Can social relationships explain the race paradox in mental health?

Abstract

Biomedical research consistently finds that blacks have worse physical health than whites, even after controlling for socioeconomic status or SES. This relationship is expected, given blacks' disproportionate exposure to psychosocial stress and discrimination. However, despite decades of research on the topic, there is surprising lack of consensus regarding race differences in mental health status. In general, studies have found that blacks tend to have better mental health than whites, although the direction and magnitude of this relationship varies depending on the outcome used. How might we resolve these discrepant findings of race differences in mental health that run counter to both the race patterns found for physical health and the well-established SES gradient in health? Most past research attributes these unexpected findings (hereafter referred to as "the race paradox in mental health" to the idea that African Americans have stronger social networks that protect them against psychosocial distress. There has been little comparative work examining race differences in the structure of social ties, and virtually no research explicitly testing whether stronger social ties among blacks relative to whites (if they exist) can account for the race paradox in mental health. Using data from the 2003-2005 National Survey of American Life, I explore the extent to which family relationships, friendships, fictive kin relationships, and relationships with church members can explain the race paradox in mental health (using measures for any DSM mood/anxiety disorder, CES-D depressive symptoms, and self-rated mental health). The findings have implications for mental health measurement and how we understand the nature of social relationships among African Americans.

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