11 Apr Depression Less Common In Rural African American Women

MedicalResearch.com Interview with:
Addie Weaver PhD
Research Investigator and LEO Adjunct Lecturer
School of Social Work
University of Michigan

Medical Research: What is the background for this study? What are the main findings?

Dr. Weaver: The mental health of both African Americans and rural Americans has been understudied. Though depression is one of the most common, debilitating mental illnesses among women, very little is known about depression among African American women living in rural areas of the United States. In fact, much of what we know about rural women’s depression in general is based on research conducted with community samples, as limited epidemiolgical research includes large enough samples of both African American respondents and rural respondents to assess potentially important subgroup differences by urbanicity (e.g., urban, suburban, rural) and race. Our study used the National Survey of American Life, the first and only nationally representative survey of African Americans, to examine the interaction of urbanicity and race/ethnicity on Major Depressive Disorder and mood disorder prevalence among African American and non-Hispanic white women residing in the South.

We found that rural residence has a differential effect on depression and mood disorder for African American women and non-Hispanic white women. Overall, African American women living in rural areas experienced significantly lower odds of meeting criteria for lifetime and 12-month Major Depressive Disorder and lifetime and 12-month mood disorder than urban African American women. Conversely, non-Hispanic white women residing in rural areas had significantly higher odds of meeting criteria for lifetime and 12-month Major Depressive and lifetime and 12-month mood disorder when compared to rural African American women, and had significantly higher prevalence rates of 12-month Major Depressive Disorder and 12-month mood disorder than urban non-Hispanic white women. All analyses controlled for age, education level, household income, and marital status, suggesting that the urbanicity differences were not due to resource disparities often experienced by individuals residing in rural communities.

Medical Research: What should clinicians and patients take away from your report?

Dr. Weaver: Results of this study suggest that clinicians should pay more attention to the rural context and understand that where someone lives may have varied impacts on mental health for different subgroups. As mental health treatment options are limited in rural communities, given a lack of providers, as well as accessibility and acceptability related barriers, many rural patients who choose to seek treatment must travel to more urbanized areas for care. It is important for both rural and urban-based clinicians to have an awareness of rural life and assess both protective and risk factors that may be associated with the rural context. For example, a patient living in a rural area may experience geographic isolation given the low population density of rural communities that exacerbates depressive symptoms; however, it is also possible that the dense social networks associated with low population density may offer greater levels of social support which could be a protective factor. It may be important for clinicians to obtain information on where patients live, and ask questions related to the rural context as part of a comprehensive biopsychosocial assessment.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Weaver: Though this study did not explore why rural residence may be protective for African American women’s depression but a risk factor for non-Hispanic white women’s depression, it provides an important first step toward understanding the cumulative effect of rural residence and race/ethnicity on women’s depression and mood disorder. Future research could build on this work by examining aspects of the rural context that may help to explain its differential effect on depression and mood disorder for African American women and non-Hispanic white women. As women in rural areas are entering the labor force at faster rates than their urban counterparts, the potential challenges of juggling multiple roles and responsibilities, including work outside the home, inside the home, and on the farm, seem important to assess in relation to rural women’s depression. Additionally, little research has considered strengths of African American women that may be related to quality of life and emotional well-being, including social support, religiosity and church involvement, mastery and control, and self-esteem. There is a need for further research exploring the association between these psychosocial factors and depression among rural African American women.

Finally, rural populations are not homogeneous and, for example, rural life in the South, which reflects our analytic sample, is very different from rural life in rust belt of the Mid-West. It is important for this research to be replicated across different regions of the country, and to include respondents of other races and ethnicities.

Citation:

Addie Weaver, Joseph A. Himle, Robert Joseph Taylor, Niki N. Matusko, Jamie M. Abelson. Urban vs Rural Residence and the Prevalence of Depression and Mood Disorder Among African American Women and Non-Hispanic White Women. JAMA Psychiatry, 2015; DOI: 10.1001/jamapsychiatry.2015.10

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MedicalResearch.com Interview with: Addie Weaver PhD (2015). Depression Less Common In Rural African American Women 

Last Updated on April 11, 2015 by Marie Benz MD FAAD