Descriptive analysis of social determinant of mental health factors in an ethnically diverse Black adult population

Abstract

AbstractBackgroundBlack adults are often treated as a homogeneous group in research and health care despite the diversity within the Black population across ethnicity. This study considers ethnicity in assessing the heterogeneity among Black adults across multiple social determinants of mental health. Understanding the diversity within the Black population will help close the gap in mental health disparities by offering a more streamlined approach to meeting unmet mental health needs.MethodsA cross-sectional descriptive study and analysis was conducted among Black adults in the United States (n = 269, ages 18-65) from diverse ethnic backgrounds (African-Americans, African immigrants, Afro-Caribbean immigrants). We calculated mean differences according to ethnicity, citizenship status, age group, and gender in the areas of medical mistrust, use of mental health services, depression symptom severity, mental health knowledge and stigma behavior.ResultsAfrican Americans with moderate to severe depression symptoms had greater stigma behavior (mean = 12.2, SD = 3.2), than African Americans who screened in the minimal to mild depression range (mean = 13.1, SD = 3.5). Black immigrants across the spectrum of depression scores had greater stigma than African Americans (p = 0.037). Participants who identified as male had a prevalence of mild depression (5-9) that was 1.7 times higher than those who identified as female. Whereas, those who identified as female had a prevalence that was 1.2 times higher for moderate to severe depression (10-19) and 4.7 times higher for severe depression (20-27) compared to males (p = 0.021). Non-United States citizens reported higher medical mistrust (mean value difference = 0.16) compared to United States citizens (p = 0.011). We found statistically significant differences in depression symptom severity based on gender, prevalence of depression, medical mistrust and stigma behavior across demographic factors within the sample.ConclusionThis study shows key variations across social determinant of mental health factors within the Black adult population. There is a need to better understand the heterogeneity within the Black population in order to improve the effectiveness of programs that seek to reduce mental health disparities.