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Methods for structural sexism and population health research: Introducing a novel analytic framework to capture life-course and intersectional effects.
Beccia, Ariel L; Agénor, Madina; Baek, Jonggyu; Ding, Eric Y; Lapane, Kate L; Austin, S Bryn.
Afiliação
  • Beccia AL; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA, 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA. Electronic address: ariel.beccia@childrens.harvard.edu.
  • Agénor M; Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, 02903, USA. Electronic address: madina_agenor@brown.edu.
  • Baek J; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA. Electronic address: jonggyu.baek@umassmed.edu.
  • Ding EY; Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA. Electronic address: eric_ding@brown.edu.
  • Lapane KL; Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, 55 Lake Ave North, Worcester, MA, 01655, USA. Electronic address: kate.lapane@umassmed.edu.
  • Austin SB; Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, 333 Longwood Avenue, Boston, MA, 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Aven
Soc Sci Med ; 351 Suppl 1: 116804, 2024 Jun.
Article em En | MEDLINE | ID: mdl-38825380
ABSTRACT
Accumulating evidence links structural sexism to gendered health inequities, yet methodological challenges have precluded comprehensive examinations into life-course and/or intersectional effects. To help address this gap, we introduce an analytic framework that uses sequential conditional mean models (SCMMs) to jointly account for longitudinal exposure trajectories and moderation by multiple dimensions of social identity/position, which we then apply to study how early life-course exposure to U.S. state-level structural sexism shapes mental health outcomes within and between gender groups. Data came from the Growing Up Today Study, a cohort of 16,875 children aged 9-14 years in 1996 who we followed through 2016. Using a composite index of relevant public policies and societal conditions (e.g., abortion bans, wage gaps), we assigned each U.S. state a year-specific structural sexism score and calculated participants' cumulative exposure by averaging the scores associated with states they had lived in during the study period, weighted according to duration of time spent in each. We then fit a series of SCMMs to estimate overall and group-specific associations between cumulative exposure from baseline through a given study wave and subsequent depressive symptomology; we also fit models using simplified (i.e., non-cumulative) exposure variables for comparison purposes. Analyses revealed that cumulative exposure to structural sexism (1) was associated with significantly increased odds of experiencing depressive symptoms by the subsequent wave; (2) disproportionately impacted multiply marginalized groups (e.g., sexual minority girls/women); and (3) was more strongly associated with depressive symptomology compared to static or point-in-time exposure operationalizations (e.g., exposure in a single year). Substantively, these findings suggest that long-term exposure to structural sexism may contribute to the inequitable social patterning of mental distress among young people living in the U.S. More broadly, the proposed analytic framework represents a promising approach to examining the complex links between structural sexism and health across the life course and for diverse social groups.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sexismo Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Sexismo Idioma: En Ano de publicação: 2024 Tipo de documento: Article