Table 1.
Summary of Selected Investigations of the Prevalence of Psychiatric Disorders and Use of Mental Health Services for Older Black Americans
| Authors | N | Sample | Dependent variables | Major independent variables | Selected findings |
|---|---|---|---|---|---|
| Within Group Analysis of Psychiatric Disorders among Older African Americans | |||||
| Ford et al., 2007 | 837 | NSAL, African Americans aged 55 and older | Any lifetime mood disorder Any lifetime anxiety disorder Any lifetime substance disorder Any lifetime disorder Any 12-month disorder | Demographics | One-quarter of sample reported one lifetime disorder and 20% had two or more. Nine percent had a 12-month disorder and 3% had two or more. Age, sex, education, and region were associated with the odds of having a lifetime disorder; demographic factors were unrelated to 12-month disorders |
| Chatters et al., 2008 | 837 | NSAL, African Americans aged 55 and older | Any lifetime mood disorder Any lifetime anxiety disorder Any lifetime substance disorder Any lifetime disorder Number of lifetime mood, anxiety and substance disorders | Religious service attendance, nonorganizational religiosity, subjective religiosity | Controlling for health and disability, religious service attendance was inversely associated with having a mood disorder |
| Lincoln et al., 2010 | 837 | NSAL, African Americans aged 55 and older | Any lifetime mood disorder Any lifetime anxiety disorder Number of lifetime mood and anxiety disorders | Emotional support with family Negative interactions with family | Negative interaction was associated with odds of having a lifetime mood disorder, a lifetime anxiety disorder and number of lifetime mood and anxiety disorders; emotional support unrelated to mood and anxiety disorders |
| Peterson et al., 2014 | 185 | NSAL, African Americans aged 55 and older with at least one lifetime psychiatric disorder | Subjective well-being (happiness, life satisfaction) | 12-month mood and anxiety disorder Lifetime psychiatric disorder Lifetime suicidal ideation Demographics | Lifetime suicidal ideation was associated with life satisfaction only; 12-month mood disorder negatively associated with both happiness and life satisfaction |
| Mouzon et al., 2017 | 837 | NSAL, African Americans aged 55 and older | Any lifetime mood disorder Any lifetime anxiety disorder Any lifetime disorder Number of lifetime mood and anxiety disorders Depressive symptoms (CES-D) Psychological distress (K6) | Overall everyday discrimination Everyday racial discrimination Everyday nonracial discrimination | Everyday discrimination (whether racial, nonracial, or overall) is associated with higher risk of psychiatric disorders, depressive symptoms, and serious psychological distress |
| Kim et al., 2017 | 429 | NSAL, African American and Black Caribbeans, aged 55 and older who indicated that their racial/ethnic background was main reason for their discriminatory experiences | Any 12-month disorder | Everyday racial discrimination | Racial discrimination related to higher odds of any past year psychiatric disorder; racial discrimination and disorder relationship strongest in West (compared to South) |
| Both Within and Between Group (Race/Ethnicity) Analysis of Psychiatric Disorders among Older Adults | |||||
| Jimenez et al., 2010 | 2,375 | CPES, non-Latino whites, Asians, African Americans, Black Caribbeans, and Latinos, aged 60 and older | Any 12-month depressive disorder Any 12-month anxiety disorder Any 12-month substance disorder Any 12-month disorder Any lifetime depressive disorder Any lifetime anxiety disorder Any lifetime substance disorder Any lifetime disorder | Nativity | Older non-Latino whites exhibited a greater prevalence on several lifetime psychiatric disorders than older Asians, African-Americans, and Black Caribbeans. |
| Woodward et al., 2012 | 3,046 | CPES, non-Latino whites, Asians, African Americans, Black Caribbeans, and Latinos aged 55 and older | Any lifetime mood disorder Any lifetime anxiety disorder | Demographics | Non-Latino whites and Latinos had higher prevalence rates of disorders, African Americans had lower prevalence of major depression and dysthymia |
| Kim et al., 2011 | 1,840 | CPES, non-Latino whites, blacks, Latinos, and Asians, aged 60 and older | Any 12-month disorder Any 12-month anxiety disorder | SRMH Race, ethnicity | SRMH and white race associated with mood and anxiety; relationship between SRMH and psychiatric disorders strongest for non-Latino whites |
| Aranda et al., 2012 | 1,439 | NSAL, African Americans, Black Caribbeans, and non-Latino whites, aged 55 and older | Lifetime MDD 12-month MDD | Demographics | Non-Latino whites had the highest odds of lifetime MDD Women had significantly greater odds of lifetime MDD compared with men. |
| Woodward et al., 2013 | 1,950 | NSAL, African Americans, Black Caribbeans, non-Latino whites, aged 50 and older | Lifetime MDD 12-month MDD | Comorbid lifetime anxiety and substance disorders Comorbid physical health problems | MDD lifetime prevalence was 12.1%; 12-month rate was 5.2%. Older whites and Black Caribbeans had significantly higher lifetime prevalence than African Americans; 12-month rates were similar across the three groups. Black Caribbean men had higher rates of lifetime MDD |
| Joe et al., 2014 | 1,141 | NSAL, African Americans, Black Caribbeans, aged 55 and older | Lifetime suicidal behavior (ideation and attempts) | 14 DSM-IV disorders (mood, anxiety, substance use); Demographics | Lifetime prevalence of suicidal ideation (6.1%) and attempts (2.1%); being male, middle-aged, having poorer health, anxiety, and multiple DSM-IV disorders associated with higher risk of suicide attempts |
| Both Within and Between Group (Race/Ethnicity) Analysis of Mental Health Service Use for Psychiatric Disorders among Older Adults | |||||
| Neighbors et al., 2008 | 837 | NSAL, African Americans, aged 55 or older | Psychiatric and nonpsychiatric mental health services, general medical care, and nonhealth care within past 12 months | Any 12-month mood, anxiety, or substance use disorders | Less than half with one disorder and half with two disorders used any service; mood disorder associated with higher service use |
| Kim et al., 2013 | 2,878 | CPES, blacks and whites, aged 60 and older | Mental health service use | Region; demographic controls | Older blacks less likely to use mental health services overall. Black elders in the South were significantly less likely than whites to use mental health services; no racial differences in Northeast, West or Midwest regions. |
Note: CES-D = Center for Epidemiologic Studies Depression scale; CPES = Collaborative Psychiatric Epidemiology Studies; DSM-IV = Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; K6 = Kessler Psychological Distress scale; MDD = major depressive disorder; NSAL = National Survey of American Life: Coping with Stress in the 21st Century; SRMH = self-rated mental health.