, ethnicity and migration status with CMD using LCA. Results showed that both the migrant, economically inactive and the White British, economically inactive classes had a similarly high prevalence of CMD. Findings suggest that LCA is a useful methodology for investigating health inequalities by intersectional identities.

Keywords

Epidemiologymental healthresearch design and methodspopulation surveycommunity mental health
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 27 , Issue 6 , December 2018 , pp. 589 - 600
Copyright
Copyright © Cambridge University Press 2017 

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Footnotes

†

Joint first authors.

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