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Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women

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  • Shervin Assari

    (Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA)

  • James Smith

    (Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA)

  • Mohsen Bazargan

    (Department of Family Medicine, Charles R Drew University of Medicine and Science, Los Angeles, CA 90095, USA
    Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90095, USA)

Abstract

Background . Although chronic medical conditions (CMCs), depression, and self-rated health (SRH) are associated, their associations may depend on race, ethnicity, gender, and their intersections. In predominantly White samples, SRH is shown to better reflect the risk of mortality and multimorbidity for men than it is for women, which suggests that poor SRH among women may be caused not only by CMCs, but also by conditions like depression and social relations—a phenomenon known as “the sponge hypothesis.” However, little is known about gender differences in the links between multimorbidity, depression, and SRH among African Americans (AAs). Objective . To study whether depression differently mediates the association between multimorbidity and SRH for economically disadvantaged AA men and women. Methods . This survey was conducted in South Los Angeles between 2015 to 2018. A total number of 740 AA older adults (age ≥ 55 years) were enrolled in this study, of which 266 were AA men and 474 were AA women. The independent variable was the number of CMCs. The dependent variable was SRH. Age and socioeconomic status (educational attainment and marital status) were covariates. Depression was the mediator. Gender was the moderator. Structural Equation Modeling (SEM) was used to analyze the data. Results . In the pooled sample that included both genders, depression partially mediated the effect of multimorbidity on SRH. In gender specific models, depression fully mediated the effects of multimorbidity on SRH for AA men but not AA women. For AA women but not AA men, social isolation was associated with depression. Conclusion . Gender differences exist in the role of depression as an underlying mechanism behind the effect of multimorbidity on the SRH of economically disadvantaged AA older adults. For AA men, depression may be the reason people with multimorbidity report worse SRH. For AA women, depression is only one of the many reasons individuals with multiple CMCs report poor SRH. Prevention of depression may differently influence the SRH of low-income AA men and women with multimorbidity.

Suggested Citation

  • Shervin Assari & James Smith & Mohsen Bazargan, 2019. "Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women," IJERPH, MDPI, vol. 16(10), pages 1-16, May.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:10:p:1670-:d:230806
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    1. Hammond, W.P., 2012. "Taking it like a man: Masculine role norms as moderators of the racial discrimination-depressive symptoms association among African American men," American Journal of Public Health, American Public Health Association, vol. 102(S2), pages 232-241.
    2. Dasbach, E.J. & Klein, R. & Klein, B.E.K. & Moss, S.E., 1994. "Self-rated health and mortality in people with diabetes," American Journal of Public Health, American Public Health Association, vol. 84(11), pages 1775-1779.
    3. Kathleen A. Cagney & Christopher R. Browning & Ming Wen, 2005. "Racial Disparities in Self-Rated Health at Older Ages: What Difference Does the Neighborhood Make?," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 60(4), pages 181-190.
    4. Idler, E.L. & Angel, R.J., 1990. "Self-rated health and mortality in the NHANES-I epidemiologic follow-up study," American Journal of Public Health, American Public Health Association, vol. 80(4), pages 446-452.
    5. Lee, S. & Schwarz, N., 2014. "Question context and priming meaning of health: Effect on differences in self-rated health between Hispanics and non-Hispanic Whites," American Journal of Public Health, American Public Health Association, vol. 104(1), pages 179-185.
    6. Manderbacka, Kristiina & Kåreholt, Ingemar & Martikainen, Pekka & Lundberg, Olle, 2003. "The effect of point of reference on the association between self-rated health and mortality," Social Science & Medicine, Elsevier, vol. 56(7), pages 1447-1452, April.
    7. Landman-Peeters, Karlien M.C. & Hartman, Catharina A. & van der Pompe, Gieta & den Boer, Johan A. & Minderaa, Ruud B. & Ormel, Johan, 2005. "Gender differences in the relation between social support, problems in parent-offspring communication, and depression and anxiety," Social Science & Medicine, Elsevier, vol. 60(11), pages 2549-2559, June.
    8. Shervin Assari & James L. Smith & Marc A. Zimmerman & Mohsen Bazargan, 2019. "Cigarette Smoking among Economically Disadvantaged African-American Older Adults in South Los Angeles: Gender Differences," IJERPH, MDPI, vol. 16(7), pages 1-16, April.
    9. Cheng, Sheung-Tak & Chan, Alfred C.M., 2006. "Social support and self-rated health revisited:: Is there a gender difference in later life?," Social Science & Medicine, Elsevier, vol. 63(1), pages 118-122, July.
    10. Desesquelles, Aline F. & Egidi, Viviana & Salvatore, Michele A., 2009. "Why do Italian people rate their health worse than French people do? An exploration of cross-country differentials of self-rated health," Social Science & Medicine, Elsevier, vol. 68(6), pages 1124-1128, March.
    11. Neal Krause, 2006. "Exploring the Stress-Buffering Effects of Church-Based and Secular Social Support on Self-Rated Health in Late Life," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 61(1), pages 35-43.
    12. Mohsen Bazargan & James L. Smith & Sharon Cobb & Lisa Barkley & Cheryl Wisseh & Emma Ngula & Ricky J. Thomas & Shervin Assari, 2019. "Emergency Department Utilization among Underserved African American Older Adults in South Los Angeles," IJERPH, MDPI, vol. 16(7), pages 1-16, April.
    13. Wim Peersman & Dirk Cambier & Jan Maeseneer & Sara Willems, 2012. "Gender, educational and age differences in meanings that underlie global self-rated health," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 57(3), pages 513-523, June.
    14. Neal Krause, 2002. "Church-Based Social Support and Health in Old Age," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 57(6), pages 332-347.
    15. Spuling, Svenja M. & Wolff, Julia K. & Wurm, Susanne, 2017. "Response shift in self-rated health after serious health events in old age," Social Science & Medicine, Elsevier, vol. 192(C), pages 85-93.
    16. Nahal Mavaddat & Richard A Parker & Simon Sanderson & Jonathan Mant & Ann Louise Kinmonth, 2014. "Relationship of Self-Rated Health with Fatal and Non-Fatal Outcomes in Cardiovascular Disease: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-13, July.
    17. Gilbert Gonzales & Jesse M. Ehrenfeld, 2018. "The Association between State Policy Environments and Self-Rated Health Disparities for Sexual Minorities in the United States," IJERPH, MDPI, vol. 15(6), pages 1-11, June.
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