# Psychosocial Determinants of Behavioral Health in Latinx Americans Nationwide: A Systematic Review Highlighting Cultural Strength Factors

## TL;DR

This paper reviews factors affecting mental health in Latinx Americans, highlighting both risks and protective cultural strengths.

## Contribution

The first systematic review of psychosocial determinants of behavioral health in Latinx Americans using the NLAAS dataset.

## Key findings

- Trauma, acculturation, and sociodemographic factors are linked to anxiety, depression, and substance use disorders.
- Protective factors like family cohesion and religious activity are associated with better mental health outcomes.
- Findings can inform culturally responsive prevention strategies for Latinx Americans.

## Abstract

Objectives: Latinx Americans represent the largest ethnic minority group (nearly 19% of the U.S. population). Their behavioral health has received increasing attention as they exhibit elevated prevalence rates of anxiety (ANX), depression (DEP), and substance use disorders (SUDs). The National Latino and Asian American Study (NLAAS) is the first national population-based mental health study of Latinx Americans and is the most comprehensive resource for understanding their behavioral health. This systematic review aims to synthesize peer-reviewed publications using the NLAAS dataset to identify psychosocial determinants of the three key outcomes. Method: We followed PRISMA to search for English peer-reviewed articles published in EBSCO, Embase, PsycINFO, Web of Science, and PubMed. Inclusion criteria were as follows: (1) Latinx in the NLAAS database; (2) ANX, DEP, or SUD; (3) risk or protective factors; and (4) peer-reviewed publications in English. Search terms such as Latino, Latina, anxiety, depressive symptoms, substance abuse, and NLAAS were used to search for relevant articles. Two authors screened the articles independently and extracted data from each study. Results: Thirty-two studies published between 2007 and 2024 were included in our final review. Among them, 12 studies investigated ANX, and 17 studies examined DEP and SUD, respectively. Sixteen studies assessed protective factors. Ten articles assessed multiple key outcomes. All risk factors were grouped into three categories: Trauma and negative relationships (e.g., childhood maltreatment, negative family relationship, traumatic life experience), acculturation- and immigration-related factors (e.g., nativity, acculturation experience, English proficiency, discrimination), and sociodemographic and social participation factors (e.g., gender, education, income level). Protective factors such as family cohesion, religious activity, gender, and education were also identified. Conclusion: This first systematic review provided comprehensive NLAAS findings on multifaceted cultural, social, and intrapersonal factors that were either negatively or positively associated with three behavioral health outcomes within the U.S. Latinx population. Potential mechanisms by which risk and protective factors influence their mental health, as well as limitations of this review, were discussed. Findings of this review can inform culturally responsive prevention strategies and interventions to reduce behavioral health disparities and to improve mental health outcomes among Latinx Americans.