Social determinants of distress in South Asian men with long-term conditions: a qualitative study in primary care

People with long-term physical conditions are more likely to experience distress, depression, or anxiety. Physical-mental comorbidity is associated with lower quality of life, poorer clinical outcomes, and increased mortality than physical conditions alone. People of South Asian origin are the largest minority group in the UK, and more likely to have long-term conditions (LTCs) such as diabetes and heart disease.

To explore how men of South Asian origin with LTCs understand and experience emotional distress as well as the experiences of GPs supporting them.

A UK qualitative study interviewing South Asian men with diabetes or coronary heart disease, and GPs working at practices with higher proportions than average in the UK of people of South Asian origin.

Online semi-structured interviews with South Asian men and GPs were undertaken. Data were analysed via reflexive thematic analysis. Topic guides were modified iteratively as data collection and analysis progressed. An ethnically appropriate patient advisory group of South Asian men was involved in all stages of the research.

Seventeen South Asian men with LTCs and 18 GPs were interviewed. Participants described contextualising distress, including LTCs influencing distress and the intersections of social determinants of distress including ethnicity, poverty, and perceptions of prejudice. Participants understood distress as different from depression with the need to negotiate multiple identities as well as integrative paradigms of health.

This study highlights the influence of social determinants of distress in South Asian men with LTCs. It provides an insight into how primary care has the potential to address health inequalities by considering the intersection of these factors.