Social Determinants of Depression: The Intersections of Race, Gender, and Socioeconomic Status

Assari, Shervin

doi:10.3390/brainsci7120156

Cited by 155 publications

(178 citation statements)

References 74 publications

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“…Food insecurity and poor access to health care were also associated with depression in at least three sites. As reported in other low‐income countries, socioeconomic status was associated with depression in adolescents . Although mostly implemented in high‐income countries, studies show that living with the single parent is a risk of depression .…”

Section: Discussionmentioning

confidence: 64%

Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub‐Saharan African adolescents aged 10‐19 years: cross‐sectional study

Nyundo

Manu

Regan

et al. 2019

Tropical Med Int Health

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objective This study aimed to determine the burden of depression, suicidal ideation and suicidal behaviour amongst adolescents at sites in six sub-Saharan African countries and examine associated risk and protective factors.methods Household-based cross-sectional study involving male and female adolescents ages 10-19 years. A total of 7,662 adolescents from eight sites in six countries participated in the survey. Three sites were urban: Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria); five were rural: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). Log-binomials models were used to estimate relative risks and confidence intervals for factors associated with depression and suicidal behaviour. This was supplemented using log-Poisson models as needed.results The prevalence of suicidal behaviour over the last 12 months ranged between 1.2% and 12.4% in the eight sites. Depressive symptoms and suicidal ideation/behaviours were associated with older age, female sex, food insecurity, poor access to health care and substance use. Depression was strongly associated with increased risk of suicidal behaviour at two sites where the multivariate model converged: Harar, Ethiopia (RR = 3.5, 95% CI 1.8, 7.0, P < 0.05) and Ibadan, Nigeria (RR = 3.7, 95% CI 2.2, 6.3, P < 0.0001).conclusions Depressive symptoms and suicidal behaviour are common amongst sub-Saharan African adolescents at these 8 sites. Most factors associated with depressive symptoms are modifiable and preventable. Routine screening for depressive symptoms in services frequented by adolescents in these and similar communities would be crucial in early detection and prompt intervention.keywords depressive symptoms, suicidal behaviour, adolescents, sub-Saharan Africa, ARISE Sustainable Development Goals (SDGs): SDG 1 (no poverty), SDG 2 (zero hunger), SDG 3 (good health and well-being), SDG 5 (gender equity), SDG 8 (decent work and economic growth), SDG 10 (reduced inequalities), SDG 17 (partnerships for the goals)

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Section: Discussionmentioning

confidence: 64%

Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub‐Saharan African adolescents aged 10‐19 years: cross‐sectional study

Nyundo

Manu

Regan

et al. 2019

Tropical Med Int Health

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“…These results suggest that long term economic processes are involved in shaping Minorities' Diminished Return, and some of these processes start early in life. These findings are important because family SES is a major contributor to racial health disparities during childhood (Assari et al 2018;Assari 2017f). Our study showed that each SES indicator reflected lower SES decades later for Black than White families.…”

Section: Discussionmentioning

confidence: 99%

Diminished Economic Return of Socioeconomic Status for Black Families

Assari

2018

Social Sciences

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Background: According to the Minorities' Diminished Return theory, socioeconomic status (SES) systemically generates larger gains for Whites compared to Blacks. It is, however, unknown whether the effects of baseline SES on future family income also varies between Blacks and Whites. Aims: Using a national sample, this study investigated racial variation in the effects of family SES (i.e., family structure, maternal education, and income) at birth on subsequent household income at age 15. Methods: This 15-year longitudinal study used data from the Fragile Families and Child Wellbeing Study (FFCWS), which followed 1471 non-Hispanic Black or White families from the time of birth of their child for 15 years. Two family SES indicators (maternal education and income) at birth were the independent variables. Family income 15 years later was the outcome. Maternal age, child gender, and family structure at baseline were covariates. Race was the focal moderator. Linear regression models were used for data analysis. Results: In the pooled sample, maternal education (b = 11.62, p < 0.001) and household income (b = 0.73, p < 0.001) at baseline were predictive of family income 15 years later. Race, however, interacted with maternal education (b = −12,073.89, p < 0.001) and household income (b = −312.47, p < 0.001) at birth on household income 15 years later, indicating smaller effects for Black compared to White families. These differential gains were independent of family structure, mother age, and child gender. Conclusions: The economic return of family SES is smaller for Black compared to White families, regardless of the SES indicator. Policies should specifically address structural barriers in the lives of racial and ethnic minorities to minimize the diminished return of SES resources across racial minority groups. Policies should also reduce extra costs of upward social mobility for racial minorities. As the likely causes are multi-level, solutions should also be also multi-level. Without such interventions, it may be very difficult if not impossible to eliminate the existing Black-White economic gap.

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“…Similarly, income better reduces number of chronic condition and depression for whites than minority groups. Among blacks, highly educated individuals may be at an increased risk of mental health problems . Although the exact causes are unknown, differential treatment by the society can cause educational attainment to show stronger effects on income and purchasing power for non‐Hispanic whites than for ethnic minority groups.…”

Section: Discussionmentioning

confidence: 99%

Ethnicity, educational attainment, and physical health of older adults in the United States

Assari

2019

Aging Medicine

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Objective Minorities’ diminished returns theory suggests that socioeconomic status (SES) resources generate fewer health benefits for racial and ethnic minority groups, compared to the majority group. The current study aimed to compare Hispanic and non-Hispanic white older adults for the association between educational attainment and poor physical self-rated health (SRH). Methods The first wave of the University of Michigan National Poll on Healthy Aging (UM-NPHA) included 1820 older adults who were 50–80 years old and were either non-Hispanic white (n = 1618) or Hispanic white (n = 202). The main independent variable of interest was educational attainment. The main dependent variable of interest was poor physical SRH. Gender, age, marital status, and employment status were covariates. Ethnicity was the focal effect modifier. Results Overall, higher level of educational attainment was associated with better physical SRH. A significant interaction was found between ethnicity and level of educational attainment, which was indicative of a smaller physical SRH gain due to high educational attainment for Hispanic white compared to non-Hispanic white older adults. In ethnic-specific models, we found evidence suggesting that high educational attainment reduced the odds of poor physical SRH for non-Hispanic whites but not for Hispanic whites. Conclusion Compared to non-Hispanic whites, Hispanic whites gain less physical SRH benefits from their educational attainment.

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Social Determinants of Depression: The Intersections of Race, Gender, and Socioeconomic Status

Cited by 155 publications

References 74 publications

Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub‐Saharan African adolescents aged 10‐19 years: cross‐sectional study

Factors associated with depressive symptoms and suicidal ideation and behaviours amongst sub‐Saharan African adolescents aged 10‐19 years: cross‐sectional study

Diminished Economic Return of Socioeconomic Status for Black Families

Ethnicity, educational attainment, and physical health of older adults in the United States

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