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June 2022 (Volume 100)
Quarterly Article
Margarita Alegría
Mario Cruz-Gonzalez
Kiara Alvarez
Glorisa Canino
Cristiane Duarte
Hector Bird
Maria Ramos-Olazagasti
Sheri Lapatin Markle
Isabel O'Malley
Doriliz Vila
Patrick E. Shrout
Sep 23, 2026
Jun 29, 2026
Jun 12, 2026
Back to The Milbank Quarterly
Policy Points:
Context: Puerto Rican youth growing up in low-income communities in the South Bronx and Puerto Rico are exposed to many of the same risk factors for major depressive disorder, generalized anxiety disorder, and psychological distress. One potentially powerful factor differs: Puerto Ricans have been socially marginalized as an ethnic minority group in the South Bronx, but are the ethnic majority of the population in Puerto Rico. A growing body of literature demonstrates the influence of neighborhood, cultural, and social factors and parental psychopathology in the development of mental health problems. An important unanswered question is whether these risk and protective factors have the same impact for youth raised as members of an ethnic majority versus minority group.
Methods: Using a population-based cohort study, with four waves of assessment from early childhood into young adulthood, we investigated whether ethnic minority context alters risk and protective factors for depression, anxiety, and psychological distress. Our longitudinal data set includes 2,491 young children at baseline (82.8% retained at wave 4). Using a quasi-experimental design, we examine how ethnic minority context can alter the development of mental health disorders as Latinx children transition to late adolescence and young adulthood.
Findings: Some risk and protective factors operated differently across minority and majority contexts. Higher discrimination and social position were more powerful risk and protective factors, respectively, in the minority context, whereas positive peer relationships mattered more in the majority context. Children of mothers with depression were significantly more likely to develop anxiety in late adolescence and young adulthood in the majority context (60.0%) compared to the minority context (4.5%).
Conclusions: Preventing depression and anxiety disorders in Latinx young adults may require targeting different childhood factors depending on whether they reside within the ethnic majority or minority context. People in the ethnic minority context may benefit more from policies aimed at reducing discrimination and improving economic opportunity, while people in the majority context may benefit more from opportunities for strengthening family and peer relationships.
Keywords: minority, depression, anxiety, longitudinal, BYS, Latinx, young adults, moderator.
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