Racial and Ethnic Disparity in Major Depressive Disorder

Shao, Zhili; Richie, William D.; Bailey, Rahn Kennedy

doi:10.1007/s40615-015-0188-6

Cited by 72 publications

(47 citation statements)

References 152 publications

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“…Untreated depression was associated with belonging to the oldest age cohort (75 years and older) and lower educational attainment (less than a high school diploma). This study is consistent with previous findings indicating that AAs experience lower rates of depression and mental health treatment, as well as decreased access to and quality of depression care [57][58][59][60][61].…”

Section: Discussionsupporting

confidence: 92%

“…Comparing the middle-aged and the oldest (75 years and older) participants, middle-aged participants had a higher probability of belonging to the untreated group of survey respondents. The odds of untreated depression increased 2.471 times (95% CI: 1.187-5.146) for middle aged participants (55)(56)(57)(58)(59)(60)(61)(62)(63)(64), compared with participants with no depression. Similarly, respondents with no high school diploma were 0.542 times (95% CI: 0.591-0.904) less likely to be untreated for depression, compared with participants who have a high school diploma.…”

Section: Multinomial Logistic Regressionmentioning

confidence: 99%

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Depression Treatment Status of Economically Disadvantaged African American Older Adults

et al. 2020

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Background: It is known that depression remains largely untreated in underserved communities. Hence, it is desirable to gain more knowledge on the prevalence and correlates of untreated depression among African-American (AA) older adults in economically disadvantaged areas. This knowledge may have the public health benefit of improving detection of AA older adults with depression who are at high risk of not receiving treatment, thereby reducing this health disparity. Objective: To study health and social correlates of untreated depression among AA older adults in economically disadvantaged areas. Methods: Between 2015 and 2018, this cross-sectional survey was conducted in South Los Angeles. Overall, 740 AA older adults who were 55+ years old entered this study. Independent variables were age, gender, living arrangement, insurance type, educational attainment, financial strain, chronic medical conditions, and pain intensity. Untreated depression was the dependent variable. Logistic and polynomial regression models were used to analyze these data. Results: According to the polynomial regression model, factors such as number of chronic medical conditions and pain intensity were higher in individuals with depression, regardless of treatment status. As our binary logistic regression showed, age, education, and number of providers were predictive of receiving treatment for depression. Conclusion: Age, educational attainment, number of providers (as a proxy of access to and use of care) may be useful to detect AA older adults with depression who are at high risk of not receiving treatment. Future research may focus on decomposition of the role of individual-level characteristics and health system-level characteristics that operate as barriers and facilitators to AA older adults receiving treatment for depression.

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Section: Discussionsupporting

confidence: 92%

Section: Multinomial Logistic Regressionmentioning

confidence: 99%

Depression Treatment Status of Economically Disadvantaged African American Older Adults

et al. 2020

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“…A lower prevalence of depression diagnoses in African–Americans has been previously reported in persons with opioid addiction, but not necessarily in other clinical conditions . Such variations may be due to genetic, environmental, or cross‐cultural differences in both reporting of symptoms and in their diagnosis, as well as other social and cultural factors . Since African‐Americans with cocaine dependence diagnoses did not have decreased odds of depression in this study, it may be postulated that factors in addition to environment and cross‐cultural presentation or diagnosing, are involved in the differential risk of depression comorbidity.…”

Section: Discussionsupporting

confidence: 43%

Can a rapid measure of self-exposure to drugs of abuse provide dimensional information on depression comorbidity?

et al. 2017

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Background and Objectives Addictions to heroin or to cocaine are associated with substantial psychiatric comorbidity, including depression. Poly-drug self-exposure (e.g., to heroin, cocaine, cannabis or alcohol) is also common, and may further affect depression comorbidity. Methods This case-control study examined the relationship of exposure to the above drugs and depression comorbidity. Participants were recruited from methadone maintenance clinics, and from the community. Adult male and female participants (n=1,201) were ascertained consecutively by experienced licensed clinicians. The instruments used were the SCID-I, and Kreek-McHugh-Schluger-Kellogg (KMSK) scales, which provide a rapid dimensional measure of maximal lifetime self-exposure to each of the above drugs. This measure ranges from no exposure to high unit dose, high frequency, and long duration of exposure. Results A multiple logistic regression with stepwise variable selection revealed that increasing exposure to heroin or to cocaine was associated greater odds of depression, with all cases and controls combined. In cases with an opioid dependence diagnosis, increasing cocaine exposure was associated with a further increase in odds of depression. However, in cases with a cocaine dependence diagnosis, increasing exposure to either cannabis or alcohol, as well as heroin, was associated with a further increase in odds of depression. Discussion and Conclusions This dimensional analysis of exposure to specific drugs provides insights on depression comorbidity with addictive diseases, and the impact of poly-drug exposure. Scientific Significance A rapid analysis of exposure to drugs of abuse reveals how specific patterns of drug and poly-drug exposure are associated with increasing odds of depression.

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“…Consensus has yet to be reached on what proportion of this disparity can be attributed to true differences in disease prevalence and manifestation between these groups as opposed to cultural and social factors yielding underreporting, underdiagnosis, and undertreatment of depression in black persons and men [ 8 ]. A host of genetic and social factors are thought to be associated with the likelihood of developing depression [ 4 , 9 , 10 , 11 , 12 , 13 , 14 ], further underscoring a need for additional investigation.…”

Section: Introductionmentioning

confidence: 99%

Allostatic Load Biomarker Associations with Depressive Symptoms Vary among US Black and White Women and Men

Bey¹,

Jesdale²,

Ulbricht³

et al. 2018

Healthcare

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The prevalence and severity of depression differ in women and men and across racial groups. Psychosocial factors such as chronic stress have been proposed as contributors, but causes of this variation are not fully understood. Allostatic load, a measure of the physiological burden of chronic stress, is known to be associated with depression. Using data from the National Health and Nutrition Examination Survey 2005–2010, we examined the associations of nine allostatic load biomarkers with depression among US black and white adults aged 18–64 years (n = 6431). Depressive symptoms were assessed using the Patient Health Questionaire-9; logistic models estimated adjusted odds of depression based on allostatic load biomarkers. High-risk levels of c-reactive protein were significantly associated with increased odds of depression among white women (adjusted odds ratio (aOR) = 1.7, 95% CI: 1.1–2.5) and men (aOR = 1.8, 95% CI: 1.1–2.8) but not black women (aOR = 0.8, 95% CI: 0.6–1.1) or men (aOR = 0.9, 95% CI: 0.5–1.5). Among black men, hypertension (aOR = 1.7, 95% CI: 1.1–2.7) and adverse serum albumin levels (aOR = 1.7, 95% CI: 1.0–2.9) predicted depression, while high total cholesterol was associated with depression among black women (aOR = 1.6, 95% CI: 1.0–2.7). The associations between allostatic load biomarkers and depression varies with gendered race, suggesting that, despite consistent symptomatology, underlying disease mechanisms may differ between these groups.

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Racial and Ethnic Disparity in Major Depressive Disorder

Cited by 72 publications

References 152 publications

Depression Treatment Status of Economically Disadvantaged African American Older Adults

Depression Treatment Status of Economically Disadvantaged African American Older Adults

Can a rapid measure of self-exposure to drugs of abuse provide dimensional information on depression comorbidity?

Allostatic Load Biomarker Associations with Depressive Symptoms Vary among US Black and White Women and Men

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