Biopsychosocial Determinants of Depression Among African American and Caribbean Black Males: National Survey of American Life

Introduction: Depression is the leading cause of disabilities worldwide. Lifetime prevalence rates for major depression are highest for non-Latino whites (18%) Caribbean Blacks (13%), and African Americans (10%). Despite the longstanding knowledge of high prevalence rates for African Americans and Caribbean Blacks, there is a scarcity of research into the factors that may be associated with depression. In an effort to better understand what factors influence depression in African Americans and Caribbean Blacks, we examine the biological, psychological, and social predictors to major depression disorder among African American and Caribbean Black males using a biopsychosocial framework.

Method: The present study examined African American and Caribbean Black male (n=1,833) respondents in the National Survey of American Life (NSAL). Biological variables include chronic illness, family history for depression, and age. The psychological variables included self-esteem, hopelessness, and mastery. Lastly, social variables included race/ethnicity income, education, work status, spirituality, perceived social support, and daily discrimination. Bivariate associations examined differences in 12-month Major Depressive Disorder (MDD-12) and biopsychosocial factors. A multivariate logistic regression was performed to examine factors associated with depression.

Results: Overall, prevalence estimates of MDD-12 was 3.1 % for African American males, and 10% for Caribbean Black. Bivariate associations showed that MDD-12 significantly affected individuals with a family history of depression, low self-esteem, high hopelessness, low mastery, and high levels of perceived discrimination. Multivariate results showed that respondents who reported having chronic-illness, low self-esteem, and high daily discrimination were more likely to have MDD-12.   

Conclusions and Implications: Overall, these findings highlight the need to consider people who have chronic illness as a risk group for MDD-12. Social work practitioners engaged in medical-care based settings may better impact African American and Caribbean Black clients through increased assessment and referral for mental health problems among individuals with chronic illness. Also, through advocating for change in social systems and policies that perpetuate low self-esteem and frequent daily discrimination, social workers may assist in reducing overall depression rates among individuals who identify as African American or Caribbean Black.