Abstract
Objectives
Black women disproportionately share the distribution of risk factors for physical and mental illnesses. The goal of this study was to examine the sociodemographic and health correlates of major depressive disorder (MDD) symptoms among black women.
Methods
Pooled data from the 2005–2010 National Health and Nutrition Examination Survey (NHANES) were used to assess the sociodemographic and health correlates of MDD symptoms among black women (n = 227). Multivariate logistic regression techniques assessed the association between MDD symptoms and age, socioeconomic status, health status, and health behaviors.
Results
Poverty income ratio and smoking status were significantly associated with the likelihood of having MDD symptoms. Black women who were smokers were also more likely to have MDD symptoms compared to non-smokers [OR = 8.05, 95% CI = (4.56, 14.23)]. After controlling for all other socioeconomic and health variables, this association remained statistically significant. In addition, after controlling for all other variables, the multivariate analyses showed that black women below 299% federal poverty level (FPL) were nearly three times more likely to have MDD symptoms compared to women above 300% FPL [OR = 2.82, 95% CI = (1.02, 7.96)].
Conclusions
These analyses suggest that poverty and smoking status are associated with MDD symptoms among black women. A deeper understanding of the underlying mechanisms and key factors which influence MDD symptoms are needed in order to develop and create mental health programs targeting women of color.
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References
Jackson KL, Janssem I, Appelhans BM, Kazlauskaite R, Kawavolos K, Dugan SA, Avery EA, Shipp-Johnson KJ, Powell LH, Kravitz HM. Body image satisfaction and depression in midlife women: the Study of Women’s Health Across the Nation (SWAN). Arch Women Ment Hlth. 2014; doi:10.1007/s00737-014-0416-9.
National Alliance for Mental Illness. (2009). African American women and depression fact sheet. 2009. http://www2.nami.org/PrinterTemplate.cfm?Section=Women_and_Depression&Template=/ContentManagement/ContentDisplay.cfm&ContentID=88884 Accessed 25 August 2016.
Bronder EC, Speight SL, Witherspoon KM, Thomas AJ. John Henryism, depression, and perceived social support in black women. J Black Psychol. 2013; doi:10.1177/0095798412474466.
National Institute of Mental Health. Major Depression Among Adults. 2012. http://www.nimh.nih.gov/health/statistics/prevalence/major-depression-among-adults.shtml. Accessed 25 August 2016.
Williams DR, Gonzalez HM, Neighbors H, Nesse R, Abelson JM, Sweetman J, Jackson JJ. Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites. Arch Gen Psychiat. 2007; doi:10.1001/archpsyc.64.3.305.
McKnight-Eily LR, Presley-Cantrell L, Elam-Evans LD, Chapman DP, Kaslow NJ, Perry GS. Prevalence and correlates of current depressive symptomatology and lifetime diagnosis of depression in black women. Womens Health Issues. 2009; doi:10.1016/j.whi.2009.04.003.
Carr ER, Szymanskiv DM, Taha F, West LM, Kaslow NJ. Understanding the link between multiple oppressions and depression among African American women: the role of internalization. Psychol Women Quart. 2014; doi:10.1177/0361684313499900.
Geronimus AT, Hicken M, Keene D, Bound J. ‘Weathering’ and age patterns of allostatic load scores among blacks and whites in the United States. Am J Public Health. 2006; doi:10.2105/AJPH.2004.060749.
Seeman TE, McEwen BS, Rowe JW, Singer BH. Allostatic load as a marker of cumulative biological risk: MacArthur studies of successful aging. P Natl Acad Sci USA. 2001; doi:10.1073/pnas.081072698.
Juster RP, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav R. 2009; doi:10.1016/j.neubiorev.2009.10.002.
Chyu L, Upchurch DM. Racial and ethnic patterns of allostatic load among adult women in the United States: findings from the National Health and Nutrition Examination Survey 1999-2004. J Women's Health. 2011; doi:10.1089/jwh.2010.2170.
Hicken MT, Gee GC, Connell C, Snow RC, Morenoff J, Hu H. Black-white blood pressure disparities: depressive symptoms and differential vulnerability to blood lead. Environ Health Perspect. 2013; doi:10.1289/ehp.1104517.
Hickson DA, Roux AVD, Gebreab SY, Wyatt SB, Dubbert PM, Sarpong DF, Sims M, Taylor HA. Social patterning of cumulative biological risk by education and income among African Americans. Am J Public Health. 2012:2012. doi:10.2105/AJPH.2011.300444.
Abdou CM, Fingerhut AW. Stereotype threat among black and white women in health care settings. Cult Divers Ethn Min. 2014; doi:10.1037/a0036946.
Keith VM, Lincoln KD, Taylor RJ, Jackson JS. Discriminatory experiences and depressive symptoms among African American women: do skin tone and mastery matter? Sex Roles. 2010; doi:10.1007/s11199-009-9706-5.
Tjora T, Hetland J, Avarø LE, Wold B, Wiium N, Øverland S. The association between smoking and depression from adolescence to adulthood. Addiction. 2014; doi:10.1111/add.12522.
Holahan CK, Holahan CJ, Powers DA, Hayes RB, Marti CN, Ockene JK. Depressive symptoms and smoking in middle aged and older women. Nicotine Tob Res. 2011; doi:10.1093/ntr/ntr066.
Stewart DW, Jones GN, Minor KS. Smoking, depression, and gender in low-income African American with HIV/AIDS. Behav Med. 2011; doi:10.1080/08964289.2011.583946.
Chaiton MO, Cohen JE, O’Loughlin J, Rehm J. A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Public Health. 2009; doi:10.1186/1471-2458-9-356.
Boden JM, Fergusson DM, Horwood LJ. Cigarette smoking and depression: tests of causal linkages using a longitudinal birth cohort. Brit J of Psychiat. 2010; doi:10.1192/bjp.bp.109.065912.
Fluharty M, Taylor AE, Grabski M, Munafò MR. The association of cigarette smoking with depression and anxiety: a systematic review. Nicotine Tob Res. 2016; doi:10.1093/ntr/ntw140.
Poleshuck EL, Cerrito B, Leshoure N, Finocan-Kaag G, Kearney MH. Underserved women in a women’s health clinic describe their experiences of depressive symptoms and why they have low uptake of psychotherapy. Community Ment Hlt J. 2013; doi:10.1007/s10597-012-9500-7.
Roxburgh S. Untangling inequalities: gender, race, and socioeconomic differences in depression. Sociol Forum. 2009; doi:10.1111/j.1573-7861.2009.01103.x.
Centers for Disease Control and Prevention. National Health and Nutrition Examination Survey Data. 2012. www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm. Accessed 25 August 2016.
SAS Institute. SAS/STAT, [computer program]. Version 9.2. Cary, NC. 2008.
Crimmins EM, Kim JK, Alley DE, Karlamangla A, Seeman T. Hispanic paradox in biological risk profiles. Am J Public Health. 2007; doi:10.2105/AJPH.2006.091892.
Huang FY, Chung H, Kroenke K, Delucchi KL, Spitzer RL. Using the patient health questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. J Gen Intern Med. 2006; doi:10.1111/j.1525-1497.2006.00409.x.
Thibodeau MA, Asmundson GJG. The PHQ-9 assesses depression similarly in men and women from the general population. Pers Indiv Differ. 2014; doi:10.1016/j.paid.2013.08.039.
Arroll B, Goodyear-Smith F, Crengle S, Gunn J, Kerse N, Fishman T, Falloon K, Hatcher S. Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Ann Fam Med. 2010; doi:10.1370/afm.1139.
Holma IAK, Holma KM, Melartin TK, Ketokivi M, Isometsa ET. Depression and smoking: a 5-year prospective study of patients with major depressive disorder. Depress Anxiety. 2013; doi:10.1002/da.22108.
Mojtabai R, Crum RM. Cigarette smoking and onset of mood and anxiety disorders. Am J Public Health. 2013;2013 doi:10.2105/AJPH.2012.300911.
Secades-Villa R, Olfson M, Okuda M, Velasquez N, Perez-Fuentes G, Liu SM, Blacco C. Trends in the prevalence of tobacco use in the United States, 1991-1992 to 2004-2005. Psychiat Serv. 2013; doi:10.1176/appi.ps.002852012.
Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E, Howes MJ, Normand SL, Manderscheid RW, Walters EE, Zaslavsky AM. Screening for serious mental illness in the general population. Arch Gen Psych. 2003;60(2):184–9.
Adams P, Hurd MD, McFadden D, Merrill A, Ribeiro T. Healthy, wealthy, and wise? Test for direct causal paths between health and socioeconomic status. In: Wise DA, editor. Perspectives on the economics of aging. Chicago: University of Chicago Press; 2004. p. 415–526.
Pratt LA, Dey AN, Cohen AJ. Characteristics of adults with serious psychological distress as measured by the K6 scale: United States, 2001–2004. In: National Center for Health Statistics. 2007. https://www.cdc.gov/nchs/data/ad/ad382.pdf. Accessed 25 August 2016.
World Health Organization. Depression: a global crisis. 2012. http://www.who.int/mental_health/management/depression/wfmh_paper_depression_wmhd_2012.pdf. Accessed 25 August 2016.
Hasson D, Von Thiele SU, Lindfors P. Self-rated health and allostatic load in women working in two occupational sectors. J Health Psychol. 2009; doi:10.1177/1359105309103576.
Miranda J, Siddique J, Belin TR, Kohn-Wood LP. Depression prevalence in disadvantaged young black women. Soc Psych Psych Epid. 2005; doi:10.1007/s00127-005-0879-0.
Peek MK, Cutchin MP, Salinas JJ, Sheffield KM, Eschbach K, Stowe RP, Goodwin JS. Allostatic load among non-Hispanic whites, non-Hispanic blacks, and people of Mexican origin: effects of ethnicity, nativity, and acculturation. Am J Public Health. 2010;2010 doi:10.2105/AJPH.2007.129312.
Jones LV. Preventing depression: culturally relevant group work with black women. Res Social Work Prac. 2007; doi:10.1177/1049731507308982.
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Amutah-Onukagha, N.N., Doamekpor, L.A. & Gardner, M. An Examination of the Sociodemographic and Health Determinants of Major Depressive Disorder Among Black Women. J. Racial and Ethnic Health Disparities 4, 1074–1082 (2017). https://doi.org/10.1007/s40615-016-0312-2
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DOI: https://doi.org/10.1007/s40615-016-0312-2