Race Attribution Modifies the Association Between Daily Discrimination and Major Depressive Disorder Among Blacks: the Role of Gender and Ethnicity

J. Racial and Ethnic Health Disparities

Burgard

Zivin

2015

Self Cite

121

Background Previous research has identified a Black-White health paradox, which can be defined as less frequent depression despite a higher prevalence of chronic medical conditions among Blacks compared to Whites in the USA. Based on this paradox, we would expect weaker associations between chronic medical conditions and depression among Blacks than Whites. However, the literature on this topic is mostly crosssectional and has provided findings that contradict the BlackWhite health paradox. The present longitudinal study extends prior research by assessing Black-White differences in reciprocal associations between number of chronic medical conditions and depressive symptoms over a 25-year period.Methods Data came from the Americans' Changing Lives Study that followed 1034 surviving Black and White respondents for 25 years from 1986 to 2011. Chronic medical conditions were measured based on a count of self-reported physician diagnoses including hypertension, diabetes, chronic lung disease, heart disease, stroke, cancer, and arthritis at baseline (1986) and follow-up (2011). Depressive symptoms were also measured at baseline and follow-up using a 10-item Center for Epidemiological Studies-Depression (CES-D) scale. Multi-group structural equation modeling was used to assess reciprocal associations between baseline and subsequent depressive symptoms and baseline and subsequent chronic medical conditions comparing Black and White respondents. Results Among White but not Black respondents, a higher number of chronic medical conditions at baseline predicted a greater increase in depressive symptoms over 25 years of follow-up. Among Whites but not Blacks, individuals with more depressive symptoms at baseline developed more chronic medical conditions over time. Conclusion Findings documented Black-White differences in reciprocal associations between chronic medical conditions and depressive symptoms over time. Our study provides longitudinal evidence for the Black-White health paradox across mid and later life, as reciprocal associations between depression and chronic medical conditions were weaker for Blacks compared to Whites.

Section: Discussionmentioning

confidence: 99%

Long-Term Reciprocal Associations Between Depressive Symptoms and Number of Chronic Medical Conditions: Longitudinal Support for Black–White Health Paradox

J. Racial and Ethnic Health Disparities

Burgard

Zivin

2015

Self Cite

121

“…Negative beliefs regarding pharmaceutical treatment (4), preference of non-pharmacologic approaches (e.g., counseling and prayer) (51), and the belief that antidepressants are addictive (51) may also operate as barriers against depression treatment among Blacks. Higher comorbidity of CMC among Blacks with depression also adds to the complexity of diagnosis of depression among Blacks (1, 2, 52, 53). Differential presentation of depression (more somatic among Blacks) may also be another barrier for diagnosis (54).…”

Section: Discussionmentioning

confidence: 99%

Chronic Medical Conditions and Negative Affect; Racial Variation in Reciprocal Associations Over Time

Lankarani²

2016

Front. Psychiatry

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BackgroundThe Black–White health paradox can be defined as lower frequency of depression despite higher prevalence of economic and social adversities as well as chronic medical conditions (CMC) among American Blacks compared to American Whites. Based on this paradox, the CMC – depressive symptoms link is expected to be weaker among Blacks than Whites. We conducted a 10-year longitudinal study to compare Blacks and Whites for bidirectional associations between number of CMC and negative affect over time.MethodsWe used data from the MIDUS (Midlife in the United States), a nationally representative longitudinal study of American adults. A total number of 7,108 individuals with an age range of 25–75 years (N = 7,108) were followed for 10 years from 1995 to 2004. Age, gender, and socioeconomic status (education and income) were measured at baseline. Negative affect and CMC were measured at baseline (1995) and end of follow up (2004). Race was the moderator. Linear regression was used to test the moderating effect of race on the reciprocal associations between CMC and negative affect, net of covariates.ResultsIn the pooled sample, while baseline CMC was predictive of an increase in negative affect over time, baseline negative affect was also predictive of an increase in CMC. We found interactions between race and baseline CMC on change in depressive symptoms, as well as race with negative affect on CMC change, suggesting that the associations between CMC and negative affect are stronger for Whites in comparison to Blacks.ConclusionBlacks and Whites differ in reciprocal links between CMC and negative affect over time. This finding replicates recent studies on differential links between psychosocial factors and physical health based on race. Findings may help us better understand how Black-White health paradox develops across mid and later life.

“…17,22,[33][34][35] In addition to exposure, 17 the intersection of race and gender also alters harmful effects of discrimination. 23,[36][37][38][39] In a short cohort, an increase in discrimination was associated with a subsequent increase in depression of male but not female Blacks, 23 a finding which could be replicated over longer periods. 24 All this evidence suggests that exposure and vulnerability to perceived discrimination are not solely a function of race or gender but their intersection.…”

Section: Introductionmentioning

confidence: 88%

“…5,19,35,64,65 Racial attribution also alters the vulnerability to discrimination. 38 It is still unknown how masculinity and other social norms explain race by gender differences in implicit bias.…”

Section: Assarimentioning

confidence: 99%

Interaction Between Race and Gender and Effect on Implicit Racial Bias Against Blacks

2018

Int J Epidemiol Res

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Background and aims: Exposure and vulnerability to racial discrimination is not solely a function of race but the intersection of race and gender, with Black men experiencing more discrimination than Black women. This phenomenon is explained by the subordinate male target hypothesis, suggesting that majority men specifically target men of color. If that is the case, implicit bias would be most common among the majority men. The current cross-sectional study investigated race by gender differences in implicit bias against Blacks. Methods: Data came from Harvard University's Project Implicit, an online survey, conducted during 2006-2016. Data included 444 422 implicit association tests (IATs) which were taken by Blacks (n=56 384) and Whites (n=388 038). Using IAT, the dependent variable was implicit bias against Blacks. Independent variables were race, gender, and age. Using SPSS, linear regressions were utilized to test the additive and multiplicative effects of race and gender on implicit bias against Blacks. Results: Race (b = 0.39; 95% CI = 0.38-0.39) and gender (b = 0.05; 95% CI = 0.05-0.05) were associated with IAT score suggesting higher implicit bias against Blacks among Whites and men. A significant interaction was found between race and gender (b = 0.05; 95% CI = 0.04-0.07), suggesting the highest level of implicit bias against Blacks among White men. Conclusion: It is not solely race and gender but their intersection that shapes social distribution of implicit bias against Blacks. This finding extends the previous literature showing that not solely race or gender but their intersection influences exposure to discrimination.