Social Determinants of Women's Mental Health and Barriers to Help-Seeking in Three Ethnically Diverse, Impoverished, and Underserved Communities

Tuesday, 23 July 2013: 1:30 PM

Mary Molewyk Doornbos, PhD1
Gail Landheer Zandee, MSN, RN1
Joleen DeGroot, BSN, RN2
(1)Department of Nursing, Calvin College, Grand Rapids, MI
(2)Spectrum Health, Grand Rapids, MI

Learning Objective 1: 1. The learner will be able to identify economic, cultural, and neighborhood issues that function as social determinants of anxiety/depression of ethnically diverse, urban women.

Learning Objective 2: 2. The learner will be able to recognize practical, psychosocial, and cultural barriers to the help-seeking behaviors of ethnically diverse, urban women.


Depression and anxiety are significant mental health issues in the United States today that tend to affect ethnically diverse, impoverished women disproportionately. These mental health issues create situations of significant burden particularly when access to care, and specifically culturally congruent care, is limited. In keeping with the newly identified Healthy People 2020 topic, the purpose of this study was to identify social determinants of mental health and barriers to help seeking in three urban, ethnically diverse, underserved, and impoverished neighborhoods.


Using the ideological perspective of community based participatory research and in the context of long-term partnerships between a department of nursing and these neighborhoods, the research team recruited sixty-one women aged 18 to 69 years. Data were collected via homogeneous focus groups comprised of Black, Hispanic, and White women respectively. The researchers conducted five of the focus groups in English and one in Spanish. The research team transcribed the focus group data and then analyzed it using NVivo9.


The women identified saturated themes around economic, cultural, and neighborhood issues that they perceived to be determinants of their depression and anxiety. There were also significant themes around practical, psychosocial, and cultural barriers to their help seeking behavior.


The results of this study have significant potential to promote women’s overall mental health by contributing to an understanding of the interrelationships between social factors and depression/anxiety as well as the barriers to help-seeking. As such, this research can make important contributions to nursing practice, client outcomes, and the science of nursing.