Racial/Ethnic Disparities, Social Support, and Depression: Examining a Social Determinant of Mental Health

Ruth S. Shim · Jiali Ye · Peter Baltrus · Yvonne W. Fry-Johnson · Elvan Daniels · George S. Rust

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Health disparities and outcomes Mental Health Treatment and Access Racial and Ethnic Identity Research

Abstract

OBJECTIVE: We examined the risk of depression as it relates to social support among individuals from African American, Caribbean black, and non-Hispanic White backgrounds. METHODS: 6,082 individuals participated in the national survey of American life (NSAL), a nationally representative, psychiatric epidemiological, cross-sectional survey of household populations. The survey is designed to explore racial and ethnic differences in mental disorders. NSAL survey questions were used as a proxy for social support. Logistic regression analysis was used to examine the correlates between having a DSM-IV diagnosis of major depressive disorder in the past year, demographic variables, and social support. RESULTS: African American race/ethnicity was associated with decreased odds of depression when compared to non-Hispanic whites, even when controlling for social support variables and demographics (OR = 0.51, 95% CI = 0.43-0.60). We found a three-fold increase in risk of depression among individuals who reported feeling "not very close at all" with family members compared to those who reported feeling "very close" to family (OR = 3.35, 95% CI = 1.81-6.19). CONCLUSIONS: These findings reinforce previous research documenting the important relationship between social support and depression, and perhaps should lead us to reexamine the individualistic models of treatment that are most evaluated in United States. The lack of evidence-based data on support groups, peer counseling, family therapy, or other social support interventions may reflect a majority-culture bias toward individualism, which belies the extensive body of research on social support deficits as a major risk factor for depression.

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References

1990Child abuse: Adolescent records vs. adult recall 2001Social Ties and Mental Health 2003Social determinants of health: the solid facts 2001Mental Health: Culture, Race, and Ethnicity—A Supplement to Mental Health: A Report of the Surgeon General 2008Family Rejection as a Predictor of Negative Health Outcomes in White and Latino Lesbian, Gay, and Bisexual Young Adults 2010Family Acceptance in Adolescence and the Health of LGBT Young Adults 2007Prevalence and Distribution of Major Depressive Disorder in African Americans, Caribbean Blacks, and Non-Hispanic Whites 2005The Health and Well-Being of Caregivers of Children With Cerebral Palsy

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2015Racial and Ethnic Disparity in Major Depressive Disorder 2013Relationships of choice: Can friendships or fictive kinships explain the race paradox in mental health?2020Do assets explain the relation between race/ethnicity and probable depression in U.S. adults?2020Quality and Quantity of Social Support Show Differential Associations With Stress and Depression in African Americans 2016

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