Do you want to avoid the hassle of traveling with your printed poster? IAPHS2026 is pleased to make poster printing available to you through our supplier PosterSessionOnline. Your poster will be professionally reviewed, printed and shipped directly to Portland and you will be able to pick it up from the Poster desk. Click here to learn more.
Primary Submission Category: Health equity
The Intersecting Association of Speaking a Non-Dominant Language and Lower Healthcare Access on Self-Reported Depression Among U.S. Adults: A Cross-Sectional Study using NHANES Data (2015-March 2020)
Authors: Vincenzo Cornacchione, Corey Linver, Jessica Kilinski, Kelly Reavis, Deborah Karasek,
Presenting Author: Vincenzo Cornacchione*
Background: Depression remains a leading public health concern in the U.S., with existing inequities in diagnosis and treatment by race, ethnicity, and language spoken. Mental health services are limited by healthcare access and, when access is available, multilingual individuals face systemic challenges in navigating an English-centric healthcare system. The joint impact of language preference and healthcare access on depression prevalence remains unexplored.
Objective: We examined the independent and joint associations between language preference and healthcare access on moderate-to-severe depression.
Methods: We conducted a cross-sectional analysis among non-institutionalized adults aged 20 and older living in the US using nationally representative data from NHANES 2015–March 2020 (n = 11,049). Depression was assessed using the PHQ-9, and we measured healthcare access using a three-level categorical measure (adequately insured, inadequately insured, and uninsured) based on Penchansky and Thomas’s Theory of Access. Multivariable logistic regression models adjusted for individual sociodemographic confounders and were used to estimate odds ratios (ORs), including interaction terms to assess joint effects.
Results: Among those who were adequately insured, odds of moderate-to-severe depression were slightly lower when speaking a non-dominant language [aOR = 0.89 (95% CI: 0.52, 0.89)], compared to those speaking a dominant language. Conversely, moderate-to-severe depression odds increased among dominant language speakers who were inadequately insured [aOR = 1.56 (95% CI: 1.11, 2.18)] or uninsured [aOR = 1.17 (95% CI: 0.90, 1.52)]. Significant interaction effects were observed (p < 0.05), where individuals who spoke a non-dominant language had significantly lower odds of moderate to severe depression when inadequately insured [aOR = 0.48 (95% CI: 0.24, 0.95)] and uninsured [aOR = 0.49 (95% CI: 0.26, 0.91)], compared to adequately insured, dominant-language speakers.
Conclusion: Contrary to dominant narratives, speaking a non-dominant language was associated with lower odds of moderate-to-severe depression, particularly among those with low healthcare access. These findings challenge deficit-based framings of multilingual populations and underscore the importance of intersectional approaches to mental health disparities.