Abstract
BACKGROUND: The prevalence of mental health problems among young adults has increased exponentially worldwide, with significant implications for public health. This study explores the structural and intermediate social determinants of health associated with emotional well-being and distress in Colombian young adults. METHODS: A cross-sectional study was conducted with 1232 university students aged 18-28 years residing in Cali, Colombia. The Social Determinants of Mental Health Questionnaire for Young Adults (SDMH) was administered to assess structural and intermediate determinants. Participants were categorized into two groups: those with mental health diagnoses (n = 252) and those without (n = 980). Descriptive, comparative association and predictive analyses were conducted. RESULTS: Significant differences were found between groups, with diagnosed participants showing higher exposure to violence and suicidal ideation. Women with diagnoses predominantly presented anxiety and depression, while men showed more externalizing symptoms. Violence experiences emerged as the strongest predictors of emotional distress in both groups. Psychosocial life skills and perceived social support were the most robust protective factors for emotional well-being, regardless of diagnostic status. CONCLUSIONS: This study reveals that multiple risk factors accumulate rather than single extreme factors characterizing mental health vulnerability. Violence prevention, life skills development, and social support enhancement should be prioritized in public health interventions for young adults. The findings emphasize the need for multisectoral approaches addressing social determinants to promote youth mental health.