Life in the Barrio: The Interrelationship of Stress, Depression and Substance Use

Background and Purpose. Residing in Mexican American barriosmay place individuals at heightened risk for chronic and acute stress which are associated with adverse mental health outcomes such as depressions. Stressors may  be exacerbated for a drug using population. This is concerning given that depressed substance users are likely to have higher levels of drug use and dependence and tend to engage in riskier behaviors such as sharing injecting implements, which increase their risk of deleterious health consequences (Havard, Teeson, Darke, and Ross, 2006).  It is important to explore the association between stress and depression in order to identify the impact that stress has toward depression and the subsequent high risk drug use behaviors associated with depression among a drug using context. This study aimed to identify the relationship between chronic stressors (i.e. poverty, incarceration, alcohol and drug use), acute stress (e.g., death of a family member, divorce, illness, and unemployment), and depression (Brugha and Crag, 1990).

Methods.The study sample is drawn from a large federally funded study of Mexican-American injection heroin using men. In the original study, a cross-sectional research design and field intensive outreach methodology was utilized along with key informants endemic to the barrio. This analysis involved dividing the entire sample (n=227) into “depressed” and “non-depressed” groups using their scores on the Center for Epidemiological Studies Depression Scale (CES-D; Radloff, 1977). Using chi-squares and logistic regression we investigated the associations between chronic and acute stress and depression. Baseline correlation analysis revealed influential covariates that were entered into a logistic regression. 

Results:Findings illustrated that depressed and non-depressed groups were significantly different on the total number of acute stressors and poverty level, after controlling for all other predictors. The total number of acute stress events was negatively related to depression, (β = -.38, OR = 0.69, 95% CI = 0.56, 0.84, p < .001). Male heroin injectors were 31% less likely to suffer from depression with each additional acute stressor.  Also, participants whose household income was above the poverty level were 60% less likely to suffer from depression, compared to the respondents whose household income was below poverty level (β = -.93, OR = 0.69, 95% CI = 0.19, 0.84, p < .05).

Conclusion and Implications: Findings from this study reveal that the benefits from living in a barrio that protect impoverished Latinos from depression appear to be absent for Latino heroin and other drug users. Poverty is the central indicator of social disorder in neighborhoods. Findings from this research highlight the need for macro- and micro- level interventions to significantly improve mental health among heroin users and drug-using populations living in such communities.