Are We Using the Same Scale? Race and Mental Health Measurement

• In Event: Sociology that Advances Equity in Mental Health

Abstract

National survey data reveal a persistent paradox: Black women often report comparable or better self-rated mental health than White women despite disproportionate exposure to structural inequality, discrimination, and chronic stress. While this Black–White mental health paradox has been documented extensively in the United States, it has not been systematically examined in Canada. This paper is the first study of its kind to empirically investigate this paradox in Canadian national data in direct relation to the established American literature.
Most research treats the paradox as a question of levels—who is better or worse off. This paper shifts the focus to scales. It introduces and empirically tests Cultural Reference Point Theory (CRPT), a theoretical framework I am developing. CRPT argues that self-assessments are anchored to culturally and structurally shaped baselines rather than neutral standards. If groups draw on different evaluative reference points, identical survey categories may not reflect equivalent underlying mental health states.
Comparing responses without testing equivalence is analogous to comparing two currencies without adjusting for exchange rates. By standardizing responses onto a common latent metric—converting both to “gold”—I test whether the gap persists once measurement differences are accounted for. Using Canadian national survey data and multi-group confirmatory factor analysis, I assess measurement invariance and latent mean differences across Black and White women. Preliminary findings suggest differences in response thresholds, indicating non-equivalent evaluative baselines and reframing the paradox as a problem of measurement equivalence rather than simple group disparity.

Author

• Anika Forde, York University