Is the Black-White Mental Health Paradox Consistent Across Gender and Psychiatric Disorders?

Psychiatric Disorders Among Older Black Americans: Within- and Between-Group Differences

Psychiatric disorders impose significant personal, social, and financial costs for individuals, families, and the nation. Despite a large amount of research and several journals focused on psychiatric conditions, there is a paucity of research on psychiatric disorders among Black Americans (i.e., African Americans and Black Caribbeans), particularly older Black Americans. The present literature review examines research on psychiatric disorders among older Black Americans and provides a broad overview of research findings that are based on nationally representative studies. Collectively, this research finds: (1) older African Americans have lower rates of psychiatric disorders than younger African Americans; (2) family support is not protective of psychiatric disorders, whereas negative interaction with family members is a risk factor; (3) everyday discrimination is a risk factor for psychiatric disorders; (4) both older African Americans and African American across the adult age range have lower prevalence rates of psychiatric disorders than non-Latino whites; (5) Black Caribbean men have particularly high rates of depression, posttraumatic stress disorder, and suicide attempts; and (6) a significant proportion of African American older adults with mental health disorders do not receive professional help. This literature review also discusses the “Race Paradox” in mental health, the Environmental Affordances Model, and the importance of investigating ethnicity differences among Black Americans. Future research directions address issues that are directly relevant to the Black American population and include the following: (1) understanding the impact of mass incarceration on the psychiatric disorders of prisoners’ family members, (2) assessing the impact of immigration from African countries for ethnic diversity within the Black American population, (3) examining the impact of racial identity and racial socialization as potential protective factors for psychiatric morbidities, and (4) assessing racial diversity in life-course events and their impact on mental health.

Differential Vulnerability to Perceived Discrimination Between African American and Caribbean Black Adolescents: The Role of Parental Nativity Status

An emerging body of research finds that African American and Caribbean Black adolescents are highly susceptible to discrimination, which negatively affects their mental health. Exposure to discrimination appears to be more consequential for mental health among Caribbean Black adolescents; however, past research investigating the differential impact of perceived discrimination on the mental health of African American and Caribbean Black adolescents has failed to take into account parental nativity status. Using data from the National Survey of American Life-Adolescent Supplement (NSAL-A), 2001-2004, this research examines differences in mental health profiles among African American adolescents (n = 783) and Caribbean Black adolescents with US-born (n = 216) and immigrant parents (n = 144) and differential vulnerability to perceptions of discrimination. Findings suggest that Caribbean Black adolescents with immigrant parents report fewer depressive symptoms than African American adolescents. Caribbean Black adolescents with immigrant parents also perceive lower levels of discrimination than Caribbean Black adolescents with US-born parents. Generally, greater perceptions of discrimination were associated with diminished mental health among all adolescents; however, relative to African American adolescents, associations between perceived discrimination and both mental health indicators were augmented among Caribbean Black adolescents with immigrant parents. No differences were observed between African American adolescents and Caribbean Black adolescents with US-born parents. Theoretical and policy implications of these findings are discussed.

Languishing in the crossroad? A scoping review of intersectional inequalities in mental health

The concept of intersectionality has gradually been introduced to health inequality research, adding depth and breadth to the way inequalities in health are approached. We conducted a scoping review with the purpose to systematically map, describe and analyze the literature about intersectional inequalities in mental health. For eligibility, the study had to analyze and report inequality defined by combinations of socioeconomic position, gender, race/ethnicity, sexual orientation or religion. The mental health outcome had to be measured as self-reported symptoms assessed through validated scales, or disorders assessed through diagnostic interviews. The search strategy was applied in two databases and the screening process yielded 20 studies. The interaction of intersectional positions showed no consistent patterns in mental health across studies, but both synergistic and antagonistic effects were observed. In most studies an absolute measure of inequality was used and few studies analyzed factors potentially explaining the intersectional inequalities. Taken together, the findings of this review highlight the value of assessing intersectional inequalities across population groups for priority setting and action on mental health inequalities.