Health and depression among American Indians: Psychosocial data from the strong heart study phase II

Abstract

In this study, we investigated relationships of lifestyle and cultural factors with report of depression among upper midwest American Indians using the Center for Epidemiological Studies—Depression (CES-D) scale as a nonclinical measure of depressive symptomatology. Lifestyle factors included level of alcohol consumption, tobacco use, physical activity, and family medical history. Cultural factors included level of native and nonnative cultural identification and fluency in native language. There were inverse relationships between CES-D score and amount of weekly exercise, academic grade completed, yearly house income, frequency of using traditional medicine or herbs, and ability to speak native language. The present findings indicate that certain demographic and culturally based factors relate to American Indians’ self-reports of depressive mood. With regard to health factors, there was an association between family history of diabetes and greater report of depression. Results of a multivariate principal components analysis on the CES-D revealed a three-factor solution: one dimension having to do with negative affect and interpersonal evaluations, another having to do with cognitive and motoric problems, and a dimension of positive and hopeful affect. The data point to a subset of demographic and cultural factors that may have particular relevance to depressive mood in Northern Plains American Indians.