What the study found
Depression in this study was associated with both overlapping individual identities and area-level conditions. The authors reported several protective factors and several risk factors, including some that differed by age, gender identity, sexual orientation, and place-level measures.
Why the authors say this matters
The authors conclude that clinical and public health strategies for depression prevention and intervention should account for overlapping identities while also using place-aware approaches. Here, intersectionality means considering how personal identities overlap, and area-level indicators refer to characteristics of the places where people live.
What the researchers tested
This was a cross-sectional study using electronic health records data from the All of Us research network. The cohort included 33,994 people who completed social determinants of health surveys and had at least one inpatient visit; 31.7% had a depression diagnosis between 2020 and 2025.
What worked and what didn't
The mixed effects logistic regression model, selected with the LASSO method and using 3-digit ZIP code as a random effect, identified protective factors including male sex at birth among straight and non-binary individuals, older adults with active military service or health insurance, and younger adults with 1–2 children. Risk factors included inability to work, housing concerns, frequent disrespect, high area deprivation in older adults, and several intersectional combinations such as non-binary identity in older adults, non-binary individuals born outside the USA, women with children, and Hispanic active-duty members.
What to keep in mind
The authors note that the study was limited by 3-digit ZIP code aggregation, which may have obscured some area-level effects. The abstract does not describe other limitations.
Key points
- The study linked depression to both individual identities and area-level conditions.
- Protective factors included male sex at birth in straight and non-binary individuals, and older adults with active military service or health insurance.
- Risk factors included inability to work, housing concerns, frequent disrespect, and high area deprivation in older adults.
- Some intersectional combinations showed elevated risk, including non-binary identity in older adults and non-binary individuals born outside the USA.
- The authors say depression strategies should account for overlapping identities and place-aware approaches.
Disclosure
- Research title:
- Intersectional and area-level factors linked to depression disparities
- Authors:
- Dmitry Scherbakov, Michael Marrone, Leslie Lenert, Alexander V. Alekseyenko
- Institutions:
- Medical University of South Carolina
- Publication date:
- 2026-03-03
- OpenAlex record:
- View
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