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Disentangling Race and Place in Depressive Symptoms in Men

Hale, Diamond, MHS; Smith, Genee, PhD; Bowie, Janice, PhD; LaVeist, Thomas A., PhD; Thorpe, Roland J. Jr, PhD

doi: 10.1097/FCH.0000000000000230
Original Articles

African American men report lower levels of depressive symptoms that their white peers in national data. However, the value of these studies is often undermined by data that confound race, socioeconomic status, and segregation. We sought to determine whether race differences in depressive symptoms were present after minimizing the effects of socioeconomic status and segregation within a cohort of southwest Baltimore (SWB) men using the data from the Exploring Health Disparities in Integrated Communities (EHDIC), a novel study of racial disparities within communities where African American and non-Hispanic white males live together and have similar median incomes. Using the Patient Health Questionnaire, a standard instrument for assessing mental disorders, we categorized participants as experiencing depressive symptoms (including depressive syndrome and major depression) or not experiencing depressive symptoms. Logistic regression was performed to examine the association between depressive symptoms and race in EHDIC-SWB, adjusting for age, marital status, income, education, insurance, physical inactivity, current smoking or drinking status, poor/fair health, hypertension, heart disease, diabetes, stroke, and obesity. Of the 628 study participants, 12.6% of white men and 8.6% of African American men reported depressive symptoms. African American males had similar odds of reporting depressive symptoms (odds ratio = 0.61, 95% confidence interval = 0.34-1.11) as compared with white men. Within this low-income urban racially integrated community, race differences in depressive symptoms among men were not observed. This finding suggests that social and environmental conditions may impact the race differences in depressive symptoms.

Program for Research on Men's Health, Hopkins Center for Health Disparities Solutions, Baltimore, Maryland (Ms Hale and Drs Bowie, LaVeist, and Thorpe); Departments of Environmental Health and Engineering (Dr Smith) and Health, Behavior and Society (Drs Bowie and Thorpe), Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Smith, Bowie, LaVeist, and Thorpe); and Department of Health Policy and Management, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana (Dr LaVeist).

Correspondence: Roland J. Thorpe Jr, PhD, Johns Hopkins Bloomberg School of Public Health, 624 N Broadway, Ste 708, Baltimore, MD 21205 (

Research was supported by grants from the National Institute for Minority Health and Health Disparities (P60MD000214), Pfizer, Inc, Johns Hopkins University Catalyst Award, and the National Institute on Aging (1K02AG059140). An earlier version of this article was developed as part of the first author's 2016-2017 MHS in the Department of Mental Health program at the Johns Hopkins Bloomberg School of Public Health.

The authors declare no conflict of interest.

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