Journal Article

Racial/ethnic differences in 12-month prevalence and persistence of mood, anxiety, and substance use disorders: Variation by nativity and socioeconomic status

Fillbrunn, Mirko, Kessler, Ronald C., Sadikova, Ekaterina, Jackson, James S., Vilsaint, Corrie L., Sampson, Nancy A., Chen, Ruijia, Alegría, Margarita, Alvarez, Kiara, Williams, David R., Green, Jennifer Greif, McLaughlin, Katie A., NeMoyer, Amanda

2019

Overview

Despite equivalent or lower lifetime and past-year prevalence of mental disorder among racial/ethnic minorities compared to non-Latino Whites in the United States, evidence suggests that mental disorders are more persistent among minorities than non-Latino Whites. But, it is unclear how nativity and socioeconomic status contribute to observed racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance disorders. Data were examined from a coordinated series of four national surveys that together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed using the Composite International Diagnostic Interview. Logistic regression analyses examined how several predictors (e.g., race/ethnicity, nativity, education, income) and the interactions between those predictors were associated with both 12-month disorder prevalence and 12-month prevalence among lifetime cases. For the second series of analyses, age of onset and time since onset were used as additional control variables to indirectly estimate disorder persistence. Non-Latino Whites demonstrated the highest unadjusted 12-month prevalence of all disorder types (p < 0.001), though differences were also observed across minority groups. In contrast, Asian, Latino, and Black adults demonstrated higher 12-month prevalence of mood disorders among lifetime cases than Whites (p < 0.001) prior to adjustments Once we introduced nativity and other relevant controls (e.g., age, sex, urbanicity), US-born Whites with at least one US-born parent demonstrated higher 12-month mood disorder prevalence than foreign-born Whites or US-born Whites with two foreign parents (OR = 0.51, 95% CI = [0.36, 0.73]); this group also demonstrated higher odds of past-year mood disorder than Asian (OR = 0.59, 95% CI = [0.42, 0.82]) and Black (OR = 0.70, 95% CI = [0.58, 0.83]) adults, but not Latino adults (OR = 0.89, 95% CI = [0.74, 1.06]). Racial/ethnic differences in 12-month mood and substance disorder prevalence were moderated by educational attainment, especially among adults without a college education. Additionally, racial/ethnic minority groups with no more than a high school education demonstrated more persistent mood and substance disorders than non-Latino Whites; these relationships reversed or disappeared at higher education levels. Nativity may be a particularly relevant consideration for diagnosing mood disorder among non-Latino Whites; additionally, lower education appears to be associated with increased relative risk of persistent mood and substance use disorders among racial/ethnic minorities compared to non-Latino Whites. •Non-Latino Whites most likely to have 12-month disorders, even with SES controls.•Link between race/ethnicity and mood disorder varied by nativity among Whites.•Race/ethnicity interacted with education, but not income, to predict prevalence.•Racial/ethnic minority groups had more persistent mood disorders than Whites.•Observed links to persistent mood and substance disorders varied by education level.

• Publisher: Elsevier Inc,Elsevier Limited,Elsevier
• Subject: Adult / Anxiety / Anxiety disorders / Anxiety Disorders - epidemiology / Anxiety Disorders - ethnology / Disorder persistence / Disorder prevalence / Drug addiction / Ethnicity / Ethnicity - psychology / Female / Health Surveys / Humans / Male / Mental disorders / Mental health / Middle Aged / Minority & ethnic groups / Mood Disorders - epidemiology / Mood Disorders - ethnology / Panic attacks / Prevalence / Race / Racial Groups - ethnology / Racial Groups - psychology / Social Class / Socioeconomic factors / Socioeconomic status / Substance use disorder / Substance-Related Disorders - epidemiology / Substance-Related Disorders - ethnology / United States - epidemiology