Depression in the Barrio: An Analysis of the Risk and Protective Nature of Cultural Values Among Mexican American Drug Users

Background and Purpose: Latinos living in the barrio face multiple risks for drug use. Cultural values such as familismo, personalismo, fatalismo, and machismo are known determinants of Latino behavior (Cuellar, Arnold & Gonzalez, 1995; Morales, Lara, Kington, Valdez, & Escarce, 2002). However, less is known regarding the association between depression, drug use and cultural values (Alergria, Takeuchi, Canino, Duan, Shrout, Meng, et al. 2004).  It is important to explore these associations in order to identify the risk or protective nature that these cultural values have toward depression and the subsequent high risk drug use behaviors associated with depression among a drug using context. This study aimed to test the following hypotheses: 1) Familismo would be inversely related to depression; 2) Personalismo would be inversely related to depression however this relationship would be moderated by the number of drug users in an individual’s social network; 3) Fatalismo would have a direct relationship with depression however the relationship between fatalism and depression would be moderated by frequency of religious attendance; and 4) Machismo would have a direct relationship with depression.

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 depression and Latino cultural values. Baseline correlation analysis revealed influential covariates that were entered into a logistic regression.  Potential moderating effects of religious adherence on fatalism and drug use networks on personalismo were tested in the final logistic regression model.

Results: Familismo and fatalismo were both protective of depression (β = -0.754, AOR = 0.471 and, β = -1.372, AOR = 0.254 respectively). In addition as age increased for the sample, the likelihood of depression decreased (β = -0.086, AOR = 0.918). Neither personalismo nor machismo had a significant effect on depression. Moderators of religious adherence and drug use network were only significant at bivariate level and did not persist in the logistic model.

Conclusion and Implications: Findings from the study revealed 43% of the sample scored as having depression. Given the tremendous risk for depression that these individuals are confronted with on a daily basis it is surprising that 57% tested negative for depression. Results from the logistic regression revealed the buffering effects of familismo and fatalism on depression. Clinicians should be aware that depression is associated with high risk drug use behaviors. Furthermore, a better understanding of the relationship between the aforementioned cultural values and depression can help guide practice when working with depressed drug users in an effort to ameliorate some of these risks. Clinicians should be aware that cohesiveness to the family provides a protective effect to depression and interventions with the family as a whole should be considered.