title: Differential mental health impact of cancer across racial/ethnic groups: findings from a population-based study in California.
abstract: BACKGROUND
  Little research has examined the interactive effect of cancer status and race/ethnicity on mental health. As such, the present study examined the mental health of adults, 18 and over, diagnosed with cancer. This study examined the extent to which a cancer diagnosis is related to poorer mental health because it erodes finances and the extent to which the mental health impact of cancer differs across racial/ethnic groups. Furthermore, this study aimed to test the stress process model, which posits that the proliferation of stress can lead to mental illness and this process can differ across racial/ethnic groups.
  
  
  METHODS
  Data from the 2005 Adult California Health Interview Survey was used (N = 42,879). The Kessler 6, a validated measure of psychological distress, was used to measure mental health, with higher scores suggesting poorer mental health. Scores on the Kessler 6 ranged from 0 to 24. Linear regression models estimating psychological distress tested each aim. The mediating effect of income and the race by cancer interaction were tested.
  
  
  RESULTS
  After controlling for gender, age, insurance status, education and race/ethnicity, cancer was associated with higher Kessler 6 scores. About 6% of this effect was mediated by household income (t = 4.547; SE = 0.011; p < 0.001). The mental health impact of cancer was significantly worse for Latinos and Blacks than for non-Hispanic Whites.
  
  
  CONCLUSIONS
  The mental health impact of cancer is not uniform across groups. Future work should explore reasons for these disparities. Efforts to increase access to mental health services among minorities with cancer are needed.
authors.affiliation: Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA. hectorapm@ucla.edu.
authors.forename: Héctor E
authors.initials: HE
authors.lastname: Alcalá
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health / Q000208:ethnology; D044383:Black People / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage; D008297:Male; D001523:Mental Disorders / Q000208:ethnology / Q000523:psychology*; D008603:Mental Health / Q000208:ethnology*; D008875:Middle Aged; D009369:Neoplasms / Q000208:ethnology / Q000523:psychology*; D012107:Research Design; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American