Older people who identify as Hispanic, black, and Asian report greater severity of depression than those identifying as non-Hispanic white, according to a new study.
In an analysis of more than 25,500 adults ages 50 and older published March 26 in the Journal of the American Medical Association’s JAMA Network Open, the researchers found that these minority groups were up to twice as likely to report more severe depressive symptoms than non-Hispanic white participants.
Depression is more common in women than men and is one of the greatest causes of disability worldwide. Depression is common across the life course and persists later in life, with one study finding 19 percent of older adults experience significant minor or major depression symptoms.
In this new study, participants in a randomized trial of cancer and cardiovascular disease prevention who indicated Hispanic origin had a 23 percent higher score on a depression questionnaire than participants indicating they are white. The participants who identified as black or Asian scored 10 percent higher than those identifying as white. Participants identifying as “other,” “multiple,” or “unspecified” race groups scored 14 percent higher than white-identifying participants.
The study authors reported adjusting the data to address confounding factors, but it was unclear if the analysis addressed individuals within the same income group to provide results that were reliably unaffected by economic factors.
It is important that we recognize depression in all populations and seek to treat clinical depression even when someone may have a reason to be depressed.
Dr. Carolyn M. Mazure
Although the study did not find a significant gender difference in depression severity, older black women with clinically significant depressive symptoms were found to be least likely to receive treatment through antidepressant medications or counseling.
In addition, Hispanic women were more likely than Hispanic men to “experience burden from core depressive symptoms and guilt” and “black women were more than 80 percent less likely than non-Hispanic white women to report receiving treatment, even when reporting both clinically significant symptom levels and clinician-diagnosed depression.”
“These disparities are striking given findings that older black adults appear as likely as older white adults to derive benefit from treatment when it is offered,” wrote the authors, led by Dr. Olivia I. Okereke of Harvard T.H. Chan School of Public Health. The authors recommend further research to address these disparities and guide prevention and treatment strategies and improve health outcomes.
“There are good data and serious concerns that a range of social, racial and ethnic populations have understandable high rates of depression, and that even when there is access to care, depression is not recognized or treated,” said Dr. Carolyn M. Mazure, Director of Women’s Health Research at Yale. “It is important that we recognize depression in all populations and seek to treat clinical depression even when someone may have a reason to be depressed.”