Ethno-racial variations in mental health symptoms among sexually-active gay, bisexual, and other men who have sex with men in Vancouver, Canada: a longitudinal analysis.

BACKGROUND: Minority stress from racism and heterosexism may uniquely interact to impact the mental health of racialized sexual minorities. We examined variations in anxiety and depressive symptoms by reported by ethno-racial identity among gay, bisexual, and other men who have sex with men (gbMSM) in Vancouver, Canada. METHODS: We recruited gbMSM aged ≥ 16 years from February 2012 to February 2015 using respondent-driven sampling (RDS). Participants completed computer assisted self-interviews (CASI) at enrollment and every 6 months until February 2017. We examined factors associated with moderate/severe anxiety and depression scores (> 10) on the Hospital Anxiety and Depression Scale (HADS) and differences in key explanatory variables including sociodemographic, psychosocial, and substance use factors. We used multivariable mixed effects models to assess whether moderate/severe scores were associated with ethno-racial identity across all visits. RESULTS: After RDS-adjustment, of 774 participants, 79.9% of participants identified as gay. 68.6% identified as white, 9.2% as Asian, 9.8% as Indigenous, 7.3% as Latin American, and 5.1% as other ethno-racial identities. Participants contributed a median of 6 follow-up visits (Q1-Q3: 4-7). In the multivariable analysis, Asian participants had decreased odds of moderate/severe anxiety scores compared to white participants (aOR = 0.39; 95% CI: 0.18-0.86), and Latin American participants had decreased odds of moderate/severe depression scores compared to both white (aOR = 0.17; 95% CI: 0.08-0.36) and Asian (aOR = 0.07; 95% CI: 0.02-0.20) participants. CONCLUSION: Asian and Latino gbMSM reported decreased mental health symptoms compared to white participants. Asian and Latino gbMSM in Vancouver appear to manage multiple minority stressors without adversely affecting their mental health.

The association between monthly social assistance disbursement days and emergency department visits for trauma, mental health, and substance use.

OBJECTIVE: Social assistance helps fulfill the basic needs of low-income individuals. In British Columbia, social assistance is issued on the third or fourth Wednesday of every month. However, this sudden influx of resources may have negative health consequences. We investigated social assistance timing and emergency department (ED) visits related to trauma, mental health, and substance use. METHODS: We conducted a retrospective multi-centre observational study using 12 years of regional ED data from Vancouver, British Columbia (2008-2020). Each cheque week (the week following social assistance disbursement) was matched to a single control week (2 weeks prior to cheque week). We compared the number of ED visits for trauma, mental health, and substance use during cheque weeks versus control weeks. RESULTS: There were 253,360 visits during all weeks of interest. Cheque week was associated with significantly more ED visits for mental health and substance-related presentations (RR 1.07, 95% CI 1.03-1.11, p = 0.0006). These visits increased significantly for both males and females and for adults aged 17-64 years. Mental health and substance-related visits increased on the day of cheque disbursement (Wednesday) and the 4 days following (Thursday-Sunday). Trauma-related ED visits were elevated on the day of cheque disbursement, but not during other days of the week. CONCLUSIONS: Social assistance disbursement is followed by an increase in mental health and substance-related ED presentations and may be associated with an increase in trauma presentations on the day of cheque disbursement. These findings support calls for clinical and policy-level changes and support to reduce cheque day-associated harm.

RéSUMé: OBJECTIF: L'aide sociale permet de répondre aux besoins fondamentaux des personnes à faible revenu. En Colombie-Britannique, l'aide sociale est versée le troisième ou le quatrième mercredi de chaque mois. Cependant, cet afflux soudain de ressources peut avoir des conséquences négatives sur la santé. Nous avons étudié le calendrier de l'aide sociale et les visites aux urgences liées aux traumatismes, à la santé mentale et à la toxicomanie. MéTHODES: Nous avons mené une étude d'observation rétrospective multicentrique en utilisant 12 années de données sur les urgences régionales de Vancouver, en Colombie-Britannique (2008-2020). Chaque semaine de chèque (la semaine suivant le versement de l'aide sociale) a été appariée à une seule semaine de contrôle (deux semaines avant la semaine de chèque). Nous avons comparé le nombre de visites aux urgences pour traumatisme, santé mentale et toxicomanie pendant les semaines de chèque et les semaines de contrôle. RéSULTATS: Il y a eu 253 360 visites pendant toutes les semaines d'intérêt. La semaine des chèques a été associée à un nombre significativement plus élevé de visites aux urgences pour des présentations liées à la santé mentale et à la toxicomanie (RR 1,07, IC 95 % 1,03-1,11, p = 0,0006). Ces visites ont augmenté considérablement chez les hommes et les femmes et chez les adultes de 17 à 64 ans. Les visites liées à la santé mentale et aux substances ont augmenté le jour du versement du chèque (mercredi) et les quatre jours suivants (jeudi ­ dimanche). Les visites aux urgences liées à un traumatisme étaient plus nombreuses le jour de la remise du chèque, mais pas les autres jours de la semaine. CONCLUSIONS: Le versement de l'aide sociale est suivi d'une augmentation des présentations aux urgences liées à la santé mentale et à la toxicomanie et peut être associé à une augmentation des présentations de traumatismes le jour du versement du chèque. Ces résultats appuient les appels à des changements et à un soutien au niveau clinique et politique afin de réduire les préjudices associés au jour du chèque.