Racial and Ethnic Differences in the Influence of Adverse Environments on Depression Among Runaway and Homeless Youths

Purpose

Onset of depression among runaway and homeless youths (RHY) is tied to the experience of trauma and stressful life events. Exposure to these adverse environments are linked to substance use, which in turn is a precursor to more severe depression. There has been less research on whether adversity exposures vary by race and ethnicity, which is needed to inform the design of more culturally responsive mental health treatments for RHY. We examined whether history of child welfare involvement, time spent homeless, number of traumatic exposures, and substance use would be independently associated with levels of depressive symptomatology across racial and ethnic groups.

Methods

Data came from 983 RHY recruited into a parent study designed to examine the impact of network ties on HIV risk-taking behaviors in RHY. Time spent homeless was determined by asking participants how long they had been homeless in their lifetime. History of child welfare involvement was assessed by asking participants whether they had ever been placed in child protection services or foster care. Exposure to traumatic stressors was assessed using the University of California, Los Angeles Posttraumatic Stress Disorder Reaction Index. Level of substance use was assessed by asking participants how many times during the previous 30 days they used marijuana, methamphetamine, ecstasy, heroin, cocaine, and prescription drugs. Severity of depressive symptoms was measured using the shortened Center for Epidemiological Studies Depression Scale. We ran multiple-group path analysis using structural equation modeling.

Results

The sample was ethnically diverse with 40.69% Whites (n = 400), 24.83% Blacks (n = 244), 14.14% Hispanics (n = 139), and 20.35% mixed race (n = 200). Participants aged between 19 and 24 (82.22%) and males (72.83%) were in the majority. Bivariable analyses did not reveal significant differences among racial and ethnic groups in severity of depressive symptoms and exposure to most of the investigated adverse environments. However, RHY belonging to racial and ethnic minority groups were more likely to have a history of child welfare involvement than did White participants. Black and mixed raced participants reported lower levels of substance use than did White and Hispanic participants. Multivariable analyses that controlled for age and gender revealed that higher number of traumatic exposures was significantly associated with higher levels of symptomatology in White, Black, and mixed race, participants, but not in Hispanic participants. Street tenure and history of child welfare involvement were not associated with levels of depressive symptomatology across all racial and ethnic groups. The investigated adverse environments, however, were significantly associated with substance use in all racial and ethnic groups except for Hispanic participants. Accordingly, substance use was significantly associated with higher levels of depressive symptomatology for all racial and ethnic groups except for Hispanics.  

Implications

The impact of the investigated adverse environments on depression in RHY did not differ significantly across race and ethnic groups, except for traumatic stressors. However, exposure to adverse environments appears to have differential impact on substance use, suggesting racial and ethnic heterogeneity in coping strategies.