Abstract

Mental well-being and various common mental disorders are profoundly influenced by the social, economic, and physical surroundings in which individuals reside. Intersectionality serves as a significant theoretical framework for analysing how various sociocultural factors intersect and the impact of societal disparities on mental health conditions. The study aims to investigate the complex interrelationships between mental health conditions and social determinants of health within ethnic communities in Bangladesh, employing an intersectional approach. The cross-sectional study was conducted among community people aged 18 years or above from Kamalganj and Sreemangal Upazila of Moulavibazar district. A total of 1268 people of age 18-60 years were a part of this study. They were selected by the systematic sampling method. A pre-tested structured questionnaire was used to interview all the

participants to obtain the study’s objectives. Descriptive analysis was done on participants’ socio-demographic variables, family characteristics, and different social determinants. We investigated the association between mental health conditions and social determinants across 10 intersectional strata defined by ethnicity and sex. We calculated odds ratios (with 95% confidence intervals) to evaluate between-strata differences using Bengali men as the comparison reference. Among the participants, male vs female was 47.8% and 52.8% respectively. In terms of educational attainment, around 80% of the participants have formal schooling and 42% of participants were labourers. Regarding the distribution of ethnic communities, the proportions were as follows: Manipuri (23.7%), Bengali (22.7%), Khasia (22.7%), Tea labour (22.2%), and Tripura (8.8%). For the mental health questions,

Cronbach’s alpha was 72%. For instance, the association between social connection and mental health was six times higher for Manipuri males (OR 5.97 [95% CI 1.16-30.77]) than for Bengali males, for domestic violence association is higher in male tea labour (OR 0.32 [95% CI 0.13- 0.75]) and for housing condition association is higher in female tea labour [(OR 0.17 [95% CI 0.04–0.76]). The intersectional approach can inform public health initiatives through the idea of proportionate universalism and offers more accurate information on the presence (or absence) of health inequities.