Perceived Discrimination Trajectories and Depressive Symptoms Among Middle-Aged and Older Black Adults

Abstract

Background and Objectives Perceived discrimination is a risk factor for poor mental health. However, most studies measure discrimination at one time point, which does not account for heterogeneity in the cumulative patterning of exposure to discrimination. To address this gap, we examine the association between discrimination trajectories and depressive symptoms among black middle-aged and older adults. Research Design and Methods Data were analyzed from a subsample of black Health and Retirement Study respondents (2006 – 2018, N = 2,926, 50+). General discrimination and racial discrimination trajectories were constructed based on the Everyday Discrimination Scale using repeated measures latent profile analyses. We examined the extent to which the association between discrimination trajectories are differentially associated with depressive symptoms (8-item Center for Epidemiologic Studies – Depression scale) using negative binomial regression models adjusted for potential confounders. Effect modification by age and gender was tested. Results Individuals in the persistently high (IRR: 1.70; 95% CI: 1.49, 1.95) and moderate general discrimination trajectories (IRR: 1.19; 95% CI: 1.06, 1.33), were more likely to have elevated depressive symptoms in comparison to those in the persistently low trajectory. This relationship was strongest among older adults aged 65+. Respondents in the persistently high racial discrimination trajectory (IRR: 1.50; 95% CI: 1.29, 1.73) had higher risk of elevated depressive symptoms in comparison to respondents in the persistently low trajectory. Sensitivity analyses indicated that there was an independent association between persistently high racial discrimination trajectory class and elevated depressive symptoms, after adjusting for racial discrimination measured at a single time point. Discussion and Implications Characterizing longitudinal patterns of perceived discrimination may facilitate the stratification of mental health risk and vulnerability among black middle-aged and older adults. Trajectories of racial discrimination may inform risk of worse depressive symptoms more accurately than a single assessment of discrimination.

Inner child of the past: long-term protective role of childhood relationships with mothers and fathers and maternal support for mental health in middle and late adulthood

“…Future studies could examine whether positive parent-child relationships are associated with longevity due to a better quality of psychological wellbeing. This study applied a common approach to analyze longitudinal data of depressive symptoms [75,101] and used weights to correct some bias from non-response (due to various reasons, including death). Future studies can use different statistical methods, such as competing risk analysis, to assess whether positive early family relationships can prolong life with improved mental health.…”

Racism and Older Black Americans’ Health: a Systematic Review

“…Of the 43 included studies, 13 were published in health outcome-specific journals [ 25 , 33 , 35 , 37 , 38 , 42 , 44 , 47 , 51 , 56 , 58 , 59 , 62 ] (e.g., Breast Cancer Research and Treatment ), 15 in aging-specific journals [ 21 , 22 , 24 , 28 , 30 , 32 , 34 , 36 , 45 , 53 – 55 , 57 , 60 , 61 ] (e.g., Journals of Gerontology ), four in racial disparities or race-specific journal [ 23 , 41 , 49 , 52 ] (e.g., Journal of Racial and Ethnic Health Disparities ) and the remainder in general health and social science journals [ 26 , 27 , 29 , 31 , 39 , 40 , 43 , 46 , 48 , 50 , 64 ] (e.g., PLOS One ).…”

“…[48] Study Design While 37 of the studies were cross-sectional in design, six were longitudinal. [21,24,46,57,60,61] As indicated in Table 2, sample sizes for older Black American participants across all 43 included studies were categorized as small (n = < 100), medium (n = 100-1000), large (n = 1000-5000), and very large (n = 5000 +). Very large studies typically used census-tract data or other area-level variables.…”

“…Very large studies typically used census-tract data or other area-level variables. Many of the studies used data from the same large parent studies such as the Health and Retirement Study [22,26,29,36,46,52,[60][61][62] and the Minority Aging Research Study. [28,37,44,57] Thirty-six of the studies used validated measures of discrimination and six [21,29,30,33,35,41] did not (or did not provide evidence of psychometrics validation).…”

Race and Mental Health Among Older Adults: Within- and Between-Group Comparisons

“… White and colleagues (2020) used data from the HRS to explore the association between discrimination trajectories and depressive symptoms among middle-aged and older Black adults. Repeated-measures latent profile analyses (a person-centered analysis approach that ascertains patterns of variables among persons that share similar attributes) were used to identify discrimination trajectories over time that reflected: (a) persistently high racial discrimination, (b) moderate discrimination, or (c) persistently low discrimination.…”