Project Summary/Abstract
Mental health inequities among Black adults in the United States are stark. In 2020, the prevalence of past-year
any mental illness based on a DSM diagnosis was 17% among Black adults (over 7 million people). In
perspective, that number is more than the combined populations of Chicago IL, Houston TX, and Philadelphia
PA. Black adults tend to be diagnosed with mental health conditions that are more severe, persist longer, and
have debilitating social consequences. Socio-structural and environmental stressors such as racial
discrimination, police brutality, and persistent poverty are well-documented predictors of poor mental health
among Black people. Social connectedness is directly associated with improved mental health and buffers the
negative impact of several health risk factors such as social isolation. Yet, research on social connectedness
and mental health among Black adults remains limited. This paucity of work reflects a critical gap in knowledge
regarding a psychosocial protective factor that may be salient to reducing poor mental health outcomes among
Black adults. To address this gap, we will use quantitative data from Black adults residing in Milwaukee, WI who
participated in the Midlife in the United States (MIDUS) study (n=1489 combined across waves) and collect
qualitative data from Black adults to contextualize the quantitative findings and develop potential intervention
strategies. Specifically, we will develop and assess the measurement properties of a multidimensional social
connectedness indicator constructed from existing items assessed in MIDUS (e.g., social integration,
religious/church-based social support, and social cohesion) (AIM 1a). Then we will test the associations between
neighborhood- and individual-level social connectedness with three mental health outcomes (e.g., Kessler-6
psychological distress, MASQ general distress-depressive symptoms, and DSM-III-R major depression) (AIM
1b). To better understand how social connectedness influences mental health, we will estimate the degree to
which social isolation and loneliness mediate the association between social connectedness and mental health
(AIM 2a) and quantify the extent to which social connectedness buffers associations between racial
discrimination and mental health outcomes (AIM 2b). Lastly, in partnership with community stakeholders, we will
conduct focus groups to contextualize the quantitative findings and use the first two steps of 6SQuID model to
develop potential intervention strategies and targets to address persistent mental health inequities among Black
adults (AIM 3). Impact: Investigating the mechanisms undergirding the associations between multidimensional
social connectedness and mental health is an important step toward advancing health equity. This study findings
will provide a strong evidence-base to inform community-based interventions to modify and leverage social
connectedness among Black people as part of a larger strategy to reduce racial health inequities. The findings
will stimulate longer term research to generate more evidence for a “social in all policies” framework to illuminate
how underlying mechanisms and processes of social relationships affect health, illness, recovery, and well-being.
