Bidirectional associations between chronic medical conditions, disability, and depressive symptoms over ۲۵ years: Black- White differences

Background and aims: Blacks have a higher rate of chronic medical conditions (CMC), disability, and depressive symptoms compared to Whites. The present study compared Blacks and Whites for bidirectional associations between CMC, disability, and depressive symptoms over a ۲۵-year period.Methods: Data came from all five waves (۱۹۸۶, ۱۹۸۹, ۱۹۹۴, ۲۰۰۱, and ۲۰۱۱) of the Americans’ Changing Lives Study (ACL). This study followed ۳,۴۹۷ Whites and Blacks for up to ۲۵ years. Number of CMC, disability, and depressive symptoms [Center for Epidemiological Studies-Depression (CES-D)] were measured at all waves. Multi-group crossed lag modeling was used to test four models, where race defined the groups.Results: Based on Models ۱ and Model ۲, cross-sectional associations between CMC and depressive symptoms at ۱۹۸۹, ۲۰۰۱, and ۲۰۱۱ were significant among Whites but not Blacks. Based on Model ۳, lagged effect of CMC in ۲۰۰۱ on depressive symptoms in ۲۰۱۱ was only significant for Whites. Based on Model ۴, cross-sectional associations between disability and depressive symptoms in ۱۹۸۹ were found among Whites but not Blacks.Conclusion: Compared to Whites, Blacks show fewer cross-sectional and longitudinal associations between CMC, disability, and depressive symptoms over time. These findings are robust, regardless of whether we conceptualize disability or depressive symptoms as the outcome.

Keywords:

Ethnic groups , Blacks , Depressive Symptoms , Medical Conditions , Disability , flourishing