Food insecurity as an underexplored pathway linking ethnic enclave contexts and anxiety among Dominicans in the United States

Introduction Migration shapes access to food environments and practices, with implications for both nutritional and mental health. Although neighborhood ethnic concentration has been linked to mental health among Latino populations, the findings remain inconsistent, and the mechanisms are not well understood. Food insecurity, a common experience among immigrant households, may represent a key psychosocial pathway linking the neighborhood context to anxiety. Caribbean Latino populations, including Dominicans, remain underrepresented in this literature. This study examined whether Dominican ethnic concentration is associated with anxiety symptoms and whether household food insecurity mediates this relationship. Methods We analyzed data from a representative multi-state sample of Dominican adults in the United States ( n = 662), 53% of whom were immigrants. Dominican ethnic concentration was operationalized using location quotients at the ZIP Code Tabulation Area level to capture enclave-like contexts in the data. Household food insecurity was assessed using a validated measure (low/very low; mild/high), and anxiety symptoms were measured using the Generalized Anxiety Disorder−4 scale (0 = not at all to 4 = nearly every day). Survey-weighted generalized structural equation models were used to test mediation, adjusting for age, sex, income, nativity, state of residence, and presence of children in the household. Results Nearly 30% of the respondents experienced low household food security. Higher Dominican ethnic concentration was associated with lower anxiety symptoms overall, with mean GAD-4 scores being highest in low-concentration areas and lower in higher-concentration and ethnic enclaves. In survey-weighted generalized structural equation models, low household food security was strongly associated with higher anxiety symptoms (β = 0.586, P < 0.001). Mediation analysis indicated that household food security partially mediated the association between Dominican concentration and anxiety ( p = 0.034). Discussion Greater Dominican concentration may protect against anxiety by reducing household food insecurity, highlighting food insecurity as a key pathway linking ethnic concentration to mental health. These findings underscore the importance of culturally sustaining food environments for the wellbeing of immigrants and subsequent generations born in the US.