Social Determinants of Health and Depression among African American Adults: A Scoping Review of Current Research

Abstract

Depression in the United States (US) is increasing across all races and ethnicities and is attributed to multiple social determinants of health (SDOH). For members of historically marginalized races and ethnicities, depression is often underreported and undertreated, and can present as more severe. Limited research explores multiple SDOH and depression among African American adults in the US. Guided by Healthy People (HP) 2030, and using cross-disciplinary mental health terminology, we conducted a comprehensive search to capture studies specific to African American adults in the US published after 2016. We applied known scoping review methodology and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. From 12,315 initial results, 60 studies were included in our final sample. Most studies explored the HP 2030 Social and Community Context domain, with a heavy focus on discrimination and social support; no studies examined Health Care Access and Quality. Researchers typically utilized cross-sectional, secondary datasets; no qualitative studies were included. We recommend research that comprehensively examines mental health risk and protective factors over the life course within, not just between, populations to inform tailored health promotion and public policy interventions for improving SDOH and reducing racial and ethnic health disparities.

Multi‐disciplinary collaborative consensus guidance statement on the assessment and treatment of mental health symptoms in patients with post‐acute sequelae of SARS‐CoV‐2 infection (PASC)

“…In addition, group therapy is a good setting for efficiently teaching adaptive coping skills that are helpful to improve patients’ mood, self‐efficacy, self‐care abilities, and quality of life. Of note, both before and during the COVID‐19 pandemic, people who identify as a member of a marginalized group (and especially with racial and ethnic minority groups) have experienced disparities in access to mental health and rehabilitative care, quality of the care delivered, and clinical outcomes achieved 118–120 . Every effort should be made to close gaps in these health disparities and ensure optimal care for this population.…”

“…Of note, both before and during the COVID-19 pandemic, people who identify as a member of a marginalized group (and especially with racial and ethnic minority groups) have experienced disparities in access to mental health and rehabilitative care, quality of the care delivered, and clinical outcomes achieved. [118][119][120] Every effort should be made to close gaps in these health disparities and ensure optimal care for this population. Public health initiatives should provide culturally responsive support to these minoritized groups.…”

Biological Role of Nutrients, Food and Dietary Patterns in the Prevention and Clinical Management of Major Depressive Disorder

“…The presence of physical or mental comorbidities together with multiple social factors can be equally prominent contributors to those suffering from MDD. In this sense, ethnic minorities, marital status (separated/divorced), poor education and healthcare access/quality, neighborhood, built environment, intimate partner violence, and lower socioeconomic resources are the most important social determinants related to the onset of MDD [ 7 , 12 , 13 ].…”

Plasma metabolomics profiles in Black and White participants of the Adventist Health Study-2 cohort

“…Racial status and culture may strongly influence dietary patterns and food preferences, consequently impacting overall health and disease susceptibility. Besides dietary behaviors, research has shown that social and environmental determinants of health, as opposed to genetic differences, are critical in propagating the burden of chronic disease disparities in African Americans [ 22 – 25 ]. Blacks are over-represented in lower-wage jobs and more likely to live in lower-income neighborhoods disproportionately higher in poverty compared to White neighborhoods [ 26 , 27 ].…”