Racial differences in depression in the United States: How do subgroup analyses inform a paradox?

David Barnes, Katherine M. Keyes, Lisa M. Bates

Research output: Contribution to journalArticle

Abstract

Purpose: Non-Hispanic Blacks in the US have lower rates of major depression than non-Hispanic Whites, in national household samples. This has been termed a "paradox," as Blacks suffer greater exposure to social stressors, a risk factor for depression. Subgroup analyses can inform hypotheses to explain this paradox. For example, it has been suggested that selection bias in household samples undercounts depression in Blacks; if selection is driving the paradox, Black-White differences should be most pronounced among young men with low education. Methods: We examined Black-White differences in lifetime major depression in subgroups defined simultaneously by sex, age, and education using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the Collaborative Psychiatric Epidemiology Surveys (CPES). Results: In NESARC and CPES, Blacks had lower odds than Whites of lifetime major depression in 21 and 23 subgroups, respectively, of 24. All statistically significant differences were in subgroups favoring Blacks, and lower odds in Blacks were more pronounced among those with more education. Conclusions: These results suggest that hypotheses to explain the paradox must posit global mechanisms that pertain to all subgroups defined by sex, age, and education. Results do not lend support for the selection bias hypothesis.

Original languageEnglish (US)
Pages (from-to)1941-1949
Number of pages9
JournalSocial Psychiatry and Psychiatric Epidemiology
Volume48
Issue number12
DOIs
StatePublished - Dec 1 2013

Fingerprint

Depression
epidemiology
Sex Education
Selection Bias
education
alcohol
Psychiatry
Epidemiology
Alcohols
Education
trend
Surveys and Questionnaires
hydroquinone

Keywords

  • Blacks
  • Major depressive disorder
  • Socioeconomic status
  • United States
  • Whites

ASJC Scopus subject areas

  • Epidemiology
  • Health(social science)
  • Social Psychology
  • Psychiatry and Mental health

Cite this

Racial differences in depression in the United States : How do subgroup analyses inform a paradox? / Barnes, David; Keyes, Katherine M.; Bates, Lisa M.

In: Social Psychiatry and Psychiatric Epidemiology, Vol. 48, No. 12, 01.12.2013, p. 1941-1949.

Research output: Contribution to journalArticle

@article{bfc22c7755364d0fa96490805543d841,
title = "Racial differences in depression in the United States: How do subgroup analyses inform a paradox?",
abstract = "Purpose: Non-Hispanic Blacks in the US have lower rates of major depression than non-Hispanic Whites, in national household samples. This has been termed a {"}paradox,{"} as Blacks suffer greater exposure to social stressors, a risk factor for depression. Subgroup analyses can inform hypotheses to explain this paradox. For example, it has been suggested that selection bias in household samples undercounts depression in Blacks; if selection is driving the paradox, Black-White differences should be most pronounced among young men with low education. Methods: We examined Black-White differences in lifetime major depression in subgroups defined simultaneously by sex, age, and education using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the Collaborative Psychiatric Epidemiology Surveys (CPES). Results: In NESARC and CPES, Blacks had lower odds than Whites of lifetime major depression in 21 and 23 subgroups, respectively, of 24. All statistically significant differences were in subgroups favoring Blacks, and lower odds in Blacks were more pronounced among those with more education. Conclusions: These results suggest that hypotheses to explain the paradox must posit global mechanisms that pertain to all subgroups defined by sex, age, and education. Results do not lend support for the selection bias hypothesis.",
keywords = "Blacks, Major depressive disorder, Socioeconomic status, United States, Whites",
author = "David Barnes and Keyes, {Katherine M.} and Bates, {Lisa M.}",
year = "2013",
month = "12",
day = "1",
doi = "10.1007/s00127-013-0718-7",
language = "English (US)",
volume = "48",
pages = "1941--1949",
journal = "Social Psychiatry",
issn = "0037-7813",
publisher = "D. Steinkopff-Verlag",
number = "12",

}

TY - JOUR

T1 - Racial differences in depression in the United States

T2 - How do subgroup analyses inform a paradox?

AU - Barnes, David

AU - Keyes, Katherine M.

AU - Bates, Lisa M.

PY - 2013/12/1

Y1 - 2013/12/1

N2 - Purpose: Non-Hispanic Blacks in the US have lower rates of major depression than non-Hispanic Whites, in national household samples. This has been termed a "paradox," as Blacks suffer greater exposure to social stressors, a risk factor for depression. Subgroup analyses can inform hypotheses to explain this paradox. For example, it has been suggested that selection bias in household samples undercounts depression in Blacks; if selection is driving the paradox, Black-White differences should be most pronounced among young men with low education. Methods: We examined Black-White differences in lifetime major depression in subgroups defined simultaneously by sex, age, and education using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the Collaborative Psychiatric Epidemiology Surveys (CPES). Results: In NESARC and CPES, Blacks had lower odds than Whites of lifetime major depression in 21 and 23 subgroups, respectively, of 24. All statistically significant differences were in subgroups favoring Blacks, and lower odds in Blacks were more pronounced among those with more education. Conclusions: These results suggest that hypotheses to explain the paradox must posit global mechanisms that pertain to all subgroups defined by sex, age, and education. Results do not lend support for the selection bias hypothesis.

AB - Purpose: Non-Hispanic Blacks in the US have lower rates of major depression than non-Hispanic Whites, in national household samples. This has been termed a "paradox," as Blacks suffer greater exposure to social stressors, a risk factor for depression. Subgroup analyses can inform hypotheses to explain this paradox. For example, it has been suggested that selection bias in household samples undercounts depression in Blacks; if selection is driving the paradox, Black-White differences should be most pronounced among young men with low education. Methods: We examined Black-White differences in lifetime major depression in subgroups defined simultaneously by sex, age, and education using data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and the Collaborative Psychiatric Epidemiology Surveys (CPES). Results: In NESARC and CPES, Blacks had lower odds than Whites of lifetime major depression in 21 and 23 subgroups, respectively, of 24. All statistically significant differences were in subgroups favoring Blacks, and lower odds in Blacks were more pronounced among those with more education. Conclusions: These results suggest that hypotheses to explain the paradox must posit global mechanisms that pertain to all subgroups defined by sex, age, and education. Results do not lend support for the selection bias hypothesis.

KW - Blacks

KW - Major depressive disorder

KW - Socioeconomic status

KW - United States

KW - Whites

UR - http://www.scopus.com/inward/record.url?scp=84890315835&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890315835&partnerID=8YFLogxK

U2 - 10.1007/s00127-013-0718-7

DO - 10.1007/s00127-013-0718-7

M3 - Article

C2 - 23732705

AN - SCOPUS:84890315835

VL - 48

SP - 1941

EP - 1949

JO - Social Psychiatry

JF - Social Psychiatry

SN - 0037-7813

IS - 12

ER -