Depression at the Intersection of Race/Ethnicity, Sexual Orientation, and Income

Abstract

The current study uses an intersectional framework to examine subgroup differences in the prevalence of depression among a community sample of predominantly low-income, racial/ethnic and sexual minority adults. Between May 2017-June 2018, participants (N=1753) were recruited from and screened for depression in community organizations that predominantly serve sexual minority clients based in Los Angeles, California and New Orleans, Louisiana. Twenty-six percent of people screened for study eligibility met criteria for depression (Patient Health Questionnaire-8≥10). As is true in higher-resourced populations, bisexual (Odds Ratio; OR: 1.50; 95% Confidence Interval; CI: 1.08, 2.09) and queer/questioning (OR: 1.86; 95% CI: 1.08, 3.19) individuals were more likely to be depressed than heterosexual and lesbian/ gay individuals. These differences remained even when accounting for income. No differences in depression were observed between lesbian/gay and heterosexual adults. In terms of racial differences, bisexual Black (OR: .47; 95% CI: 0.21, 1.04) and Hispanic (OR: .51; 95% CI: 0.23, 1.12) adults were marginally less likely to be depressed than bisexual White adults. No racial differences emerged across other sexual orientations. Differences across some sexual minority subgroups may be race-specific, suggesting that intersectional frameworks may be the best way to understand how multiple marginalization affects different subgroups.

Keywords: Bisexuality; depression; intersectionality; low-income; racial/ ethnic minorities.