Intersectionality and mental health in university students: a jeopardy index approach

To explore the associations between current mental health symptoms and social disparities in university students.

We recruited participants from nine public universities in Brazil, from August to November 2022, using online advertisements and in-person lectures. All participants completed an online survey containing social (sex, race/color, gender identity, sexual orientation, and income) and mental health assessments. The Jeopardy index was composed of social variables. The index considered zero points for subjects with less oppressive experienced characteristics (men, White, cisgender, heterosexual, higher income) and one point for the opposite characteristics. We defined six clusters according to Jeopardy Index results: 0, 1, 2, 3, 4, and 5 points, with the greatest number of points representing the most disadvantaged group. The mental health symptoms were assessed on two levels. First by the "DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure - Adult," and second by the "Patient Health Questionnaire-9," and the "Generalized Anxiety Disorder Questionnaire-7." Adjusted Odds Ratio (OR) analyses was performed for age and educational level.

748 participants were allocated into the six Jeopardy clusters: 0 (n = 46; 6.1%), 1 (n = 112; 15.0%), 2 (n = 163; 21.8%), 3 (n = 218; 29.1%), 4 (n = 171; 22.9%), and 5 (n = 38; 5.1%). It was observed a high prevalence of anxiety (42.5%) and depression (51.0%), however, the less privileged group (5) had a higher risk of having severe symptoms of anxiety (OR = 6.21; 1.51-25.58; p < 0.01) and depression (OR = 8.60; 2.15-34.43; p < 0.01), compared against the most privileged group.

Although anxiety and depressive symptoms were highly prevalent for all participants, these disorders are not equally distributed in this population and the intersectionality between social factors plays an important role in contributing to these differences.