Commentary: Race and mental health more questions than answers

Williams, David R.; Earl, Tara R.

doi:10.1093/ije/dym114

Cited by 68 publications

(50 citation statements)

References 14 publications

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“…In our study, reciprocal associations between depression and medical conditions among Whites could not be found among Blacks, supporting the Black-White health paradox [8,9,46,47]. Our findings, however, do contrast with the hypothesis that depression is more consequential for Blacks than Whites [13,15,45].…”

Section: Discussioncontrasting

confidence: 53%

Long-Term Reciprocal Associations Between Depressive Symptoms and Number of Chronic Medical Conditions: Longitudinal Support for Black–White Health Paradox

Assari

Burgard

Zivin

2015

J. Racial and Ethnic Health Disparities

121

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Background Previous research has identified a Black-White health paradox, which can be defined as less frequent depression despite a higher prevalence of chronic medical conditions among Blacks compared to Whites in the USA. Based on this paradox, we would expect weaker associations between chronic medical conditions and depression among Blacks than Whites. However, the literature on this topic is mostly crosssectional and has provided findings that contradict the BlackWhite health paradox. The present longitudinal study extends prior research by assessing Black-White differences in reciprocal associations between number of chronic medical conditions and depressive symptoms over a 25-year period.Methods Data came from the Americans' Changing Lives Study that followed 1034 surviving Black and White respondents for 25 years from 1986 to 2011. Chronic medical conditions were measured based on a count of self-reported physician diagnoses including hypertension, diabetes, chronic lung disease, heart disease, stroke, cancer, and arthritis at baseline (1986) and follow-up (2011). Depressive symptoms were also measured at baseline and follow-up using a 10-item Center for Epidemiological Studies-Depression (CES-D) scale. Multi-group structural equation modeling was used to assess reciprocal associations between baseline and subsequent depressive symptoms and baseline and subsequent chronic medical conditions comparing Black and White respondents. Results Among White but not Black respondents, a higher number of chronic medical conditions at baseline predicted a greater increase in depressive symptoms over 25 years of follow-up. Among Whites but not Blacks, individuals with more depressive symptoms at baseline developed more chronic medical conditions over time. Conclusion Findings documented Black-White differences in reciprocal associations between chronic medical conditions and depressive symptoms over time. Our study provides longitudinal evidence for the Black-White health paradox across mid and later life, as reciprocal associations between depression and chronic medical conditions were weaker for Blacks compared to Whites.

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Section: Discussioncontrasting

confidence: 53%

Long-Term Reciprocal Associations Between Depressive Symptoms and Number of Chronic Medical Conditions: Longitudinal Support for Black–White Health Paradox

Assari

Burgard

Zivin

2015

J. Racial and Ethnic Health Disparities

121

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“…Here, the veracity of reported high rates of psychosis in Black populations has been the subject of acrimonious debate, the fundamental critique being that they are an artefact of misdiagnosis. Similar debates have occurred in the USA (Williams & Earl, 2007). In brief, the argument is that emotional distress arising from difficult life circumstances in Black populations is misconstrued as psychosis by predominantly White psychiatrists influenced by negative cultural stereotypes of Black people (Fernando, 1991).…”

Section: Artefact or Real Health Disparity ?mentioning

confidence: 91%

The social determinants of psychosis in migrant and ethnic minority populations: a public health tragedy

2009

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High rates of schizophrenia and other psychoses have been repeatedly found in migrant populations. However, the development of public health responses has been hindered by unfounded claims that the high rates are an artefact of misdiagnosis. Recent research implicating exposure to social adversity across the life course as the key explanation for these high rates has the potential to inform initiatives to tackle this major public health problem.

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“…There are more than twice as many black and Hispanic adolescents living in poverty (34% and 28%, respectively) than non-Latino white adolescents (12%) (Kids Count Data Center, 2017). Thus, much of the disparity in mental health outcomes across racial and ethnic groups can be explained by socioeconomic status and other neighborhood-level factors such as segregation, social isolation, and exposure to violent crime (Williams andEarl, 2007, Alegria et al, 2015). Further, research on mental health service has shown mental health services are less available in neighborhoods with higher racial and ethnic minority populations, making it more challenging for minority populations to receive treatment (VanderWielen et al, 2015).…”

Section: Race and Ethnicitymentioning

confidence: 99%

Adolescents in crisis: A geographic exploration of help-seeking behavior using data from Crisis Text Line

Thompson

Sugg

Runkle

2018

Social Science & Medicine

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Prior research has demonstrated that a variety of demographic, socioeconomic, and environmental factors can influence the prevalence and severity of mental distress and whether an individual is likely to receive treatment. Behavioral health research has been limited to self-reported survey data, but advances in technology have provided increased opportunities to continuously capture and store data, and to learn about the help-seeking habits of its contributors. In response to the growing prevalence of technologically mediated crisis counseling services, this county-level ecological study evaluated whether these same disparities exist for help-seeking via Crisis Text Line, a free, ubiquitous, technology-based crisis counseling service. Because most suicide attempts are impulsive acts, crisis hotlines are often the only resource available to suicidal or at-risk individuals. It is critical that researchers and practitioners are aware of any population-level disparities limiting the use of these invaluable resources. To date, this is the first study to examine text-based help-seeking behavior among adolescents at a national scale. Results identify several factors associated with increased or reduced help-seeking behavior among adolescents in the U.S. Increased v rates of CTL usage occur in counties with higher mean household incomes, higher divorce rates, and lower residential stability. Rurality was the strongest predictor for low rates of help-seeking, and this finding is particularly concerning in light of elevated rates of suicide among rural counties. Low rates of help-seeking compound ongoing rural-urban disparities in traditional mental health services, and this finding suggests that increased suicide risk in rural areas cannot be explained by mental health professional shortages alone. Rural communities, particularly those with low support-seeking behavior and comparatively high suicide rates, should be the target of future research and outreach.vi

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Commentary: Race and mental health more questions than answers

Cited by 68 publications

References 14 publications

Long-Term Reciprocal Associations Between Depressive Symptoms and Number of Chronic Medical Conditions: Longitudinal Support for Black–White Health Paradox

Long-Term Reciprocal Associations Between Depressive Symptoms and Number of Chronic Medical Conditions: Longitudinal Support for Black–White Health Paradox

The social determinants of psychosis in migrant and ethnic minority populations: a public health tragedy

Adolescents in crisis: A geographic exploration of help-seeking behavior using data from Crisis Text Line

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