Abstract: Depression in a Marginalized Community and Household-Level Social Determinants of Health (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

All in-person and virtual presentations are in Mountain Standard Time Zone (MST).

SSWR 2023 Poster Gallery: as a registered in-person and virtual attendee, you have access to the virtual Poster Gallery which includes only the posters that elected to present virtually. The rest of the posters are presented in-person in the Poster/Exhibit Hall located in Phoenix A/B, 3rd floor. The access to the Poster Gallery will be available via the virtual conference platform the week of January 9. You will receive an email with instructions how to access the virtual conference platform.

258P Depression in a Marginalized Community and Household-Level Social Determinants of Health

Friday, January 13, 2023
Phoenix C, 3rd Level (Sheraton Phoenix Downtown)
* noted as presenting author
Victor Lushin, PhD, Assistant Professor, Long Island University, Brooklyn Campus, Brooklyn, NY
Rebecca Rivera, PhD, Assistant Professor, Long Island University, Brooklyn, NY
Marquis Chandler, PhD, Assistant Professor, Long Island University, Brooklyn
Jo Rees, PhD, Associate Dean, School of Health Professions, Long Island University, Brooklyn, NY
Michelle Horne-Findley, MS, Masters Degree Student, Long Island University, NY
Justyna Rzewinski, LCSW, Assistant Adjunct Professor, Long Island University
Background and Purpose: Low-income, underrepresented communities of color are disproportionality affected by depression. According to studies, about 30% of residents in low-income communities tend to suffer from major depression, almost twice the prevalence of major depression among those living outside poverty-affected communities (16%). Overall socio-economic deprivation, community violence, and the substandard quality of built environments have been tied to elevated depression in low-income communities. However, little is known about malleable, household-level determinants of depression, addressable by feasible, stigma-neutral community-based interventions.

The present study for the first time explored relative contributions of various household-level social determinants of health (SDOH) to depression in an urban, low-income underrepresented community, which has long experienced systemic economic and racial injustice. The SDOH in question included respondents’ exposures to household members’ manifestations of anger, alcohol and substance use, as well as residential crowding, household members’ health, communication and cohesiveness. Our analysis built evidence for a novel, theoretically grounded model explaining elevated depression among low-income urban community residents by better understanding their own perspectives on the currently understudied aspects of their domestic lives, and informing potential interventions, which can reduce depressive impacts of household-level SDOH.


We analyzed data from a community services survey (N=677) of residents in a low-income urban community of color. Survey respondents’ depression was measured by Center for Epidemiologic Studies Depression Scale. Respondents also rated their exposures to household members’ angry behavior, alcohol and drug use, and other household-level SDOH. The relative contributions of these household-level SDOH to the depression among the survey respondents were derived via dominance indices, the gold-standard approach to relative importance analysis. Each SDOH’s unique contribution to the explained variance of depression was derived, free of collinearity. The SDOH with the largest relative importance/dominance indices made the greatest contribution to depression and provided the most important preventive intervention targets, relative to other SDOH in this model.

Results: The overall model explained a substantial fraction of depression variance among respondents (R2 = 0.26). The largest contributors to respondents’ depression were exposures to alcohol use and angry behavior among household members, which accounted for 18.6%, and 18.1%, respectively, of the explained variance of depression. Additionally, concerns about household members’ physical and mental health issues, excessive weight, marijuana and hard drug use accounted for between 6% and 13% of explained variance each.

Conclusions and Implications: A modest group of household-level-only SDOH explained more than a quarter of depression variance. This suggests the utility of community efforts to screen for and address household-level depressogenic SDOH such as alcohol dependence and anger, to prevent/reduce depression in communities overburdened by it. Existing efficient and effective household-based interventions for alcohol and anger-related problems are likely to be less stigmatizing, and thus more acceptable for the residents of low-income communities of color than psychiatric treatment of depression, because members of marginalized communities tend to associate greater stigma with psychiatric problems than with specific risk behaviors.