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Among
elderly, depression more prevalent in Hispanics and Blacks
Elderly
Hispanics and African Americans have higher rates of depression than their
white counterparts, due largely to greater health burdens and lack of
health insurance, a Northwestern University study has found.
The study, published in the November
online issue of the American Journal of Public Health, showed that major
depression was most prevalent among Hispanics -- 10.8 percent -- followed
by almost 9 percent in African Americans and approximately 8 percent in
whites in this age group.
The odds of depressive disorders among
older Hispanics were 44 percent greater than among whites, representing a
significantly greater prevalence of major depression, said lead author
Dorothy D. Dunlop, research associate professor at the Institute for
Health Services Research and Policy Studies at the Feinberg School of
Medicine at Northwestern University.
The study, which evaluated almost 7,700
adults aged 54 to 65 for racial/ethnic differences in rates of major
depression and examined possible mediators, also found that younger age,
female gender, being widowed or divorced, living alone and providing care
for a parent each significantly increased the odds of depression.
The strong association of caregiving
with major depression is comparable to the well-known risk of depression
resulting from the loss of a spouse through death or divorce, Dunlop said.
"This finding points to the
potential importance of providing social support for caregivers to reduce
the burden associated with this complex role," she said.
All health needs, including chronic
diseases, such as arthritis, diabetes, high blood pressure and obesity, as
well as functional limitations and health behaviors, were significantly
associated with major depression.
Physical limitations were the factor
most strongly associated with major depression, more than doubling the
odds of depression after other factors had been taken into account, the
authors said. The strong association between depression and functional
limitation is particularly notable, they said, since such limitations are
consequences of disease processes.
Other characteristics that significantly
increased the odds of major depression included potentially
life-threatening illnesses such as cancer, heart or lung disease and
stroke, limitations in activities of daily living, lack of regular
exercise and tobacco use.
Having fewer economic resources -- less
education, income or wealth; lack of private health insurance coverage or
employment - was associated with a greater frequency of depression.
Reliance on government health insurance somewhat increased the odds of
depression, the authors said.
"Our finding that lack of health
insurance coverage is strongly associated with frequency of major
depression particularly implicates the need for health insurance carriers
to facilitate better access to medical care among ethnic minority
groups," Dunlop and colleagues said.
"Given the clear association
between frequency of major depression and greater health burden and fewer
economic resources, factors common to older ethnic minority individuals,
more effective treatment, public health or public policy programs that
increase access to mental health care and general medical care may lead to
long-term reductions in racial/ethnic disparities in depression,"
Dunlop and co-researchers said.
Source: Northwestern
University
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