The Modifying Effect of Minority Stressors on the Associations Between Neighborhood Deprivation and Mental Health Among US Sexual Minority Women

IntroductionLittle is known about how neighborhood socioeconomic disadvantage influences sexual minority women's (e.g., lesbian, bisexual) mental health and whether minority stress moderates these associations. We examined the association between neighborhood deprivation and mental health and the potential moderating effects of minority stressors in a community-based sample of sexual minority women.MethodsUsing data from Wave 4 of the Chicago Health and Life Experiences of Women study (N = 359, surveyed 2017-2019), we examined associations between census-tract deprivation-measured using the area deprivation index-and days of poor mental health, with moderation by minority stressors (LGBT community connectedness, internalized homophobia, concealment, stigma consciousness, gender presentation). We controlled for individual and neighborhood demographics and other stressors.ResultsHigher area deprivation was unrelated to days of poor self-rated mental health in adjusted models, but effects were heterogeneous by gender presentation and LGBT community connectedness. As deprivation increased, more masculine and androgynous women evidenced no increased risks of poor mental health. However, among women presenting as neither masculine nor androgynous, risks were positively associated with deprivation (IRRs: 1.44 and 1.34, respectively). Unexpectedly, women with higher levels of LGBT community connectedness (IRR: 1.48) reported worse mental health as deprivation increased. No other minority stressor moderated associations.ConclusionsGender presentation appears to be a key factor in the impact of neighborhood deprivation on poor mental health among sexual minority women; the relationship may be more complicated for community connectedness. Our findings suggest that to improve sexual minority women's mental health, interventions targeting deprivation ought to complement interventions targeting sexual minority stigma.Policy ImplicationsTo improve mental health among sexual minority women, advocates must promote both broad economic policies and specific protective, anti-stigma policies.