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. Author manuscript; available in PMC: 2023 Jul 18.
Published in final edited form as: Clin Psychol Sci. 2022 Dec 14;11(3):444–457. doi: 10.1177/21677026221129628

Discrimination and Depressive Symptoms Among Mexican American Women: Exploring Multilevel Sociocultural Moderators

Sarah G Curci 1, Juan C Hernández 1, Laura K Winstone 1, Marisol Perez 1, Linda J Luecken 1
PMCID: PMC10353733  NIHMSID: NIHMS1836231  PMID: 37465841

Abstract

Relative to empirical studies on risk factors, less research has focused on culturally based protective factors that reduce the impact of discrimination on mental health. The current prospective study evaluated two potential moderators of the effect of discrimination on depressive symptoms among Mexican American women: individually held familism values and neighborhood cultural cohesion. Mexican-origin women in the United States (N = 322; mean age = 27.8 years; 86% born in Mexico) reported on frequency of discrimination, depressive symptoms, familism, and neighborhood cultural cohesion. Independent models evaluated familism and neighborhood cultural cohesion as moderators of the effect of discrimination on subsequent depressive symptoms. More frequent discrimination predicted higher subsequent depressive symptoms. High familism buffered the harmful effect of discrimination on depressive symptoms, such that more frequent discrimination was associated with higher subsequent depressive symptoms only for women who reported average and low familism. Neighborhood cultural cohesion did not buffer the effect of discrimination on depressive symptoms.

Keywords: discrimination, depressive symptoms, familism, neighborhood cultural cohesion, Mexican American women

Experiences of discrimination directed at individuals or their racial-ethnic groups are widely reported in the United States. In the prior year, nearly 40% of Hispanic/ Latinx individuals living in the United States, the majority of whom identify as being Mexican in origin, reported experiences of discrimination, such as being criticized for speaking Spanish or being told to go back to their home country (Gonzalez-Barrera & Lopez, 2020). Experiences of discrimination are a significant psychosocial stressor with potential deleterious effects on mental and physical health (Lewis et al., 2015). Such experiences have been shown to affect Mexican American women’s mental health, particularly leading to increased depressive symptoms (Calzada et al., 2016; Coburn et al., 2016; D’Anna-Hernandez et al., 2015; Earnshaw et al., 2013). Depression has immense social and economic costs, potentially affecting educational attainment, marital functioning, parental functioning, child development, physical health, and numerous other adverse outcomes (Kessler, 2012). Systemic barriers to accessing mental health care, such as language issues or low rates of health insurance, compound mental health risk among this population (Ramos-Sánchez & Atkinson, 2009). Given that Mexican-origin women are members of the second-fastest-growing racial or ethnic group in the United States (Krogstad et al., 2022), their mental health is a critical public health concern.

Mexican American women can experience discrimination alone or in concert with other significant cultural stressors (e.g., acculturative stress, family conflict related to acculturation) or general stressors (e.g., economic hardship, marital conflict; Calzada et al., 2016; Coburn et al., 2016; D’Anna-Hernandez et al., 2015; Fernandez & Loukas, 2014; Flores et al., 2008; Walker et al., 2012). Although some research suggests that discrimination has less of an impact on depressive symptoms than other major stressors for Mexican American women (e.g., Coburn et al., 2016; D’Anna-Hernandez et al., 2015), other research finds a significant independent effect of perceived discrimination on depressive symptoms (Flores et al., 2008; Walker et al., 2012). Thus, further research on the relation between discrimination and depressive symptoms among Mexican American women is needed, particularly with an eye toward factors that may moderate the impact of discrimination on depression.

Relative to empirical studies on risk factors, less research has been conducted on protective factors that reduce the impact of discrimination experiences among Mexican Americans (Ponting et al., 2020). However, several key cultural variables have been identified that may strengthen resiliency against depressive symptoms among Mexican American women. Among a sample of immigrant Hispanic women experiencing depressive symptoms, support from family and community members was found to be preferable to formal support from mental health providers (Callister et al., 2011), a finding that warrants investigation of culturally based protective factors relevant to family and community support. Individually held familismo (familism) values, a central aspect of traditional Mexican culture, have been found to possess protective influences on psychological functioning throughout the life span (e.g., Campos et al., 2014; Corona et al., 2017; Stein et al., 2015). Traditional Mexican familism values emphasize prioritizing the needs of the family over and above individual needs, foster support among family members, and encompass both attitudes (e.g., feelings of loyalty, solidarity, reciprocity among family members) and behaviors (e.g., considering family members in decision-making; Steidel & Contreras, 2003). Higher familism values are theorized to exert a protective effect on psychological well-being and physical health both directly and indirectly (see, e.g., the stress-buffering model; Corona et al., 2017) by promoting family-based support networks and shaping how individuals interpret current and future social interactions (Campos & Kim, 2017). For example, familism among Latinos has been linked to reduced interparent conflict (Taylor et al., 2012; e.g., parents may perceive directions from each other as encouragement rather than criticism) and familial prosocial behavior (Calderón-Tena et al., 2011; e.g., individuals may perceive their own offering of emotional support as highly valuable rather than insignificant). Meta-analytic evidence offers support for a small direct effect of familism on some aspects of mental health (e.g., depression, suicide, internalizing behaviors) but not for others (e.g., substance abuse and externalizing symptoms; Valdivieso-Mora et al., 2016). Among samples of adult Latinas, the majority of whom identified as Mexican American, higher maternal and familial alignment to familism values has been associated with more adaptive psychological functioning across domains of mood (Campos et al., 2008; D’Anna-Hernandez et al., 2015).

In the face of discrimination, strong familism values may promote access to and utilization of familial support and bolster adaptive coping strategies to mitigate detrimental effects on mental health. However, prior empirical work has yielded mixed support for a moderating role of familism values on the association between perceived discrimination and depressive symptoms (e.g., Umaña-Taylor et al., 2011; Wheeler et al., 2021), with many differences emerging between studies, such as how discrimination was assessed (e.g., specific to the workplace vs. broader everyday experience, specific to a particular identity), the age of the sample (e.g., adolescents vs. adults), and the breadth of the lens through which familism values were examined (e.g., distinct subcomponents vs. overall factors). Corona and colleagues (2017) reported a main protective effect but no stress-buffering effect of familism values on depression, which suggests that the positive relational processes that facilitate closeness, support, and prosocial behavior may be beneficial independently of stress levels (Cohen & Wills, 1985). However, the strength and type of stressor being counteracted is important when considering familism values, particularly as stressors with a relational component (e.g., interpersonal conflict) may be differentially impactful (Hernández et al., 2010). For example, among a sample of adolescent Latina mothers, familism did not moderate the association between discrimination and depressive symptoms (Umaña-Taylor et al., 2011). Importantly, adolescent mothers may face unique stressors related to teenage pregnancy, so pathways of risk and resilience (i.e., the buffering effect of familism) may not generalize to other populations of Mexican-origin women. Umaña-Taylor et al. (2011) also theorize that the protective effects of familism may not be fully realized until adulthood. Calls for future research include longitudinal investigations among adult samples, in which familism and the role of family may be a more central construct (Stein et al., 2019; Umaña-Taylor et al., 2011).

Among Mexican American women, social support has been shown to buffer the negative impact of multiple domains of stress on depressive symptoms (Coburn et al., 2016). Examining the multilevel nature of culturally based systems of support (e.g., individuals nested within families, individuals nested within neighborhoods) allows for an expanded range of potential buffers of the relation between discrimination and depression. Exposure to and perception of discrimination varies with neighborhood context (Dailey et al., 2010), and qualitative work suggests that Mexican American women experience less discrimination in their own neighborhoods than in other more diverse spaces (Richardson & Nuru-Jeter, 2012). Yet less empirical work has been conducted on neighborhood support relative to support from other sources. Neighborhood social and cultural cohesion is defined by shared mutual values, goals, cultural traditions, and trust among neighbors (Nair et al., 2013; Sampson et al., 1997). Previous research among a national sample of U.S. adults suggests that higher perceived neighborhood cohesion predicts fewer self-reported daily stressors and physical health symptoms, higher positive affect, and lower negative affect (Robinette et al., 2013). Supportive neighborhoods have been shown to promote positive family processes (García Coll et al., 1996), trusting relationships through neighbor’s mutual values (Sampson et al., 1997), and an appreciation for shared heritage (Nair et al., 2013). Neighborhood cohesion is theorized to reduce exposure to discrimination and/or provide protection against perception of discrimination among coethnic residents by allowing Mexican American women to replicate many Mexican customs and traditions on a community level (Viruell-Fuentes, 2007). Particularly among immigrant families, ethnic enclaves provide social, economic, and cultural resources that mediate interactions with the host society and therefore are theorized to buffer strains of dislocation and threats of “othering” (Viruell-Fuentes, 2007). Empirical work is needed to evaluate these effects among Mexican-origin women in the United States.

The Current Study

In response to calls for empirical work evaluating strength-based pathways of positive psychological adjustment among Mexican American women (Ponting et al., 2020), the current study evaluated two potential moderators of the effect of discrimination on subsequent depressive symptoms among Mexican American women across two levels of analysis: individual alignment to familism values and neighborhood cultural cohesion. As we work to decrease discrimination, it is also important to identify multilevel protective factors that support individuals facing discriminatory experiences. Consistent with a stress-buffering model, stronger familism values and higher neighborhood cultural cohesion were hypothesized to independently buffer the harmful effects of discrimination on women’s subsequent depressive symptoms.

Method

Participants

The current sample included low-income Mexican American women participating in the broader ongoing Las Madres Nuevas study, a longitudinal study of maternal and child health and development. Women were recruited from hospital-based prenatal clinics while pregnant. At enrollment, eligibility criteria included self-identifying as Mexican or Mexican American, being fluent in English or Spanish, being at least 18 years old, having a low-income status (self-reported family income below $25,000 or eligibility of Medicaid or Federal Emergency Services coverage for childbirth), and anticipating delivery of a singleton baby without prenatal evidence of health or developmental problems.

The majority of participating women were born in Mexico (86%) and spoke Spanish as their primary language (86%). At enrollment, most women were unemployed (83.5%), and reported a modal family income of $10,001 to $15,000 for a family of four. On average, women had lived in the United States for 12 years (range 0–32). The majority of women were unmarried but living with a romantic partner (45.7%) and were not first-time mothers (77.8%); of multiparous women, the number of other biological children ranged from one to nine.

Procedure

The parent study was approved by the institutional review boards at Arizona State University and Maricopa Integrated Health System. Written informed consent from participants was obtained at the initial prenatal interview. Data for the current analyses were collected at a prenatal home visit (conducted throughout 2010–2012), a postpartum phone survey at 4 years (2014–2017), and two postpartum laboratory visits at 4.5 years (2015–2017) and 6 years (2016–2019), respectively. Interviews were conducted in participants’ preferred language of Spanish (86%) or English (14%). Participants were read informed consent and survey questions and were provided with visual aids containing written and graphic descriptions of item responses. Participants were compensated with $50 and small baby gifts at the home visit, $20 for the phone survey, and $100 for the laboratory visits and additionally received up to $50 in travel expenses.

The full sample (N = 322) completed the prenatal visit, 210 women (65.2%) completed the 4-year phone survey, 230 women (75.4%) completed the 4.5-year visit, and 212 women (65.6%) completed the 6-year visit. One hundred sixty-six women completed all four of these interviews (i.e., had no missing data at any time point). Measures without an existing, validated Spanish translation were translated into Spanish and then back-translated by certified translators (native, bilingual Spanish speakers). Translation discrepancies were resolved by the principal investigators and lead translators and adapted for cultural sensitivity.

Measures

Data for the current study included demographic information collected at the prenatal visit; self-reports of familism values at the 4-year follow-up phone survey; self-reports of discrimination, neighborhood cultural cohesion, and depressive symptoms at 4.5 years; and self-reports of depressive symptoms at 6 years.

Discrimination.

Women reported their experiences of everyday discrimination at the 4.5-year visit using 11 items (Cronbach’s αSpanish = .94, Cronbach’s αEnglish = .95), which included nine items from a psychometrically validated everyday discrimination instrument (Williams et al., 1997) and two additional items capturing additional everyday discrimination experiences. Women were prompted with “These next questions are about the experiences that people of Mexican origin sometimes have in this country. Please tell us how often you experience the following because you are Mexican or Mexican American.” Participants rated how often they experienced various discriminatory situations because of their Mexican or Mexican American identity on a 5-point Likert scale (1 = never, 5 = always). Items included “You are treated with less courtesy than other people,” “You are treated with less respect than other people,” “You received more poor service than others in restaurants and stores,” “People act as if they think you are not smart,” “People act as if they are afraid of you,” “People act as if they think you are not honest,” “People act as if they are better than you,” “You are told profanity or are insulted,” “You are threatened or harassed,” “You are treated badly or unfairly,” “You feel rejected from others.” Higher scores indicate more frequent experiences of discrimination. Higher scores indicate more frequent experiences of discrimination.

Maternal depressive symptoms.

Women reported their depressive symptoms using the Center for Epidemiological Studies Depression Scale (CES-D) at the 4.5- and 6-year visits (Radloff, 1977; 4.5-year visit: Cronbach’s αSpanish = .91, Cronbach’s αEnglish = .84; 6-year visit: Cronbach’s αSpanish = .92, Cronbach’s αEnglish = .88). The CES-D is a 20-item self-report measure of depressive symptoms experienced in the last week. Participants rate the frequency with which they experienced each symptom on a 4-point Likert scale ranging from 0, rarely or none of the time (less than 1 day), to 3, most or all of the time (5–7 days). Higher scores indicate more severe depressive symptoms. Approximately 27.1% and 31% of the sample met criteria for clinically significant levels of depressive symptoms at 4.5 and 6 years, respectively, as defined by a sum score of 16 or greater. The CES-D has been validated in Spanish among Mexican American individuals (Roberts et al., 1989).

Familism values.

Women reported on their alignment to traditional Mexican American familism values using specific subscales of the Mexican American Cultural Values Scale (MACVS) during the 4-year phone survey (Knight et al., 2010; Cronbach’s αSpanish = .83, Cronbach’s αEnglish = .83). Higher scores indicate stronger alignment to familism values. Familism subscales yield measures of alignment to overall attitudinal familism values and three components of familism: familial support and emotional closeness (six items; e.g., “Family provides a sense of security because they will always be there for you”; Cronbach’s αSpanish = .66, Cronbach’s αEnglish = .70), familial obligation (five items; e.g., “If a relative is having a hard time financially, you should help them out if you can”; Cronbach’s αSpanish = .61, Cronbach’s αEnglish = .54), and family as referent (five items; e.g., “When it comes to important decisions, the family should seek advice from close relatives”; Cronbach’s αSpanish = .66, Cronbach’s αEnglish = .73). Cronbach’s αs for these familism subscales are lower than the overall familism scale in our sample, consistent with original measurement work on this measure (Knight et al., 2010), which noted average Cronbach’s αs of .62, .55, and .59 for the supportive, obligation, and referent familism subscales respectively.

Neighborhood cultural cohesion.

Women reported the degree to which their neighborhoods were culturally cohesive using an 11-item scale that assessed the degree to which their neighborhoods supported local Mexican families, culture, and traditions at the 4.5-year visit (Nair et al., 2013; Cronbach’s αSpanish = .89, Cronbach’s αEnglish = .61). Participants rated the frequency with which various scenarios occurred in the neighborhood (e.g., neighbors gave advice or help about immigration problems, the neighborhood felt like a safe place for Mexicans and Mexicans Americans) on a 5-point Likert scale (1 = never, 5 = almost always or always). Higher scores indicate higher perceived neighborhood cultural cohesion.

Sociodemographic variables and potential covariates.

At the prenatal visit, women reported on several sociodemographic characteristics considered as potential covariates, including age, country of birth, family income, and number of other children. Age (Somers et al., 2021), country of birth (Coburn et al., 2016), and income (Vega et al., 1986) have been associated with depressive symptoms in prior work with Mexican-origin women in the United States. At the 4.5-year visit, women reported on their family’s economic stress using the 20-item Economic Hardship Scale (Barrera et al., 2001; Cronbach’s α = 75), which assesses economic hardship across domains of financial strain, inability to make ends meet, not enough money, and economic adjustments. Subscale scores are converted to z scores and summed to capture overall economic stress.

Data analysis

Preliminary analyses.

Preliminary analyses included examinations of descriptive statistics, zero-order correlations for primary study variables, attrition, and potential covariates. The intraclass correlation coefficient (ICC) and design effect (DEFF) were calculated for the dependent variable (6-year maternal depressive symptoms) on the basis of neighborhood census tract to determine whether clustering was affecting the significance of primary findings.

Primary analyses.

In our primary analyses, we evaluated two separate moderation models using multiple regression analysis in Mplus (Version 8; L. Muthén & Muthén, 2017), which uses all available values and maximum likelihood estimation for cases with missing data (Enders, 2001). Significant interaction effects were probed by testing the significance of the simple slopes of the effect of discrimination on maternal depressive symptoms at average, low (−1 SD), and high (+1 SD) levels of each moderator variable (familism values, neighborhood cultural cohesion; Aiken & West, 1991).

Exploratory analyses.

Although it is more common for studies to use the overall scale score for familism measures in studies of mental health (Cahill et al., 2021), a growing body of work among diverse samples suggests that different subcomponents of familism may differentially confer protection or risk across various domains of adjustment (Losada et al., 2010; Mendez-Luck et al., 2016; Zeiders et al., 2013). Supportive familism values have been associated with higher social support and lower levels of depressive symptoms (Losada et al., 2010; Zeiders et al., 2013). Obligation familism values have been associated with dysfunctional thoughts and avoidant coping, and thus higher levels of depressive symptoms (Losada et al., 2010; Sayegh & Knight, 2011). Referent familism values have been documented to pose both protection and risk (Losada et al., 2010; Zeiders et al., 2013). Qualitative work among Mexican women in the United States highlights familism values as both a risk and protective factor for low-income Latino families (Calzada et al., 2013). For example, familial support and obligation, manifested across domains of financial support, shared living and daily activities, immigration, and child-rearing may be particularly essential for low-income families. However, those same values may burden or strain women when they, too, have responsibility to provide financial support or housing to additional family members (Calzada et al., 2013).

By teasing apart unique aspects of familism values, we can strengthen our understanding of mechanisms of protection. As described in the measures section, the MACVS measure of familism can be further broken down into three aspects of familism: supportive familism, obligation familism, and referent familism. Exploratory analyses independently tested each of these three aspects of familism as moderators of the effect of discrimination on subsequent depressive symptoms.

Results

Preliminary results

Descriptive statistics.

Table 1 presents descriptive statistics and zero-order correlations for primary study variables and potential covariates. Values of kurtosis and skewness for each primary study variable and covariate were within acceptable ranges. Women’s country of birth was significantly correlated with at least one of the primary study variables and correlated with missingness on 6-year depressive symptoms, thus it was included in the final models. Women’s perceived economic hardship was significantly correlated with discrimination and depressive symptoms and was thus included in final models. Women’s depressive symptoms at 4.5 years was included as an additional covariate. Women’s age, family income, or number of other children were not correlated with any of the primary study variables nor missingness on any primary study variable (all ps > .05) and were thus not included in the final analyses. Missingness at 6 years was not associated with primary study variables, including 4-year familism, 4.5-year depressive symptoms, 4.5-year discrimination, or 4.5-year neighborhood cultural cohesion (all ps > .05).

Table 1.

Descriptive Statistics and Correlations Among Primary Study Variables, Covariates, and Demographic Variables

Correlations
Variable M (SD) Range 1 2 3 4 5 6 7 8 9 10 11 12
1. Discrimination 1.66 (0.70) [1.00, 5.00] —
2. Depressive symptoms (6 years) 12.35 (10.52) [0.0, 47.00] .434 —
3. Familism values 68.49 (10.76) [19.00, 18.00] −.027 .024 —
4. Neighborhood cultural cohesion 3.11 (0.82) [0.75, 5.00] .001 −.037 .067 —
5. Depressive symptoms (4.5 years) 11.99 (10.02) [0.0, 51.00] .431 .568 .069 −.108 —
6. Country of birtha 1.86 (0.34) [1, 2] −.157 −.085 .003 −.038 −.189 —
7. Supportive familism 28.27 (2.36) [18.00, 30.00] −.148 −.044 .770 .161 −.118 −.009 —
8. Obligation familism 20.74 (3.11) [9.00, 25.00] −.059 .178 .818 .113 .149 −.116 .491 —
9. Referent familism 21.08 (3.51) [9.00, 25.00] −.068 .095 .877 .090 −.047 .065 .566 .650 —
10. Family incomeb $10,001-$15,000 [< $5,000, to $85,001–90,000] .009 −.072 −.060 .072 −.082 −.047 .007 −.093 −.118 —
11. Age 27.79 (6.48) [18, 42] −.025 .040 .095 .089 .051 .327 .072 .052 .053 .062 —
12. Number of other children 1.98 (1.68) [0, 9] −.079 .107 .080 .067 .093 .252 −.050 .087 .087 −.089 .612 —
13. Family economic hardship 0.00 (3.05) [−5.42, 9.63] .264 .401 .118 −.187 .430 .023 −.053 .209 .0 66 −.158 .165 .241
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Note: Values in boldface are statistically significant atp < .05.

a

Maternal country of birth was coded 1 for United States and 2 for Mexico.

b

Modal family income at enrollment was $10,001 to $15,000 (range = < $5,000 to $85,001–90,000).

Evaluation of clustering.

There were 125 unique census tracts represented among the 220 participants with neighborhood data available at 4.5 years (i.e., there was an average of 1.76 participants living in each tract). Clustering effects were tested with the DEFF (DEFF = SQRT[(1 + (m − 1)(ICC)], where SQRT = square root and m = average number of observations per cluster), given clustered, nonmultilevel data (Lai & Kwok, 2015). The DEFF estimate was 1.0199 for maternal depressive symptoms at 6 years. DEFF values below 1.4 are considered acceptable to model without adjusting for clustering (Lai & Kwok, 2015; B. O. Muthén & Satorra, 1995); thus, primary analyses presented do not adjust for clustering.

Primary results

Model 1: familism values.

The first model evaluated the interactive effect of discrimination and women’s familism values on 6-year depressive symptoms, controlling for 4.5-year depressive symptoms, country of birth, and family economic hardship (see Table 2). More frequent discrimination (b = 3.862, SE = 1.029, p < .001), family economic hardship (b = 0.539, SE = 0.225, p = .017), and 4.5-year depressive symptoms (b = 0.409, SE = 0.092, p < .001) emerged as significant predictors of 6-year depressive symptoms. The interaction of discrimination and familism was a significant predictor of 6-year depressive symptoms (b = −0.307, SE = 0.155, p = .048). Neither familism values (p = .25) nor country of birth (p = .53) predicted 6-year depressive symptoms. Maternal country of birth (b = −0.712, SE = 0.283, p = .012), discrimination (b = 2.878, SE = 0.660, p < .001), and family economic hardship (b = 13.325, SE = 2.453, p < .001) were significantly correlated with 4.5-year depressive symptoms; specifically, women born in the United States and those experiencing more frequent discrimination reported higher concurrent depressive symptoms at 4.5 years. Greater family economic hardship was associated with more frequent discrimination (b = 0.535, SE = 0.175, p = .002).

Table 2.

Model 1 and 2 Results

Outcome and predictor b SE p R 2
Depressive symptoms (6 years) .437*
 Discrimination 4.862 1.029 .000
 Familism values −0.080 0.070 .253
 Discrimination × Familism Values −0.307 0.155 .048
 Depressive symptoms (4.5 years) 0.409 0.092 .000
 Country of birth 1.167 1.853 .529
 Family economic hardship 0.539 0.225 .017
Depressive symptoms (6 years) .401*
 Discrimination 3.650 1.179 .002
 Neighborhood cultural cohesion 0.393 0.712 .581
  Discrimination × Neighborhood Cultural Cohesion −0.210 1.107 .850
 Depressive symptoms (4.5 years) 0.431 0.091 .000
 Country of birth 0.666 1.905 .727
 Family economic hardship 0.550 0.226 .015
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Note: Values in boldface are statistically significant at p < .05.

*

p ≤ .001.

Probing the simple slopes at average, low (−1 SD), and high (+1 SD) familism revealed that high familism values appeared to buffer the harmful effect of discrimination on depressive symptoms (see Fig. 1). More frequent discrimination significantly predicted higher 6-year depressive symptoms at average (b = 3.857, SE = 1.041, p < .001) and low (b = 7.150, SE = 2.165, p = .001) familism values but not at high familism values (p = .76).

Fig. 1.

Fig. 1.

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Interactive effect of discrimination on depressive symptoms 6 years after childbirth at low (−1 SD), average, and high (+1 SD) levels of familism. Analyses controlled for maternal country of birth and 4.5-year depressive symptoms. Asterisks indicate significant effects (p ≤ .001).

Model 2: neighborhood cultural cohesion.

The second model evaluated the interactive effect of discrimination and neighborhood cultural cohesion on 6-year depressive symptoms, controlling for 4.5-year depressive symptoms, country of birth, and family economic hardship (see Table 2). More frequent discrimination (b = 3.650, SE = 1.179, p = .002), family economic hardship (b = 0.550, SE = 0.226, p = .015), and 4.5-year depressive symptoms (b = 0.431, SE = 0.091, p < .001) again emerged as significant predictors of 6-year depressive symptoms. Neither neighborhood cultural cohesion (p = .58), the interaction of discrimination and neighborhood cultural cohesion (p = .85), or country of birth (p = .73) significantly predicted 6-year depressive symptoms. Maternal country of birth (b = −0.710, SE = 0.286, p = .013), discrimination (b = 2.882, SE = 0.665, p < .001), and family economic hardship (b = 13.824, SE = 2.449, p < .001) were significantly correlated with 4.5-year depressive symptoms; specifically, women born in the United States, those reporting higher family economic hardship, and those experiencing more frequent discrimination reported higher concurrent depressive symptoms at 4.5 years. Greater family economic hardship was associated with reports of less neighborhood cultural cohesion (b = −0.469, SE = 0.167, p = .005) and more frequent discrimination (b = 0.533, SE = 0.175, p = .002). Given that the interaction term was nonsignificant, simple slopes of the effect of discrimination on 6-year depressive symptoms at average, low, and high neighborhood cultural cohesion were not probed.1

Exploratory analyses: subcomponents of familism.

Exploratory post hoc analyses with three separate models evaluated the interactive effect of discrimination and one subcomponent of familism values on 6-year depressive symptoms, controlling for 4.5-year depressive symptoms, country of birth, and family economic hardship. Obligation familism (p = .93) and supportive familism (p = .13) did not significantly moderate the effect of discrimination on 6-year depressive symptoms. However, referent familism was a statistically significant moderator of the effect of discrimination on 6-year depressive symptoms (b = −0.827, SE = 0.377, p = .028; see Fig. 2); specifically, more frequent discrimination predicted higher levels of 6-year depressive symptoms only at average (b = 4.121, SE = 1.041, p < .001) and below average (b = 7.019, SE = 1.903, p < .001) referent familism values but not at above average referent familism values (p = .39).

Fig. 2.

Fig. 2.

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Interactive effect of discrimination on depressive symptoms 6 years after childbirth at low (−1 SD), average, and high (+1 SD) levels of referent familism. Analyses controlled for maternal country of birth and 4.5-year depressive symptoms. Asterisks indicate significant effects (p ≤ .001).

Discussion

A growing body of work demonstrates the harmful effects of discrimination on the mental health of Mexican American women (Calzada et al., 2016; Coburn et al., 2016; D’Anna-Hernandez et al., 2015; Earnshaw et al., 2013), yet less work has identified protective factors that buffer such harmful effects. The current study evaluated two potential sociocultural buffers of the effect of discrimination on subsequent depressive symptoms among a sample of Mexican American women: individual-level familism values and neighborhoodlevel cultural cohesion. More frequent discrimination emerged as a significant predictor of higher depressive symptoms 1.5 years later, even when analyses controlled for earlier depressive symptoms. However, high familism values emerged as a significant buffer of the harmful effect of discrimination on depressive symptoms; specifically, more frequent discrimination was associated with higher subsequent depressive symptoms only for women who reported average and low alignment with familism values. Neighborhood cultural cohesion did not buffer the effect of discrimination on depressive symptoms.

Consistent with prior empirical work (Calzada et al., 2016; Coburn et al., 2016; D’Anna-Hernandez et al., 2015; Earnshaw et al., 2013; Walker et al., 2012), the results reinforce the potential harmful effects of discrimination on depressive symptoms among Mexican American women, even when adjusted for earlier depressive symptoms and current economic stress. Given the low mean levels of reported everyday discrimination in the sample, the findings suggest that even relatively infrequent experiences of everyday discrimination can impact mental health. However, consistent with our hypothesis, results show that strong alignment to familism values provides protection against the negative effect of discrimination on depressive symptoms. Overall, our results suggest that support for cultural values, such as familism, may be an important target for mental health interventions with Mexican American women. Muñoz et al. (2007) developed a cognitive-behavioral treatment adaptation of depression for Latina women with modifications for cultural fit that included reinforcing and validating values such as collectivism and familism, fostering new outlets of support in a foreign context, and providing women with an opportunity to discuss their frustrations about discrimination and racism. This treatment was well received and had high retention rates. However, barriers to accessing mental health care are well-documented among this population (Ramos-Sánchez & Atkinson, 2009), highlighting the importance of informal networks of support (e.g., family members). Women adhering more strongly to familism values may be more likely to access and benefit from familial networks of support in the face of culture-specific stressors such as discrimination.

Exploratory analyses were designed to strengthen our understanding of theoretical pathways through which subcomponents of familism confer protection in the context of discrimination. Among women in our sample, the buffering effect appeared to be driven primarily by referent familism, or the degree to which one is grounded in the family. Our results are consistent with those of Zeiders and colleagues (2013), who reported the strongest association between increased referent familism and lower levels of depressive symptoms among Mexican-origin youth. These results deviate, however, from other research suggesting that familial emotional support drives the protection against depressive symptoms and more closely aligns with previous studies highlighting a sense of belonging and attachment to a cultural group as important cultural resources (Hansen & Sassenberg, 2006; Mossakowski, 2003; Torres & Ong, 2010). The reconciliation of perceived social disconnectedness prompted by protective group identification may therefore be a key prevention mechanism among Mexican American women experiencing discrimination, which supports previous literature on the psychological mediation framework of minority stress stating that social and individual resources (e.g., perceived social connection) mediate the relation between minority stressors (e.g., discrimination) and mental health outcomes (Hatzenbuehler, 2009).

Neither supportive nor obligation familism significantly moderated the effect of perceived discrimination on depressive symptoms in the current study. Prior work suggests that higher alignment to obligation familism may positively affect depressive symptoms among Latinx adults (Stein et al., 2019), and the current results similarly showed a positive concurrent correlation between alignment to obligation familism and depressive symptoms. Familial obligation has been associated with increased financial burden among low-income Mexican-origin families (Calzada et al., 2013). Obligation familism values may confer risk when they prompt sacrifices that overextend individual resources (Calzada et al., 2013). Indeed, higher familism obligation values were associated with higher family economic hardship in our sample. Familial obligations may be more dynamic across time and thus exert stronger concurrent effects on mental health, whereas referent familism values may reflect a more stable, trait-like variable with the potential to exert longer-term effects on mental health. Therefore, researchers who design interventions with the aim of buffering the harmful effects of discrimination on Mexican American women’s depression should be cautious in attempts to increase the level of responsibility to other family members and instead may focus on setting realistic value-based goals. Our findings are consistent with a growing body of empirical work showing that distinct aspects of the complex construct of familism may differentially confer risk and/or protection. In future studies, researchers may consider how subcomponents of familism correspond to other aspects of ethnic identification, such as the degree to which race/ethnicity is central to Mexican American women’s identity, how they evaluate their racial/ethnic group, and/or how salient their race/ ethnicity is across different situations (for more details, see the multidimensional model of racial identity proposed by Sellers et al., 1998).

Contrary to our second hypothesis, neighborhood cultural cohesion did not buffer the harmful impact of discrimination on depressive symptoms and was not correlated with concurrent depressive symptoms. Although past research suggests that neighborhood characteristics may constitute a resource for individuals, women’s neighborhoods may be too distal sources of support to protect Mexican American women from the negative impact of discrimination. Mexican American women have described stores, schools, and public transportation as the primary contexts in which they experience discrimination (Richardson & Nuru-Jeter, 2012). Therefore, internally based characteristics that generalize across contexts (e.g., personal familism values, ethnic identity) may be more beneficial in coping with discrimination. In future work, researchers may explore how neighborhood cultural cohesion contextually promotes the development of the positive ethnic identity or individual alignment to cultural values that may buffer the broad experiences of discrimination. Alternatively, an association between discrimination and depressive symptoms may emerge when evaluating individuals living in more diverse neighborhoods. Although our neighborhood cultural cohesion measure was normally distributed, the majority of the current sample of women lived in neighborhoods with high percentages of Hispanic/Latinx residents (Curci et al., 2021). Further, less economic hardship was correlated with more neighborhood cultural cohesion, suggesting that neighborhood support may target women’s material burdens rather than mental health among the current sample. Exploring how perceived neighborhood cohesion operates in more diverse neighborhoods may inform how to best promote person-level psychological resources within an array of neighborhoods and across socioeconomic levels. Last, future research may explore associations between neighborhood-specific iterations of discrimination and depressive symptoms, such as housing discrimination and discrimination by law enforcement.

Recent empirical work suggests that the protective effect of individual alignment to cultural values on Mexican American women’s health may be dependent on the broader cultural context (Calzada et al., 2014; Calzada & Sales, 2019), such that strong familism values may be harmful to mental health within a context that provides little community-level support or among individuals who endorse low individual-neighborhood cultural congruity, defined as the similarity in cultural alignment between individuals and their surrounding communities (Bhugra & Arya, 2005). The current sample was underpowered to test a three-way interaction among discrimination, familism, and neighborhood cultural cohesion; however, future work may evaluate a three-way interaction among discrimination, individually held cultural values, and the broader cultural context.

Future work is also recommended to identify mechanisms through which familism values buffer the effect of discrimination on depressive symptoms. The current study evaluated the longitudinal effect of discrimination on depressive symptoms; however, ecological momentary assessment studies suggest that discrimination may occur more frequently than is captured by survey research, with negative implications for mental health at the daily level (Broudy et al., 2007; Potter et al., 2019). Intensive longitudinal data collection may also reveal important insights into the mechanisms by which culturally based values, such as familism, operate to protect an individual during or after an experience of discrimination. Given that familism values possess both attitudinal and behavioral components, a cognitive behavioral framework that examines the thought processes and behaviors following an antecedent discriminatory event may be informative about mechanisms underlying protective effects of familism in pathways of depressive symptoms. Studies with repeated measures of mental health symptoms, discrimination, and culturally-based values, practices, and coping mechanisms needed to tease apart bidirectionality. Finally, discrimination is one of many culturally based and general stressors faced by low-income Mexican-origin women in the United States. In the current study, we aimed to identify for whom discrimination predicts elevated depressive symptoms, and the direct and interactive effects of discrimination on subsequent depressive symptoms remained even when we adjusted for family economic hardship, a measure of economic stress particularly relevant to our low-income sample. Future studies may explore how familism operates protectively in pathways of mental health within the context of alternative stressors (e.g., acculturative stress; D’Anna-Hernandez et al., 2015; Hill et al., 2019).

The results should be interpreted in consideration of several limitations. Women self-reported primary study variables, introducing the potential issue of shared method variance. However, the longitudinal design allowed us to adjust for concurrent depressive symptoms when evaluating the effect of discrimination on subsequent depressive symptoms. Indeed, the longitudinal effect of discrimination on subsequent depressive symptoms persisted even when we controlled for concurrent symptoms. Although the CES-D has been validated among Spanish-speaking Mexican American individuals (Roberts et al., 1989), other work suggests that the factor structure and utility of clinical cutoff scores may vary across culturally and linguistically diverse samples (Kim et al., 2011). Maternal country of birth and preferred language were evaluated in primary models to address potential concerns for measurement invariance; however, we recommend caution when comparing prevalence rates of clinically significant depressive symptoms among the current sample with others. Additionally, the limited range of neighborhood characteristics may have limited our statistical power to detect a buffering effect of neighborhood cultural cohesion on women’s depressive symptoms. Similarly, across the sample, the frequency of endorsement of everyday discrimination items was relatively low but was consistent with other reports among a national sample of middle-aged women in the United States identifying as African American, Hispanic, Chinese, and Japanese (Lewis et al., 2012). Last, the results were detected among a sample of low-income, primarily Spanish-speaking Mexican American women, all of whom are mothers. The results may not generalize to more acculturated Mexican American women of higher socioeconomic status or those who are not mothers. Data on primary study variables were collected from 2014 to 2019, spanning large-scale political and social events, many of which were marked by anti-immigration rhetoric and policies. Discriminatory experiences and their effect on mental health among Mexican-origin women in the United States may differ across sociopolitical contexts (Lopez et al., 2018; Pew Research Center Staff, 2017).

Our study extends the existing literature by measuring perceived discrimination specific to women’s identification as Mexican or Mexican American. Importantly, Mexican American women may experience discrimination across multiple intersecting social statuses and identities (LeBrón & Viruell-Fuentes, 2020). The longitudinal methodology and measurement of earlier depressive symptoms strengthened our ability to interpret the effect of discrimination on subsequent depressive symptoms. Exploratory analyses, which teased apart subcomponents of familism values, contribute to a growing body of work suggesting that familism values may confer both risk and protection and contribute to theoretical mechanisms of risk and protection.

In the current study, we aimed to take a strengths-based approach by exploring multilevel (individual and neighborhood) culturally relevant protective factors that may benefit Mexican-origin women experiencing discrimination. We found that although more frequent experiences of discrimination were associated with elevated depressive symptoms, a strong alignment to traditional cultural values of familism may help buffer their impact. Women facing discrimination who reported higher familism values experienced fewer depressive symptoms 1.5 years later. Contrary to expectations, results showed that residing in a neighborhood with stronger cultural cohesion did not provide a protective effect against the experience of discrimination. While we continue to work toward eliminating discrimination against Mexican-origin individuals in the United States, providing support for traditional Mexican cultural values may help minimize discrimination’s detrimental mental health impact.

Acknowledgments

We thank Jody Southworth-Brown, Kirsten Letham, Anne Mauricio, Monica Gutierrez, and Elizabeth Nelson for their assistance with data collection and management; Dean Coonrod and the Maricopa Integrated Health System for their assistance with recruitment; and our entire team of interviewers and undergraduate research assistants for their commitment and dedication to this project.

Funding

This research was supported by the National Institute of Mental Health (R01 MH083173-01, MH083173-01A1S; principal investigators: L. J. Luecken, Keith Crnic, and Nancy Gonzales), the National Institute of Child Health and Human Development (R01 HD083027; principal investigators: L. J. Luecken, Keith Crnic, and Nancy Gonzales), and the National Institute on Minority Health and Health Disparities (R01 MD011599; principal investigators: M. Perez and Linda J. Luecken). S. G. Curci is supported by a Predoctoral Fellowship from the American Heart Association (Award No. 906185). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Footnotes

Declaration of Conflicting Interests

The author(s) declared that there were no conflicts of interest with respect to the authorship or the publication of this article.

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