Depressive symptoms in midlife african american and white women

PURPOSE: To describe ethnic, sociodemographic, psychosocial, and health characteristics associated with high levels of depressive symptoms in 2914 midlife women. METHODS: Data for this study are from the baseline evaluation of a multiethnic cohort of women, aged 42-52, who are participants in the longitudinal 7-site Study of Womenʹs Health Across the Nation (SWAN). All women completed the Center for Epidemiologic Studies of Depression Scale (CES-D), a 20-item standardized measure of depressive symptoms. The usual cut-off score of greater-or-equal, slanted16 was used to identify women with high depressive symptoms. Women provided data on numerous demographic, psychosocial, and health related factors. We used univariate and multiple logistic regressions to assess ethnic differences in prevalence of and independent contributions of ethnicity and covariates to CES-D greater-or-equal, slanted16. RESULTS: Overall, 24% of the sample had a CES-D greater-or-equal, slanted 16. Ethnic group prevalences varied (p < .0001). Unadjusted prevalences of CES-D greater-or-equal, slanted 16 were highest among the Hispanics (42%) and lowest among the Chinese (13.4%) and the Japanese (14.8%); prevalences for African Americans and Whites were 27.2% and 22.2%, respectively. After adjustment, younger age was the only sociodemographic variable significantly associated with CES-D greater-or-equal, slanted 16 . Compared to those with good health, high support, and low stress, odds (95% CI) of CES-D greater-or-equal, slanted 16 were significantly greater among those with fair/poor perceived health, 1.9 (1.3, 2.8), 2 or more physical symptoms, 1.7 (1.3, 2.2), vasomotor symptoms, 1.7 (1.2, 2.3), sleep problems, 1.7 (1.3, 2.1), low physical activity, .85 (.77, .95), low support, 2.8 (2.2, 3.7), and at least one very stressful life event, 1.8, (1.4, 2.2). CONCLUSIONS: In our sample of midlife women, prevalences of CES-D greater-or-equal, slanted 16 were highest among Hispanics and African Americans and lowest among Chinese and Japanese. However, the ethnic variation appears to be due to psychosocial and health factors which are linked to socioeconomic status. Women with high stress, low support, and health-related problems are at greatest risk for high depressive symptom levels.