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Exploring the social determinants of mental health by race and ethnicity in Army wives

APA Citation:

Dodge, J., Sullivan, K., Miech, E., Clomax, A., Riviere, L., & Castro, C. (2024). Exploring the social determinants of mental health by race and ethnicity in Army wives. Journal of Racial and Ethnic Health Disparities, 11, 669-684. https://doi.org/10.1007/s40615-023-01551-3

Abstract Created by REACH:

Social determinants of health are economic and social conditions (e.g., economic stability, community context, access to health care) that contribute to differences in health outcomes. This study investigated racial and ethnic differences in the social determinants of clinical depression among 327 women spouses of Soldiers. Spouses reported on many factors, including social support, employment, psychological barriers to mental health care (e.g., being seen as weak), their history of adverse childhood experiences (ACEs), whether they lived on post, whether they had recently given birth, and their demographic characteristics (e.g., race). Overall, the social determinants of clinical depression differed among Black, Latina, and White spouses.


Mental health

Branch of Service:


Military Affiliation:

Active Duty

Subject Affiliation:

Spouse of service member or veteran


Adulthood (18 yrs & older)
Young adulthood (18 - 29 yrs)
Thirties (30 - 39 yrs)


Cross sectional study
Quantitative Study
Secondary Analysis


Dodge, Jessica, Sullivan, Kathrine, Miech, Edward, Clomax, Adriane, Riviere, Lyndon, Castro, Carl


Objective To explore the social determinants of mental health (SDoMH) by race/ethnicity in a sample with equal access to healthcare. Using an adaptation of the World Health Organization’s SDoMH Framework, this secondary analysis examines the socio-economic factors that make up the SDoMH by race/ethnicity. Method This paper employed configurational comparative methods (CCMs) to analyze various racial/ethnic subsets from quantitative survey data from (N = 327) active-duty Army wives. Data was collected in 2012 by Walter Reed Army Institute of Research. Results Initial exploratory analysis revealed the highest-scoring factors for each racial/ethnic subgroup: non-Hispanic Black: employment and a history of adverse childhood events (ACEs); Hispanic: living off post and a recent childbirth; junior enlisted non-Hispanic White: high work-family conflict and ACEs; non-Hispanic other race: high work-family conflict and not having a military history. Final analysis showed four models consistently explained clinically significant depression symptoms and four models consistently explained the absence of clinical depression symptoms, providing a solution for each racial/ethnic minority group (non-Hispanic Black, Hispanic, junior enlisted non-Hispanic White, and non-Hispanic other). Discussion These findings highlight that Army wives are not a monolithic group, despite their collective exposure to military-specific stressors. These findings also highlight the potential for applying configurational approaches to gain new insights into mental health outcomes for social science and clinical researchers.

Publication Type:

REACH Publication


Army, coincidence analysis, mental health, military spouses, qualitative comparative analysis, social determinants of health

View Research Summary:

REACH Publication Type:

Research Summary

REACH Newsletter:

  July 2023

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