Racial Discrimination, Depressive Symptom Typologies, and BMI Among African Americans: A Test of the Environmental Affordances Model (WITHDRAWN)

Background and Purpose: Research has consistently identified lower rates of psychopathology but higher rates of physical morbidities and mortality among African Americans than Whites.  Relative to other race groups, African Americans are more likely to be socially disadvantaged and consequently exposed to greater stress.  This disadvantage and disproportionate stress exposure is likely to contribute to physical health disparities between African Americans and Whites.  However, it is less clear why African Americans have lower rates of psychopathology than Whites despite their social disadvantage.  The Environmental Affordances Model (EAM) provides a theoretical framework to clarify the mechanisms underlying this paradox.  This model posits that when faced with chronic stressors consequent to low socioeconomic position, many socially disadvantaged individuals respond by engaging in unhealthy behaviors (e.g., overeating) to cope with these stressors because these coping strategies tend to be more accessible within disadvantaged communities.  While these coping strategies alleviate the psychological symptoms of stress, they also lead to poor physical health.

The purpose of this study is to evaluate the utility of the EAM for assessing links between racial discrimination – a stressor that is uniquely relevant to African Americans, depressive symptom typologies (i.e., categories/clusters of depressive symptoms), and unhealthy behaviors.  These relationships have yet to be tested using the EAM and awaits confirmation.

Methods: Analysis was based on 3,570 African American respondents from the National Survey of American Life.  Experiences of racial discrimination were assessed by the Major Experiences of Discrimination Scale.  BMI was used as a proxy for unhealthy behaviors, particularly unhealthy eating and physical inactivity.  Latent class analysis was used to identify depressive symptom typologies from the 12-item CES-D Scale.  The three distinct depressive symptom typologies identified were: (1) severe, (2) somatic, and (3) mild.  Latent class multinomial logistic regression analysis was used to assess the relationship between discrimination, depressive symptom typologies, and BMI.  The mild symptom type was set as the reference group.

Results: This analysis indicated that respondents who reported high discrimination were more likely to belong to the severe symptom typology as compared to respondents who reported no discrimination.  Further, the significant interaction between BMI and discrimination confirmed that BMI moderated the relationship between discrimination on depressive symptom typology.  Specifically, among respondents who reported high discrimination, as BMI increased, the risk of belonging to the severe symptom typology decreased. 

Conclusions and Implications: The findings support the EAM and underscore the adverse effects of racial discrimination on African American mental health and revealed that behaviors considered harmful to physical health may in fact be effective for coping with the negative psychological effects of racial discrimination. Collectively, these findings demonstrate that mental and physical health are interconnected and must be considered jointly rather than independently when investigating racial disparities in health.  A more complete understanding of the EAM will inform more effective interventions for reducing health disparities.