Mental Health
Intersectional inequalities in measurement and outcomes in youth mental health: evidence from a UK birth cohort Darío Moreno-Agostino* Darío Moreno-Agostino Moreno-Agostino Moreno-Agostino Moreno-Agostino Moreno-Agostino Moreno-Agostino Moreno-Agostino UCL Centre for Longitudinal Studies
Youth mental (ill-)health, the leading contributor to the global burden of disease in young people, is shaped by intersecting social identities such as gender, ethnicity, sexuality, and socioeconomic position (SEP). Yet most research examines these factors in isolation, and even when intersectionality is acknowledged, systematic differences in measurement and missing data across intersectional positions are rarely addressed.
This pre-registered study, shaped by the involvement of young people with lived experience of mental ill-health and/or social discrimination, will apply an innovative analytic framework combining Intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (I-MAIHDA), measurement invariance testing (alignment), and bootstrapping with multiple imputation. Using an intersectional framework, we will analyse inequalities in both measurement and levels of three complementary mental health outcomes: psychological distress (Kessler-6), wellbeing (Short Warwick-Edinburgh Mental Well-Being Scale), and self-harm and attempted suicide. We will use data from age 23 sweep (2023-24) of the Millennium Cohort Study, a nationally representative birth cohort study of around 19,000 people born in the UK in 2000-02. Inequalities will be analysed at the intersection of gender (2 categories), ethnicity (4), sexuality (2), and SEP (2).
This study will deliver an up-to-date, comprehensive, and multifaceted sociodemographic mapping of youth mental health inequalities available at a critical period of transition into adulthood. Findings will inform policymakers aiming to reduce health inequities, guide data producers on potential measurement bias in widely used instruments, and provide health equity researchers with a methodological exemplar for addressing intersectional complexity in both outcomes and measurement.