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. 2025 Jul 29.
doi: 10.1007/s40615-025-02559-7. Online ahead of print.

Resilience Mediates the Association Between Discrimination and Psychological Distress Among Rural, Black Women in South Carolina: A Structural Equation Model

Camryn Garrett  1   2 , Abhishek Aggarwal  1   2 , Huiyi Xia  1   2 , Cheuk Chi Tam  1   2 , Bankole Olatosi  1   3 , Sara Wilcox  4   5 , Xiaoming Li  1   2 , Shan Qiao  6   7
Affiliations

Resilience Mediates the Association Between Discrimination and Psychological Distress Among Rural, Black Women in South Carolina: A Structural Equation Model

Camryn Garrett et al. J Racial Ethn Health Disparities. .

Abstract

Introduction: The marginalization of intersecting racial, gender, and rural identities compounds the structural vulnerabilities (e.g., discrimination, stigma, health disparities) experienced by Black women in South Carolina's rural areas. Discriminatory experiences can deteriorate mental health; however, resilience can potentially reduce the ill effects of discrimination by decreasing associated psychological distress. This study examines the mediating role of resilience in the association between discrimination and psychological distress among rural, Black women in South Carolina in the post-pandemic era.

Methods: Black women (n = 300, mean age = 48.6) living in rural South Carolina were recruited from January to February 2024 using a cluster sampling method. Participants completed surveys assessing experiences of discrimination, resilience, and psychological distress (i.e., anxiety, depression, PTSD). A structural equation modeling analysis was performed using the Lavaan package in R.

Results: Discrimination was negatively associated with resilience (β = - 0.107, p < .05) and positively associated with psychological distress (β = 0.387, p < .001). Discrimination had a reduced, positive indirect effect on psychological distress through the path of resilience (β = 0.042, z = 2.004, p < .05), after controlling for participants' demographics. The model fit was satisfactory (RMSEA = 0.038; CFI = 0.986; TLI = 0.979; SRMR = 0.042; chi-square/df = 22.867/16, p = .117). Age (β = - 0.182, p < .001) was found to act as a moderator between discrimination and psychological distress.

Conclusion: The findings reveal that resilience significantly reduces psychological distress among rural Black women, in the context of the adverse effects of discrimination on well-being. Aging appears to exert a protective influence on mental health outcomes, in the presence of discrimination, perhaps as related to generational differences in experiences, perceptions, and coping. In alignment with the advancement towards racial equity, reducing discrimination and fostering process-oriented resilience that is multilevel and multidimensional emerge as potential strategies to lessen the negative impacts on psychological well-being.

Keywords: Discrimination; Psychological well-being; Resilience; Structural equation modeling.

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Conflict of interest statement

Declarations. Ethics Approval: This study was performed in line with the Belmont Report and the Declaration of Helsinki. The study activities were reviewed and approved by the Institutional Review Board at the University of South Carolina. Consent to Participate: Informed consent, through an invitation to participate, was obtained from all individual participants included in the study. Competing Interests: The authors declare no competing interests.

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