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Race/Ethnicity, Gender, and Trajectories of Depressive Symptoms Across Early- and Mid-Life Among the Add Health Cohort

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Abstract

While disparities in depressive symptoms by race/ethnicity and gender have been documented, left unclear is how such status characteristics intersect to influence mental health, particularly across early life and among a diverse set of population subgroups. This study investigates how intra- and inter-individual trends in depressive symptoms unfold across a 30-year span (ages 12–42) and are structured by the intersection of race/ethnicity and gender among White, Black, Hispanic, and Asian American young adults (N = 18,566). Analyses use data from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative study of adolescents who have been followed through their fourth decade of life. We draw on Waves I–IV and a representative subsample of the brand new Wave V data. Growth curve models indicated depressive symptoms decreased across adolescence and young adulthood before increasing in the early 30s. Racial/ethnic minorities reported more depressive symptoms than Whites. Women reported more depressive symptoms than men and experienced especially steep increases in their late 30s. Racial/ethnic-gender disparities remained stable with age, except for Hispanic-White disparities among women and Asian American-White disparities among men, which narrowed with age. Overall, findings demonstrate dynamic inequalities across a longer period of the life span than was previously known, as well as heterogeneity in trajectories of poor mental health within and between racial/ethnic-gender groups. Results also suggest that Black and Asian American women experience the highest mental health risks and that interventions for reducing disparities in depressive symptoms should focus on adults in their late 20s/early 30s, particularly women of color.

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Data Availability

Information on how to obtain the Add Health data files is available on the Add Health website (http://www.cpc.unc.edu/addhealth).

References

  1. Child Trends Databank (CTD). Child trends of the National Health Interview Survey. Young Adult Depression. 2015. https://www.childtrends.org/?indicators=young-adult-depression. Accessed August 2019.

  2. Mojtabai R, Olfson M, Han B. National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics. 2016;138(6):1–11.

    Google Scholar 

  3. Greenberg PE, Fournier AA, Sisitsky T, Pike CT, Kessler RC. The economic burden of adults with major depressive disorder in the United States (2005 and 2010). J Clin Psychiat. 2015;76(2):155–62.

    Google Scholar 

  4. Kessler RC. The costs of depression. Psychiat Clin N AM. 2012;35(1):1–4.

    Google Scholar 

  5. Pan A, Sun Q, Okereke OI, Rexrode KM, Hu FB. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA. 2011;306(11):1241–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Fletcher JM. Adolescent depression and educational attainment: results using sibling fixed effects. Health Econ. 2010;19(7):855–71.

    PubMed  Google Scholar 

  7. Fletcher JM. Adolescent depression and adult labor market outcomes. South Econ J. 2013;80(1):26–49.

    Google Scholar 

  8. Lépine JP, Briley M. The increasing burden of depression. Neuropsych Dis Treat. 2011;7(Suppl 1):3–7.

    Google Scholar 

  9. Mirowsky J, Ross CE. Social causes of psychological distress. 2nd ed. New York: Routledge; 2017.

    Google Scholar 

  10. Sutin AR, Terracciano A, Milaneschi Y, An Y, Ferrucci L, Zonderman AB. The trajectory of depressive symptoms across the adult life span. JAMA Psychiat. 2013;70(8):803–11.

    Google Scholar 

  11. Bratter JL, Eschbach K. Race/ethnic differences in nonspecific psychological distress: evidence from the National Health Interview Survey. Soc Sci Quarter. 2005;86(3):620–44.

    Google Scholar 

  12. Adkins D, Wang V, Dupre M, van den Oord E, Elder G. Structure and stress: trajectories of depressive symptoms across adolescence and young adulthood. Soc Forces. 2009;88(1):31–60.

    PubMed  PubMed Central  Google Scholar 

  13. Brown JS, Meadows SO, Elder GH Jr. Race-ethnic inequality and psychological distress: depressive symptoms from adolescence to young adulthood. Dev Psych. 2007;43(6):1295–311.

    Google Scholar 

  14. McLeod JD, Owens TJ. Psychological well-being in the early life course: variations by socioeconomic status, gender, and race/ethnicity. Soc Psych Quart. 2004;67(3):257–78.

    Google Scholar 

  15. Walsemann KM, Gee GC, Geronimus AT. Ethnic differences in trajectories of depressive symptoms: disadvantage in family background, high school experiences, and adult characteristics. J Health Soc Behav. 2009;50(1):82–98.

    PubMed  PubMed Central  Google Scholar 

  16. Collins PH. Intersectionality’s definitional dilemmas. Ann Rev Soc. 2015;41:1–20.

    Google Scholar 

  17. Bowleg L. The problem with the phrase women and minorities: intersectionality—an important theoretical framework for public health. Am J Pub Health. 2012;102(7):1267–73.

    Google Scholar 

  18. Rao D, Andrasik MP, Lipira L. HIV stigma among black women in the United States: Intersectionality, support, resilience. Am J Pub Health. 2018;108(4):446–8.

    Google Scholar 

  19. Brown TH, Richardson LJ, Hargrove TW, Thomas CS. Using multiple hierarchy stratification and life course approaches to understand health inequalities: The intersecting consequences of race, gender, SES, and age. J Health Soc Behav. 2016;57(2):200–22.

    PubMed  PubMed Central  Google Scholar 

  20. Hargrove TH. Intersecting social inequalities and body mass index trajectories from adolescence to early adulthood. J Health Soc Behav. 2018;59(1):56–73.

    PubMed  PubMed Central  Google Scholar 

  21. Rosenfield S. Triple jeopardy? Mental health at the intersection of gender, race, and class. Soc Sci & Med. 2012;74(11):1791–801.

    Google Scholar 

  22. Patil PA, Porche MV, Shippen NA, Dallenbach NT, Fortuna LR. Which girls, which boys? The intersectional risk for depression by race and ethnicity, and gender in the US. Clin Psych Rev. 2018;66:51–68.

    Google Scholar 

  23. Assari S. Social determinants of depression: the intersections of race, gender, and socioeconomic status. Brain Sci. 2017;7(12):156.

    PubMed Central  Google Scholar 

  24. Assari S, Lankarani MM. Association between stressful life events and depression; intersection of race and gender. J Racial Ethn Heath Disparities. 2016;3(2):349–56.

    Google Scholar 

  25. Mair CA. Social ties and depression: an intersectional examination of black and white community-dwelling older adults. J Applied Ger. 2010;29(6):667–96.

    Google Scholar 

  26. Barnes DM, Bates LM. Do racial patterns in psychological distress shed light on the black-white depression paradox? A systematic review. Soc Psychiatry Psychiatr Epidemiol. 2017;52(8):913–28.

    PubMed  Google Scholar 

  27. Clarke P, Marshall V, House J, Lantz P. The social structuring of mental health over the adult life course: advancing theory in the sociology of aging. Soc Forces. 2011;89(4):1287–313.

    PubMed  PubMed Central  Google Scholar 

  28. Crockett LJ. Cultural, historical, and subcultural contexts of adolescence: implications for health and development. In: Schulenberg J, Maggs JL, Hurrelmann K, editors. Health risks and developmental transitions during adolescence: Cambridge University Press; 1997. p. 23–53.

  29. Harris KM. An integrative approach to health. Demography. 2010;47(1):1–22.

    PubMed  PubMed Central  Google Scholar 

  30. Mirowsky J, Ross CE. Age and depression. J Health Social Behav. 1992;33(3):187–205.

    CAS  Google Scholar 

  31. Mirowsky J. Age and the gender gap in depression. J Health Social Behav. 1996;37(4):362–80.

    CAS  Google Scholar 

  32. Yang Y, George LK. Functional disability, disability transitions, and depressive symptoms in late life. J Aging Health. 2005;17(3):263–92.

    PubMed  Google Scholar 

  33. Elder GH, Johnson MK, Crosnoe R. Emergence and development of life course theory. In: Mortimer JT, Shanahan MJ, editors. Handbook of the life course. New York: Kluwer; 2003. p. 3–22.

    Google Scholar 

  34. Clarke P, Wheaton B. Mapping social context on mental health trajectories through adulthood. Adv Life Course Res. 2005;9:269–301.

    Google Scholar 

  35. Ferraro KF. Life course lens on aging and health. In: Shanahan MJ, Mortimer JT, Johnson MK, editors. Handbook of the life course. Cham: Springer; 2016. p. 389–406.

    Google Scholar 

  36. Western B, Pettit B. Incarceration & social inequality. Daedalus. 2010;139(3):8–19.

    PubMed  Google Scholar 

  37. Edwards F, Esposito MH, Lee H. Risk of police-involved death by race/ethnicity and place, United States, 2012–2018. Am J Pub Health. 2018;108(9):1241–8.

    Google Scholar 

  38. Current Population Survey (CPS), U.S. Department of Commerce, Census Bureau. Annual Social and Economic Supplement, 1996 through 2015.

  39. Brown TH. Diverging fortunes: racial/ethnic inequality in wealth trajectories in middle and late life. Race and Soc Prob. 2016;8(1):29–41.

    Google Scholar 

  40. Read JN, Gorman BK. Gender and health inequality. Ann Rev Soc. 2010;11(36):371–86.

    Google Scholar 

  41. Holland KJ, Cortina LM. Sexual harassment: undermining the wellbeing of working women. In: Handbook on well-being of working women. Dordrecht: Springer; 2016. p. 83–101.

    Google Scholar 

  42. Petrosky E, Blair JM, Betz CJ, Fowler KA, Jack SP, Lyons BH. Racial and ethnic differences in homicides of adult women and the role of intimate partner violence—United States, 2003–2014. MMWR-Morbid Mort W. 2017;66(28):741–6.

    Google Scholar 

  43. Harris KM, Halpern CT, Whitsel EA, Hussey JM, Killeya-Jones LA, Tabor J, et al. Cohort profile: the National Longitudinal Study of adolescent to adult health (add health). Int Journ Epi. 2019. https://doi.org/10.1093/ije/dyz115.

  44. Harris KM, Halpern CT, Hussey J, Whitsel EA, Killeya-Jones L, Tabor J, et al. Social, behavioral, and genetic linkages from adolescence into adulthood. Am J Pub Health. 2013;103(S1):S25–32.

    Google Scholar 

  45. Perreira KM, Deeb-Sossa N, Harris KM, Bollen K. What are we measuring? An evaluation of the CES-D across race/ethnicity and immigrant generation. Soc Forces. 2005;83(4):1567–601.

    Google Scholar 

  46. Raudenbush SW, Bryk AS. Hierarchical linear models: applications and data analysis methods. Thousand Oaks: Sage; 2002.

    Google Scholar 

  47. Chow GC. Tests of equality between sets of coefficients in two linear regressions. Econometrica: J Econ Society. 1960;28(3):591–605.

    Google Scholar 

  48. Landry B, editor. Race, gender and class: theory and methods of analysis. Routledge; 2007.

  49. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, et al. Global burden of disease attributable to mental and substance use disorders: findings from the global burden of disease study 2010. Lancet. 2013;382(9904):1575–86.

    PubMed  Google Scholar 

  50. Thapar A, Collishaw S, Pine DS, Thapar AK. Depression in adolescence. Lancet. 2012;379(9820):1056–67.

    PubMed  PubMed Central  Google Scholar 

  51. Seaton EK, Caldwell CH, Sellers RM, Jackson JS. An intersectional approach for understanding perceived discrimination and psychological well-being among African American and Caribbean black youth. Dev Psych. 2010;6(5):1372.

    Google Scholar 

  52. Harker K. Immigrant generation, assimilation, and adolescent psychological well-being. Soc Forces. 2001;79(3):969–1004.

    Google Scholar 

  53. Pachter LM, Bernstein BA, Szalacha LA, Coll CG. Perceived racism and discrimination in children and youths: an exploratory study. Health Soc Work. 2010;35(1):61–9.

    PubMed  Google Scholar 

  54. Lui PP. Intergenerational cultural conflict, mental health, and educational outcomes among Asian and Latino/a Americans: qualitative and meta-analytic review. Psychol Bull. 2015;141(2):404.

    PubMed  Google Scholar 

  55. Rogers-Sirin L, Ryce P, Sirin SR. Acculturation, acculturative stress, and cultural mismatch and their influences on immigrant children and adolescents’ well-being. In: Dimitrova R, Bender M, van de Vijver F, editors. Global perspectives on well-being in immigrant families. New York: Springer; 2014. p. 11–30.

    Google Scholar 

  56. Landale NS, Oropesa RS, Bradatan C. Hispanic families in the United States: family structure and process in an era of family change. In: Tienda M, Mitchell F, editors. Hispanics and the future of America. Washington, DC: National Academies Press; 2006. p. 138–78.

    Google Scholar 

  57. Courtenay WH. Engendering health: a social constructionist examination of men’s health beliefs and behaviors. Psych Men & Masculin. 2000;1(1):4.

    Google Scholar 

  58. Griffith DM. An intersectional approach to men’s health. J Men's Health. 2012;9(2):106–12.

    Google Scholar 

  59. Pyke KD. Class-based masculinities: the interdependence of gender, class, and interpersonal power. Gend Soc. 1996;10(5):527–49.

    Google Scholar 

  60. Fontenot K, Semega J, Kollar M. Income and poverty in the United States: 2017. Current population reports. Washington, DC: U.S. government printing office; 2018. p. 60–263.

    Google Scholar 

  61. U.S. Census Bureau, Current Population Survey. 2017 Annual Social and Economic Supplement. https://www.census.gov/data/tables/2017/demo/education-attainment/cps-detailed-tables.html. Accessed 19 Nov 2018.

  62. Phelan JC, Link BG, Tehranifar P. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010;51(S):S28–40.

    PubMed  Google Scholar 

  63. Chen P. Assimilation of immigrants and their adult children: college education, cohabitation, and work. El Paso: LFB Scholarly Publishing LLC; 2011.

    Google Scholar 

  64. Pyke KD, Johnson DL. Asian American women and racialized femininities: “doing” gender across cultural worlds. Gend Soc. 2003;17(1):33–53.

    Google Scholar 

  65. Kibria N. Family tightrope: the changing lives of Vietnamese Americans: Princeton University Press; 1995.

  66. Alumkal AW. Preserving patriarchy: assimilation, gender norms, and second-generation Korean American evangelicals. Qual Sociol. 1999;22(2):127–40.

    Google Scholar 

  67. Sodowsky GR, Kwan KL, Pannu R. Ethnic identity of Asians in the United States. In: Ponterotto JG, Casas JM, Suzuki LA, Alexander CM, editors. Handbook of multicultural counseling. Thousand Oaks: Sage; 1995. p. 123–54.

    Google Scholar 

  68. Chung RH. Gender, ethnicity, and acculturation in intergenerational conflict of Asian American college students. Cultural Divers Ethn Minor Psych. 2001;7(4):376.

    CAS  Google Scholar 

  69. Tsai-Chae AH, Nagata DK. Asian values and perceptions of intergenerational family conflict among Asian American students. Cultural Divers Ethn Minor Psych. 2008;14(3):205.

    Google Scholar 

  70. Greenberger E, Chen C. Perceived family relationships and depressed mood in early and late adolescence: a comparison of European and Asian Americans. Devel Psych. 1996;32(4):707.

    Google Scholar 

  71. Alegría M, Mulvaney-Day N, Torres M, Polo A, Cao Z, Canino G. Prevalence of psychiatric disorders across Latino subgroups in the United States. Am Journ Pub Health. 2007;97(1):68–75.

    Google Scholar 

  72. Chu JP, Sue S. Asian American mental health: what we know and what we don't know. Online ReadPsychol Culture. 2011;3(1):4.

    Google Scholar 

  73. Dey AN, Lucas JW. Physical and mental health characteristics of US-and foreign-born adults, United States, 1998–2003. Advance Data from Vital and Health Statistics. Hyattsville: National Center for Health Statistics; 2006.

    Google Scholar 

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Acknowledgments

This research uses data from Add Health, a program project directed by Kathleen Mullan Harris and designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris at the University of North Carolina at Chapel Hill. Special acknowledgment is due Ronald R. Rindfuss and Barbara Entwisle for assistance in the original design.

Funding

This research is funded by grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 23 other federal agencies and foundations.

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Authors and Affiliations

  1. Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Taylor W. Hargrove, Carolyn T. Halpern, Jon M. Hussey, Nancy Dole, Robert A. Hummer & Kathleen Mullan Harris

  2. Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Taylor W. Hargrove, Robert A. Hummer & Kathleen Mullan Harris

  3. Department of Maternal and Child Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Carolyn T. Halpern & Jon M. Hussey

  4. Center for Medicine, Health, and Society, Public Policy Studies, Vanderbilt University, Nashville, TN, USA

    Lauren Gaydosh

  5. Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Eric A. Whitsel

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  1. Taylor W. Hargrove
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Correspondence to Taylor W. Hargrove.

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Hargrove, T.W., Halpern, C.T., Gaydosh, L. et al. Race/Ethnicity, Gender, and Trajectories of Depressive Symptoms Across Early- and Mid-Life Among the Add Health Cohort. J. Racial and Ethnic Health Disparities 7, 619–629 (2020). https://doi.org/10.1007/s40615-019-00692-8

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