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      Mediation analysis of mental health characteristics linking social needs to life satisfaction among immigrants

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          Abstract

          Background

          Life satisfaction contributes to improved long and healthy lives, enhanced biological function, better mental health, and decreased mortality risks. Social needs (e.g., food security, employment, healthcare utilization) are important determinants of mental health and life satisfaction among immigrants. However, there is limited literature on how social needs influence mental health, which, in turn, affects life satisfaction among immigrants. We examined whether mental health influences the mechanisms of the relationship between social needs and life satisfaction among immigrants.

          Methods

          We used the 2021 cross-sectional National Health Interview Survey data on U.S. immigrants (n = 4320) aged ≥18 years. We conducted weighted mediation analyses with multiple linear regression. Life satisfaction (scores 0–10; ≥1 as higher life satisfaction) was the dependent variable; independent variables were food security, employment, and healthcare utilization; and the mediator, serious psychological distress (SPD: scores 0–24; ≥1 as higher SPD).

          Results

          The total effect (not accounting for SPD) of food insecurity (vs. secure) on life satisfaction was negative (β = −0.61, p < 0.001); the direct effect (after accounting for SPD) was not statistically significant (β = −0.21, p = 0.153), while the indirect effect (food insecurity's effect explained by SPD) was negative (β = −0.40, p < 0.001). The total (β = 0.32, p < 0.001), direct (β = 0.24, p = 0.004), and indirect (β = 0.09, p = 0.006) effects of being employed (vs. unemployed) on life satisfaction were positive. The total (β = −0.12, p = 0.116) and direct (β = −0.03, p = 0.683) effects of healthcare utilization within the past year (vs. more than a year) on life satisfaction were not statistically significant, whereas the indirect effect was negative (β = −0.09, p < 0.001).

          Conclusions

          SPD mediates the effect of food security, healthcare utilization, and employment on life satisfaction, suggesting the need to improve social needs and mental health among immigrants.

          Highlights

          • Mental health symptoms mediate the association between social needs and life satisfaction among immigrants in the US.

          • Serious psychological distress (SPD) partially mediated the negative effect of food insecurity and past-year healthcare use on lower life satisfaction.

          • The positive effect of employment on higher life satisfaction was reduced by about 26.60% after accounting for SPD.

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          Most cited references47

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          The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations.

          In this article, we attempt to distinguish between the properties of moderator and mediator variables at a number of levels. First, we seek to make theorists and researchers aware of the importance of not using the terms moderator and mediator interchangeably by carefully elaborating, both conceptually and strategically, the many ways in which moderators and mediators differ. We then go beyond this largely pedagogical function and delineate the conceptual and strategic implications of making use of such distinctions with regard to a wide range of phenomena, including control and stress, attitudes, and personality traits. We also provide a specific compendium of analytic procedures appropriate for making the most effective use of the moderator and mediator distinction, both separately and in terms of a broader causal system that includes both moderators and mediators.
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            Reconsidering Baron and Kenny: Myths and Truths about Mediation Analysis

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              SPSS and SAS procedures for estimating indirect effects in simple mediation models

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                Author and article information

                Contributors
                Journal
                SSM Popul Health
                SSM Popul Health
                SSM - Population Health
                Elsevier
                2352-8273
                04 October 2023
                December 2023
                04 October 2023
                : 24
                : 101522
                Affiliations
                [1]Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
                Author notes
                []Corresponding author. Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, North Bethesda, MD, 20852, USA. david.adzrago@ 123456nih.gov
                Article
                S2352-8273(23)00187-8 101522
                10.1016/j.ssmph.2023.101522
                10563063
                37822807
                349c130e-eadd-4389-8e71-21401ac5bfcb

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 20 May 2023
                : 22 August 2023
                : 23 September 2023
                Categories
                Regular Article

                quality of life,well-being,mental health,immigration,socioeconomics,mediation analysis

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