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Neighborhood matters: the impact of Hispanic ethnic density on future depressive symptoms 1-year following an ACS event among Hispanic patients

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An Erratum to this article was published on 30 October 2015

Abstract

The Ethnic Density hypothesis posits that living around others from similar ethnic backgrounds reduces the risk of adverse mental health outcomes such as depression. Contrary to this hypothesis, previous work has shown that Hispanic ethnic density is cross-sectionally associated with increased depressive symptom severity among patients hospitalized with an acute coronary syndrome (ACS; myocardial infarction or unstable angina pectoris). To date, no study has examined the prospective association of Hispanic ethnic density on long-term depressive symptom severity following an acute medical event. We prospectively assessed the impact of Hispanic ethnic density on depressive symptoms, 1-year following an ACS event, among Hispanic adult patients. We tested the non-linear association between ethnic density and depressive symptoms to account for inconsistent findings on the ethnic density hypothesis. At the time of an index ACS event (i.e., baseline, N = 326) and 1-year later (N = 252), Hispanic patients from the Prescription Usage, Lifestyle, and Stress Evaluation prospective cohort study completed the Beck Depression Inventory as a measure of depressive symptom severity. Hispanic ethnic density was defined by the percentage of Hispanic residents within each patient’s census tract using data extracted from the American Community Survey Census (2010–2013). Covariates included baseline demographic factors (age, gender, English fluency, education, nativity status), cardiovascular factors (Charlson comorbidity index, left ventricular ejection fraction, Global Registry of Acute Coronary Events 6-month prognostic risk score), and neighborhood factors (residential density, income, and percentage of households receiving public assistance). In an adjusted multivariable linear regression analysis there was a significant curvilinear association between Hispanic ethnic density and depressive symptom severity at 1 year. As Hispanic ethnic density increased from low to moderate density, there was an increase in depressive symptoms, but depressive symptoms slightly declined in census tracts with the highest density of Hispanics. Furthermore, gender significantly moderated the relation between Hispanic ethnic density and 1-year depressive symptom severity, such that Hispanic ethnic density was significantly associated with increased depressive symptom severity for female Hispanic patients with ACS, but not for male Hispanic patients. Previous research suggests that ethnic density may be protective against depression in Hispanic enclaves; however, our findings suggest a non-linear ethnic density effect and an overall more complex association between ethnic density and depression. These data add to a growing body of literature on the effects of sociodemographic and contextual factors on health.

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Acknowledgments

The authors gratefully acknowledge the mentorship and support of Elizabeth Brondolo, PhD. The authors appreciate the contributions of field research assistants.

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Authors and Affiliations

  1. Department of Psychology, City University of New York College of Staten Island, 2800 Victory Blvd., Building 4S, Room 229, Staten Island, NY, 10314, USA

    Ellen-ge D. Denton

  2. University of Colorado Denver - Denver Campus, CLAS-Psychology, 3NC North Classroom, 1255 10th Street Mall, Denver, CO, 80217, USA

    Jonathan A. Shaffer

  3. Columbia University School of Social Work, 1255 Amsterdam Avenue, Room 810, MC 4600, New York, NY, 10027, USA

    Carmela Alcantara

  4. Department of Psychology, Clark University, 950 Main Street, Worcester, MA, 01610-1477, USA

    Esteban Cadermil

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  1. Ellen-ge D. Denton
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Ellen-ge D. Denton, Jonathan A. Shaffer, Carmela Alcantara, and Esteban Cadermil, declares that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all participants for being included in the study.

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Denton, Eg.D., Shaffer, J.A., Alcantara, C. et al. Neighborhood matters: the impact of Hispanic ethnic density on future depressive symptoms 1-year following an ACS event among Hispanic patients. J Behav Med 39, 28–40 (2016). https://doi.org/10.1007/s10865-015-9679-5

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