Psychosocial Determinants for Mental Health of Latino Americans Nationwide: Systematic Review with a Strength Perspective

Objectives: Latinx Americans represent the largest ethnic minority group, at nearly 19% of the U.S. population. Their mental health has received increasing attention as they exhibit elevated prevalence rates of anxiety (ANX) and depression (DEP), as well as substance use disorders (SUD). The National Latino and Asian American Study (NLAAS) is the first national population-based mental health study of Latinx Americans, yielding the most comprehensive dataset. Despite many studies revealing risk factors for ANX, DEP, and SUD among Latinos, few have focused on protective factors that may counteract the damage of distress-inducing factors. Further, no systematic review has integrated all related findings. The current project examined NLAAS-based publications on the above three outcomes to identify their psychosocial determinants. We also extracted protective factors from the included articles that address a critical but underreported aspect of the literature to advance clinical assessments and interventions for the targeted population. Method: Following PRISMA guidelines, we searched English-language articles published in EBSCO, Embase, PsycINFO, Web of Science, and PubMed using search terms as Latino, Latina, anxiety, depressive symptoms, substance abuse, and NLAAS. Studies that met all of the following criteria were included: 1) must have sampled and separately reported results for Latinx population; 2) must have outcomes variables including ANX, DEP, or SUD (e.g., alcohol use disorder/AUD); 3) must have results of risk or protective factors that related to the three key outcomes; and 4) must be peer-reviewed empirical articles and have been published in English. We excluded articles that: 1) had Latino population but reported results combing participants in other ethnic groups (e.g., Asian population); 2) used other outcomes (e.g., self-rated mental health, mental health service utilization); 3) used other databases that did not include NLAAS (e.g., National Survey of American Life); or 4) were not peer-reviewed empirical articles (e.g., reviews, abstracts, and dissertations). Two authors screened the articles independently and extracted data from each study. Results: Thirty-two studies published between 2007 and 2024 were included in the final review. Among them, 13 studies investigated ANX, 17 studies examined DEP and SUD, respectively. Sixteen studies assessed protective factors. Ten articles assessed multiple key outcomes. All risk factors were grouped into three categories: trauma and negative relationships (e.g., traumatic experiences, family conflict), acculturation- and immigration-related factors (e.g., discrimination, nativity, acculturation stress, English proficiency), and sociodemographic and social participation factors (e.g., gender, education, low SES). Protective factors (e.g., positive acculturative experiences, family cohesion, religious activities, education) were also investigated. Conclusion: This first systematic review provides comprehensive evidence on the multifaceted cultural, social, and intrapersonal factors that were either negatively or positively associated with mental and behavioral health within the U.S. Latinx population. The study categorizes all trauma-related and other risk factors previously revealed in a national sample of Latinx Americans. But, more importantly, it underscores their strengths and protectors that are deeply embraced in their tradition and current circumstances in life. Findings of this review can inform culturally responsive prevention and intervention strategies to reduce public health disparities and to improve all Latinos’ mental health.