Mid Sweden University

Background: Mental ill-health is a health challenge that has increased over time. Sweden's national minorities may face a higher risk of structural and socioeconomic disadvantage, along with mental ill-health. Objective: To examine serious psychological distress among Sweden's national minorities and the Indigenous Sámi from an intersectional perspective, according to age, gender and minority versus general population status. Methods: A cross-sectional study based on data from Region Dalarna's supplementary sample in the survey Health on Equal Terms 2021 and 2024. The sample included 61,405 individuals and a total of 25,235 responded (response rate 41.1%). Serious psychological distress was measured by the Kessler-6. The intersectional variable was constructed by combining gender, age and national minority/general population status, resulting in 8 subgroups. Univariable binary logistic regression analyses were conducted separately for each variable. Multivariable binary logistic regression analysis was performed for the final intersectional variable adjusted for income, country of birth and year. The regression analyses were presented as OR with 95% CI. Results: Overall, the minorities had higher odds of reporting serious psychological distress compared to the general population (OR = 1.54, 95% CI: 1.23–1.92). In the adjusted intersectional analysis, the minorities had higher odds than the reference group of older men from the general population. Among the minorities, the highest odds were found among younger men (OR = 3.69, 95% CI: 1.92–6.57), followed by younger women (OR = 3.02, 95% CI: 1.44–5.71), older women (OR = 2.63, 95% CI: 1.77-3.84) and the lowest odds were found among older men (OR = 2.10, 95% CI: 1.36- 3.14). Conclusions: The results highlight the value of an intersectional perspective to examine inequalities in health. Authorities should acknowledge intersecting identities to better address the health of different groups. Future research can examine related aspects of mental ill-health and include qualitative intersectional studies.