The Association between Multiple Chronic Conditions and Depressive Symptoms: Intersectional Distinctions by Race, Nativity, and Gender

Abstract

Using random coefficient growth curve analysis, this study utilizes 12 waves of data from the Health and Retirement Study (1994–2016; person-waves = 145,177) to examine the association between multiple chronic conditions (MCC) and depressive symptoms among older adults. Applying cumulative disadvantage and intersectionality theories, we also test whether the association between MCC and depressive symptoms differs by race, nativity, and gender. Findings reveal that MCC prevalence is highest among U.S.-born black women, whereas depressive symptoms are highest among foreign-born Hispanic women. Compared to men, MCC has a stronger effect on women’s depressive symptoms. Furthermore, the MCC–depressive symptoms association is strongest for foreign-born Hispanic women. Despite an increase in MCC in the transition from midlife to late life, all race–nativity–gender groups experience a decline in depressive symptoms as they age. The decline in depressive symptoms is steepest for U.S.-born black and foreign-born Hispanic women. Study implications are discussed.

Gendered Racial Microaggressions, Psychosocial Resources, and Depressive Symptoms among Black Women Attending a Historically Black University

“…Accordingly, our study results suggest that sociological stress research underestimates the influence of stress on black women’s health when intersectional stressors like GRMS are not included in empirical research. Black women’s stress exposure is critical to assess, as they remain a race-gender group with disproportionately poor health outcomes including self-rated health (Smith 2021), multiple chronic conditions (Erving and Frazier 2021), and post-traumatic stress disorder (Erving, Thomas, and Frazier 2019). Although we examined psychological health in this study, over time, the psychological health effects of GRMs could contribute to the activation of the body’s stress response and result in physiological dysregulation.…”

“…The dependent measure, depressive symptoms, is the 12-item version of the Center for Epidemiological Studies–Depression (CES-D) Scale (Radloff 1977). This version of the CES-D has been used extensively to assess depressive symptomatology among U.S. black women (Erving, Patterson 2021; Erving, Satcher 2021; Keith et al 2010; Torres 2012). Respondents were asked the frequency with which they experienced symptoms in the past week.…”

Multimorbidity in African ancestry populations: a scoping review

“…Ancestry effects in diaspora studies varied depending on recent migrations to Europe or AA in North America. In the USA, AA ethnicity consistently posed a risk factor for MM across most MM clusters 19 57–61. One study assessing MM risk among men in a racially balanced and economically homogenous cohort in the USA found no difference in MM risk between AA and whites when in the same social environment 62.…”

Intersectional Approaches to Minority Aging Research

“…Garcia and colleagues [59] documented additional nuances among Latinx subpopulations, such that older US-born Latinx adults had poorer cognitive function than non-Latinx Whites and foreign-born Latinxs. Investigating the relationship between multiple chronic conditions (MCC) (e.g., heart disease, cancer) and depressive symptoms, Erving and Frazier [60] also identified race-gendernativity nuances among Black, Latinx, and White older adults; specifically, MCC was the most distress-inducing for foreign-born Latina women, a socially marginalized group who experiences oppression attributable to structural disadvantage at the intersection of race, nativity, and gender. Moreover, though MCC rates were highest among Black women, they did not appear to psychologically succumb to its detrimental effects.…”