An intersectional and social determinants of health framework for understanding Latinx psychological distress in 2020: Disentangling the effects of immigration policy and practices, the Trump Administration, and COVID-19-specific factors.

Public Significance Statement This study finds that worries about deportation, perceptions of anti-Hispanic discrimination, and having higher levels of COVID-19-related financial and health concerns were significantly associated with increased psychological distress among Latinxs in Spring 2020, net of other covariates. Gender-stratified analyses reveal that worries about deportation, legal and citizenship status, and pandemic-related effects on personal lives and health increased distress among Latinas but not Latinos. This highlights the array of gendered impacts and social determinants of health affecting Latinx psychological well-being during the pandemic. The COVID-19 pandemic has disproportionately impacted U.S. communities of color, such as the Latino/x population. The pandemic coincides with other major contemporary structural factors affecting Latinxs, including the effects of U.S. immigration policies and President Trump's xenophobic rhetoric and priorities. Yet, the independent and simultaneous implications of the larger sociopolitical climate and specific COVID-19 concerns for Latinx mental health remain less clear. The present study uses an intersectional and social determinants of health framework to examine these relationships. Multivariable regression models were estimated with three waves of population-based panel data from the Pew American Trends Study (collected between 2019 and 2020) with Latinx adults (n = 1,132). We simultaneously examined how worries regarding deportation, respondents' citizenship and legal status, perceptions regarding the Trump Administration, anti-Hispanic discrimination, and pandemic-related concerns predicted variation in Latinx self-reported psychological distress, after adjusting for other important covariates. We also conducted analyses separately by gender. The results indicated that worrying about a family member or a friend being deported, perceiving higher anti-Hispanic discrimination, and viewing coronavirus as a threat to respondents' personal health and finances were significantly associated with higher levels of psychological distress. Stratified analyses revealed that gender filters the ways that some of these stressors affect the mental health of Latinas, such as perceived threats about deportation, compared to Latinos. Taken together, this work demonstrates the diverse social determinants shaping Latinx mental health in intersectional ways early in the pandemic.