Michael Ling Xiao Yin
Religious minorities living under authoritarian governance face unique psychosocial stressors, yet these stressors remain understudied in public health. Using unregistered Protestant churches in China as a case study, this analytic essay examines how state-sponsored marginalization shapes mental health. Integrating public health, sociology of religion, and political science, this article proposes the authoritarian pressure-resilience (APR) framework. The framework combines a socioecological perspective with theories of minority stress and disciplinary power to explain pathways from structural pressure to psychosocial outcomes. The APR framework identifies legal-political and ideological-cultural pressures as key stressors mediated through community adaptation. It offers a means of studying political repression as a social determinant of mental health and informing culturally safe interventions. (Am J Public Health. Published online ahead of print August 20, 2026:e1-e9. https://doi.org/10.2105/AJPH.2026.308623).