Deidre M. Anglin

Neighborhood social factors have increasingly been found relevant for the mental health of ethnoracial minoritized young people. This study examined neighborhood ethnic density, the racial or ethnic composition of one's neighborhood, in relation to anxiety and depression and whether racial discrimination mediated these relations among specific ethnoracial minoritized groups in the United States. Participants were 1,019 ethnoracial minoritized undergraduate students at a large urban public university who completed self-report surveys and provided their zip codes. Perceived and zip code-level neighborhood ethnic density was attained both before and after age 12, given evidence that neighborhood ethnic density during childhood may be more relevant to mental health outcomes. Generalized estimating equations were computed, accounting for zip code clustering and deprivation. Discrimination mediated the relationship between zip code-level ethnic density and depression in the Latine sample and mediated the relationship between perceived ethnic density and depression in the Black and Latine samples. Perceived ethnic density had direct effects on depression and anxiety in the Asian sample. Notably, discordant minority density (residing in a neighborhood where a different racial minority group predominates) was associated with greater depressive symptoms for Black and Latine individuals and greater anxiety for Asian individuals. Findings suggest distal neighborhood cultural factors may influence mental health outcomes among minoritized young people in nuanced ways for specific ethnoracial groups, in part because of exposure to racial discrimination in these sociocultural contexts. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The study aim was to identify ethnoracial disparities in the prevalence of schizophrenia spectrum disorders (SSDs) and positive psychotic symptoms in the United States and examine the role of social neighborhood inequities. Participants in the Mental and Substance Use Disorders Prevalence Study, a national household sample of nonelderly adults (N=4,764), were assessed by clinicians with the Structured Clinical Interview for DSM-5 (SCID-5) for SSDs (past year and lifetime), including schizophrenia, schizoaffective disorder, and schizophreniform disorder, and for psychotic symptoms. Weighted logistic regression models estimated ethnoracial differences in the prevalence of SSDs and psychotic symptoms in unadjusted models, age- and sex-adjusted models, and models further adjusted for a neighborhood Social Vulnerability Metric (SVM) score, a composite index of five social determinants of health domains. Compared to non-Hispanic White individuals, non-Hispanic Black individuals had a significantly higher prevalence of SSDs (4.1% vs. 1.2%; adjusted odds ratio=3.49, 95% CI=1.37, 8.91) and psychotic symptoms (9.3% vs. 4.9%; adjusted odds ratio=2.04, 95% CI=1.15, 3.63), and non-Hispanic multiracial individuals had a significantly higher prevalence of SSDs (5.6%; adjusted odds ratio=4.59, 95% CI=1.53, 13.76). Further adjustment for SVM score lowered the Black-White group difference for SSDs (adjusted odds ratio=2.49, 95% CI=0.63, 9.90) and psychotic symptoms (adjusted odds ratio=1.69, 95% CI=0.83, 3.44), and the associations were no longer statistically significant. The difference in SSDs between the non-Hispanic multiracial and White groups was attenuated after SVM score adjustment (adjusted odds ratio=3.95, 95% CI=1.30, 12.00) but remained significant. This national U.S. household study found ethnoracial differences in the prevalence of clinician-assessed SCID-based schizophrenia spectrum disorders and positive psychotic symptoms. The higher prevalence among minoritized groups, particularly Black individuals, was connected to social inequities and community-level vulnerabilities embedded in neighborhoods and associated with structural racism.

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Biological mechanisms associated with psychosis risk are often formed by generations of social-environmental experiences within families, communities, and neighborhoods, and further shaped by structural policies. This column first describes conceptual work that integrates macrolevel structural, individual-level social, and biological domains to better understand psychosis risk. It then highlights the interconnection of low neighborhood ethnic density and racial exclusion as an example of how social determinants connect to social and biological consequences associated with psychosis outcomes. Neighborhood ethnoracial diversity may be protective against social and biological mechanisms connected to psychosis outcomes among minoritized groups at risk for psychosis. This is particularly salient during childhood because such diversity attenuates stress processes associated with social exclusion and discrimination. Moreover, ethnoracially diverse communities foster close relationships and social connection. We provide supportive literature to illustrate the importance of multilevel/multifactorial approaches for identifying psychosis risk and protective factors. Investing further in integrative approaches for understanding psychosis risk and prognosis may translate into more substantial improvements for individuals with these lived experiences.

The Centers for Disease Control and Prevention has identified racism as a serious threat to public health. Structural racism is a fundamental cause of inequity within interconnected institutions and the social environments in which we live and develop. This review illustrates how these ethnoracial inequities impact risk for the extended psychosis phenotype. Black and Latinx populations are more likely than White populations to report psychotic experiences in the United States due to social determining factors such as racial discrimination, food insecurity, and police violence. Unless we dismantle these discriminatory structures, the chronic stress and biological consequences of this race-based stress and trauma will impact the next generation's risk for psychosis directly, and indirectly through Black and Latina pregnant mothers. Multidisciplinary early psychosis interventions show promise in improving prognosis, but coordinated care and other treatments still need to be more accessible and address the racism-specific adversities many Black and Latinx people face in their neighborhoods and social environments.