Abstract
To clarify the ways in which Black Americans’ experiences of structural racism may influence their mental and physical health in distinct ways, the present study evaluated whether major discrimination moderates the association between depressive symptoms and chronic physical health conditions among this population. t-tests and chi-squared tests of significance were used to determine significant differences between women and men. The association between major discrimination and depressive symptoms was examined by assessing mean depressive symptoms scores across levels of major discrimination. ANOVA tests indicated whether there were significant differences in symptom scores across each discrimination category. Additional t-tests determined significant gender differences within each level of discrimination. Gender-stratified negative binomial models were used, and odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for the relationship between depressive symptoms, major discrimination, and chronic conditions. Our findings indicated that the association between depressive symptoms and chronic conditions depends on lifetime experiences of major discrimination among Black Americans and varies significantly between women and men. Considering that major discrimination conditioned the depressive symptom-chronic conditions association among our sample, this provides insight into potential pathways for intervention in efforts to offset the detrimental mental and physical consequences of experiencing racism.
Highlights
Inequities in physical and mental health among racial and ethnic subgroups in the United States have been well-documented
To clarify the ways in which Black Americans’ experiences of structural racism may influence their mental and physical health in distinct ways, the present study evaluated whether major discrimination moderates the association between depressive symptoms and chronic physical health conditions among this population
Our study demonstrated that the impact of depressive symptoms on chronic conditions depends upon prior exposure to major discrimination among Black Americans
Summary
Inequities in physical and mental health among racial and ethnic subgroups in the United States have been well-documented. Black Americans experience chronic cardiometabolic conditions (e.g., diabetes, hypertension, obesity), premature death, and disability at two to four times the rates of their White counterparts [1,2,3]. Americans are more likely to experience comorbidities that are associated with a greater risk of disease progression [4], accelerated physiological aging [5], and reduced quality of life [6]. As previous research has demonstrated a significant, and often bidirectional, link between mental and physical health [7,8], efforts to reduce the high rates of chronic physical health conditions (hereafter referred to as “chronic conditions”) among Black Americans may be enhanced by a focus on depressive symptoms among this population. The association between depression and chronic conditions is well-established in the literature
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