Black Americans: Study documents differences within community
A U-M study of more than 6,000 African American, Afro-Caribbean and non-Hispanic white adultsthe first known study to include a national probability sample of Blacks of Caribbean ancestryshows strikingly different patterns of prevalence of major mental and physical disorders within the U.S. Black population.
Those areas include surprisingly low rates of depression, generalized anxiety disorder and panic disorder among African American men, and exceptionally low rates of all mental health problems except post-traumatic stress disorder among Afro-Caribbean women.
The study, the most comprehensive survey to date of the mental health of Black Americans, documents significant differences within the Black community that point to explanations for racial and ethnic health disparities. The survey also assessed physical health, experiences of discrimination including police harassment and exposure to everyday stress linked with racial prejudice.
Headed by U-M social psychologist James Jackson and funded by the National Institutes of Health, the survey was conducted between February 2001 and March 2003. "Our data show that the simplistic notion of a black-and-white world is no longer tenable," says Jackson, senior research scientist at the Institute for Social Research and director of the Center for Afroamerican and African Studies. "The picture is very different for African Americans and for Afro-Caribbeans."
Jackson discussed these and other issues Jan. 21 at a Department of Psychiatry event that was part of the MLK Symposium.
The study shows African Americans have lower rates of major depression than Afro-Caribbeans or white Americans (10.6 percent, 11.3 percent and 18.3 percent, respectively).
The study shows surprisingly low rates of several major mental disordersincluding panic disorder, social phobia and generalized anxiety disorder in addition to major depressionamong African Americans, especially among African American men. The study also shows that African American women are nearly twice as likely as African American men to have suffered a bout of major depression sometime in their lives (13.1 percent vs. 7.4 percent).
By contrast, 10 percent of Afro-Caribbean women and 12.6 percent of Afro-Caribbean men report suffering from major depression sometime in their lives, compared to 20.1 percent of white women and 16.1 percent of white men surveyed.
Overall, 58 percent of the people interviewed were African American, 26 percent were Black with Caribbean ancestry and 16 percent were non-Hispanic whites. About 49 percent of African Americans, 54.3 percent of Afro-Caribbeans and 53.5 percent of whites surveyed were working full-time, while 11.2 percent, 10.8 percent and 6.3 percent, respectively, reported that they were unemployed.
African Americans had a significant disadvantage in income, with just 16.1 percent estimated to have a family income of $60,000 or more, compared with 26.2 percent of Afro-Caribbeans and whites. Educationally, African Americans were disadvantaged as well, with 37.4 percent, compared to 51.9 percent of Afro-Caribbeans and 54 percent of whites, reporting that they had attended some college or earned a college degree.
When asked to assess their overall mental health, 37.8 percent of Afro-Caribbeans, 31.1 percent of African Americans and 20.4 percent of whites said that it was excellent. Looking at the lifetime prevalence of specific mental disorders, the researchers found that African Americans had significantly lower rates than whites of panic disorder (2.7 percent vs. 4.2 percent) generalized anxiety disorder (4.5 percent vs. 7.9 percent) and social phobia (7.5 percent vs. 12.6 percent) as well as much lower rates of major depression. Afro-Caribbeans had slightly lower rates than African Americans of social phobia (6 percent vs. 7.5 percent), with Afro Caribbean women showing the lowest rates of prevalence for all but one major mental disorderpost-traumatic stress disorder.
Jackson and colleagues found that 22.8 percent of Afro-Caribbeans surveyed reported that their overall physical health was excellent, compared with 16.3 percent of African Americans and 11.8 percent of whites surveyed.
About 61 percent of African Americans and 63.9 percent of Afro-Caribbeans, compared with 70.7 percent of whites, said they went to a doctor for medical advice, compared to 14.6 percent, 12.6 percent and 15.0 percent who went to a clinic. But while just 7.4 percent of whites said they went to a hospital for medical advice, 14.9 percent of African Americans and 14.1 percent of Afro-Caribbeans said that they did so.
"The importance of this study lies in going beyond simplistic categories of race and ethnicity to gain a better perspective on the ways that intra-group dynamics, as well as inter-group differences, and associated environmental, social and personal risk factors, play a role in disparities in physical and mental health and service use," Jackson says.
"The findings should help local and national policy makers to develop new programs to assist individuals from all ethnic and racial groups in using formal, as well as informal and personal, resources in their everyday lives to cope with the stresses and strains created by living in the complex world of the 21st century."
To see charts with more information, visit http://www.umich.edu/news/index.html?Releases/2004/Jan04/nsaltables.