High Risk of Depression in High-Income African American Boys



Despite the well-established literature on the protective effect of socioeconomic status (SES) on physical and mental health, there are a few reports on poor mental health of blacks with high SES. Using a national sample, this study investigated the association between household income and risk of major depressive disorder (MDD) in black youth based on ethnicity, gender, and their intersection.


One thousand one hundred seventeen black adolescents (810 African Americans and 360 Caribbean blacks) were included in the current study. Household income was the main predictor. MDD (lifetime, 12-month, and 30-day) was the main outcome. Age was the covariate. Ethnicity and gender were the focal moderators. Logistic regressions were used for data analysis.


In the pooled sample, household income was not associated with risk of MDD (lifetime, 12-month, or 30-day). We found significant interactions between income and gender on lifetime and 12-month MDD, suggesting a stronger protective effect of income on MDD for females than males. We also found significant interaction between income and ethnicity on 30-day MDD, suggesting stronger protective effect of income against MDD for Caribbean blacks than African Americans. In African American males, high household income was associated with higher risk of lifetime, 12-month, and 30-day MDD. For Caribbean black males and females, high household income was associated with lower odds of 30-day MDD.


Findings suggest that ethnicity and gender influence how socioeconomic resources such as income are associated with MDD risk among black youth. Higher household income may be associated with higher risk of MDD for African American males.

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Shervin Assari is supported by the Heinz C. Prechter Bipolar Research Fund and the Richard Tam Foundation at the University of Michigan Depression Center.

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Shervin Assari designed the work, analyzed the data, and prepared the first draft of the manuscript. Cleopatra Caldwell was the Co-PI of the NSAL-A and contributed to design of the mother study. Cleopatra Caldwell also contributed to the revision of the paper.

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Correspondence to Shervin Assari.

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The NSAL is mostly supported by the National Institute of Mental Health, with grant U01-MH57716 to Dr. James S. Jackson. Other support came from the Office of Behavioral and Social Science Research at the National Institutes of Health and the University of Michigan.

Parental informed consent and assent were obtained from all adolescent participants included in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Assari, S., Caldwell, C.H. High Risk of Depression in High-Income African American Boys. J. Racial and Ethnic Health Disparities 5, 808–819 (2018). https://doi.org/10.1007/s40615-017-0426-1

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  • Ethnic groups
  • Blacks
  • Ethnicity
  • Gender
  • Depression
  • Socioeconomic status (SES)
  • Income