, Volume 26, Issue 2, pp 167-179

The prevention of psychopathology in African Americans: An epidemiologic perspective

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Abstract

Although improving the mental health status of African Americans is an important goal, it is not clear that this can be accomplished by increasing access to professional services. Many have argued that stressful social conditions are the major cause of mental disorder in blacks and thus, psychopathology can be prevented by eliminating racism, oppression and poor economic conditions. This review argues that while the notion of primary prevention with African Americans should be taken seriously, there is still a need for more and better epidemiologic research. Three bodies of knowledge relevant to black mental health are addressed: 1) the need for an epidemiologic knowledge base for prevention; 2) coping capacity and vulnerability to stress; 3) risk factor identification. Findings from a national survey of adult African Americans are presented as an example of risk factor identification for the purpose of specifying targets for preventive interventions. The paper concludes that before the prevention of psychopathology in black populations can be achieved, a number of measurement, theoretical and policy issues must be addressed. Specific directions for future research are outlined.

Many of the ideas for this paper were formulated while the author was supported by an NIMH New Investigator Research Award (NIRA) funded by the Prevention Research Branch. The author would also like to thank James S. Jackson and two anonymous reviewers for comments on earlier drafts of the manuscript. Finaly, special thanks to Ms. Johanna Lackner for critical and editorial comments.