Structural Gendered Racism-Related Policies and Mental Health among Cisgender Women at Intersecting Axes of Race, Ethnicity, and Nativity: An Intersectional Mixed Methods Study - Project Summary In the United States, women are twice as likely to report depression and anxiety than men, and face stressors related to interlocking systems of oppression such as racism, sexism, and xenophobia. Interlocking systems of oppression can exacerbate inequalities in mental health by manifesting an unequal distribution of women’s resources and result in symptoms of depression and anxiety like exhaustion, hopelessness, and loss of interest. Despite the growing recognition of the mental health impacts of systems of oppression, several studies have analyzed this relationship at the individual-level, and not the structural or policy-level. Political intersectionality focuses on how policies and laws enact unfair practices against intersectional groups and subdue their rights. Policies related to structural gendered racism may shape the inequitable allocation of women’s social, economic, and political resources across racial, ethnic, and nativity groups, which may put racially and ethnically minoritized women at risk for depression and anxiety. The objective of this R01 grant proposal is to use novel theoretical frameworks and methodologies to examine how structural gendered racism-related policies impact depression and anxiety through intersectional social-structural factors among US- and foreign-born Black, Latina, and white women. This proposal will also aim to identify the best strategies to enhance adoption of supportive policies, and de-implement harmful policies that perpetuate systemic inequities. Informed by Intersectionality, Constrained Choice theory, and a policy implementation science, we propose a sequential explanatory mixed methods study with US- and foreign-born Black, Latina, and white women, and policy stakeholders. Aim 1 examines the direct and indirect relationships between structural gendered racism-related policies, intersectional social-structural factors, depression and anxiety among US- and foreign-born Black, Latina, and white women. Population-based data of adult women’s depression and anxiety from the National Health Interview Survey will be linked to state structural gendered racism-related policies, and an existing structural sexism and racism index of state social, economic, and political data from publicly available administrative sources. Aim 2 includes conducting focus groups with US- and foreign-born Black, Latina, and white women to explicate quantitative findings and identifying unanticipated themes. Aim 3 includes integrating findings from Aims 1 and 2 to systematically develop policy implementation strategies using a three-round Delphi method approach with US- and foreign-born Black, Latina, and white women, and policy stakeholders. This proposal responds to RFA-NR-25-004 by analyzing “relevant policies that reinforce intersectional social-structural factors and identify social-structural interventions to improve mental health.”
