(PS1-43) Examining the mediating role of self-rated health and health distress in the relationship between anxiety and behavioral help-seeking behaviors among Latinx individuals.

Abstract Text: Latinxs are one of the fastest-growing populations in the United States (Krogstad et al., 2023) and continue to be at an increased risk for mental illness and health inequities (Piñeros-Leaño et al., 2022) due to systemic and oppressive policies and experiences. In 2022, 16% of Latinx adults reported some level of anxiety within two weeks of completing a survey (Terlizzi & Zablotsky, 2024). While symptoms of anxiety is a significant predictor of healthcare use (Horenstein & Heimberg, 2020), only 34.6% of Latinxs utilize behavioral health care compared to 70.3% of non-Latinx White individuals (Benuto et al., 2019). Barriers such as lack of insurance and language barriers, and low self-rated perceptions of poor health and self-rated decreased need for services are directly associated with decreased help-seeking behaviors and health care utilization (Acosta et al., 2017; Brenner et al., 2018; Newberry et al., 2024). To date, limited studies have explored the mediating role of self-rated health and health distress in the association between anxiety and help-seeking behaviors and health utilization in a Latinx sample.
The sample comprised 168 Latinxs aged 18 to 79 (M = 42.04, SD = 14.62). Participants completed measures related to anxiety symptoms (Spitzer et al., 2006), self-rated health (Lorig et al., 1996), health distress (Lorig et al., 1996), behavioral help-seeking (Mansfield et al., 2005), and healthcare utilization (Ritter et al., 2001).
Using the Baron and Kenny approach (1986), mediation analyses were conducted to examine the role of self-rated health and health distress in the relationship between anxiety and behavioral help-seeking behaviors and health utilization. Gender (0 = Male, 1 = Female) was included in all models as a covariate. Mediation model 1 results suggested that increased anxiety significantly predicted increased need for behavioral help-seeking (β = .25, p = .002) and higher self-rated poor health (β = .43, p < .001). However, when anxiety and self-rated health were included together, self-rated health was not shown to be a mediator for behavioral help-seeking (β =.04, p = .681). Mediation model 2 results suggested that increased anxiety significantly predicted a higher need for behavioral help-seeking (β = .25, p = .002) and increased health distress (β = .59, p < .001). When anxiety and health distress were included together, the relation between health distress and behavioral help-seeking was significant (β =.26, p = .005), but anxiety was non-significant (β =.11, p = .254). A Sobel test confirmed that health distress mediated the relationship between anxiety and behavioral help-seeking (z = 2.66, p = .008). A linear regression model indicated that anxiety did not significantly predict health care utilization (β =.07, p = .382). Thus, mediation analyses did not examine the role of self-rated health and health distress in this association.
Findings of the present study suggest that health distress is an essential factor to consider when assessing Latinx adult behavioral help-seeking. Future studies should continue to identify pathways for behavioral help-seeking and health care utilization among Latinx adults with anxiety.