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The associations between socio-economic status and major depressive disorder among Blacks, Latinos, Asians and non-Hispanic Whites: findings from the Collaborative Psychiatric Epidemiology Studies

  • A. R. Gavin (a1), E. Walton (a2), D. H. Chae (a3), M. Alegria (a4), J. S. Jackson (a5) and D. Takeuchi (a1)...

This study examined whether there were associations between individual measures of socio-economic status (SES) and the 12-month prevalence of major depressive disorder (MDD) in representative samples of Blacks, Latinos, Asians and Whites in the USA.


The data used were from the Collaborative Psychiatric Epidemiology Studies (CPES).


There was an association between household income and MDD among Whites. However, the association was not statistically significant. Statistically significant associations were present between educational attainment and MDD among Whites. Among both Whites and Latinos, being out of the labor force was significantly associated with MDD. In analyses by nativity, being out of the labor force was significantly associated with MDD among US-born and foreign-born Latinos.


Significant associations between various measures of SES and MDD were consistently observed among White and, in some cases, Latino populations. Future studies should continue to examine sociopsychological factors related to SES that increase the risk of MDD among people from racial-ethnic communities.

Corresponding author
*Address for correspondence: Dr A. R. Gavin, School of Social Work, University of Washington, 4101 15th Avenue NE, Seattle, WA 98105-6299, USA. (Email:
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Adler N, Boyce T, Chesney M, Cohen S, Folkman S, Kahn R, Syme L (1994). Socioeconomic status and health. American Psychologist 49, 1524.
Alegria M, Bijl R, Lin E, Walters E, Kessler R (2000). Income differences in persons seeking outpatient treatment for mental disorders: a comparison of the United States with Ontario and the Netherlands. Archives of General Psychiatry 57, 383391.
Alegria M, Mulvaney-Day N, Torres M, Polo A, Cao Z, Canino G (2007 a). Prevalence of psychiatric disorders across Latino subgroups in the United States. American Journal of Public Health 97, 6875.
Alegria M, Shrout P, Woo M, Guarnaccia P, Sribney W, Vila D, Polo A, Cao Z, Mulvaney-Day N, Torres M, Canino G (2007 b). Understanding differences in past year psychiatric disorders for Latinos living in the US. Social Science and Medicine 65, 214230.
Alegria M, Takeuchi D, Canino G, Duan N, Shrout P, Meng X, Vega W, Zane N, Vila D, Woo M, Vera M, Guarnaccia P, Aguilar-Gaxiola S, Sue S, Escobar J, Lin K, Gong F (2004). Considering context, place and culture: the National Latino and Asian American Study. International Journal of Methods in Psychiatric Research 13, 208220.
Anderson N, Armstead C (1995). Toward understanding the association of socioeconomic status and health: a new challenge for the biopsychosocial approach. Psychosomatic Medicine 57, 213225.
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.
Ballenger J, Davidson J, Lecrubier Y, Nutt D, Kirmayer L, Lepine J, Lin K, Tajima S, Ono Y (2001). Consensus statement on transcultural issues in depression and anxiety from the international consensus group on depression and anxiety. Journal of Clinical Psychiatry 62, 4755.
Blazer D, George K, Landerman R, Pennybacker M, Melville M, Woodbury M, Manton K, Jordan K, Locke B (1985). Psychiatric disorders: a rural/urban comparison. Archives of General Psychiatry 42, 651656.
Blazer D, Kessler R, McGonagle K, Swartz M (1994). The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. American Journal of Psychiatry 151, 979986.
Breslau J, Aguilar-Gaxiola S, Kendler K, Su M, Williams D, Kessler R (2006). Specifying race-ethnic differences in risk for psychiatric disorder in USA national sample. Psychological Medicine 36, 5768.
Breslau J, Kendler K, Su M, Gaxiola-Aguilar S, Kessler R (2005). Lifetime risk and persistence of psychiatric disorder across ethnic groups in the United States. Psychological Medicine 35, 317327.
Bruce M, Takeuchi D, Leaf P (1991). Poverty and psychiatric status: longitudinal evidence from the New Haven Epidemiologic Catchment Area Study. Archives of General Psychiatry 48, 470474.
Coiro MJ (2001). Depressive symptoms among women receiving welfare. Women Health 32, 123.
DeNavas-Walt C, Proctor BD, Smith J (2007). Income, Poverty, and Health Insurance Coverage in the United States: 2006. U.S. Census Bureau, Current Population Reports, P60–233.
Eaton WM, Muntaner C, Bovasso G, Smith C (2001). Socioeconomic status and depressive syndrome: the role of inter- and intra-generational mobility, government assistance, and work environment. Journal of Health and Social Behavior 42, 277294.
Ellison C, Boardman J, Williams D, Jackson J (2001). Religious involvement, stress and mental health: findings from the 1995 Detroit Area Study. Social Forces 80, 215249.
Farmer M, Ferraro K (2005). Are racial disparities in health conditional on socioeconomic status? Social Science and Medicine 60, 191204.
First M, Spitzer R, Gibbon M, Williams J (1997). Structured Clinical Interview for DSM-IV Axis I Disorders, Research Version, Non-Patient Edition (SCID-1/NP). Biometrics Research, New York State Psychiatric Institute: New York.
Heeringa S, Wagner J, Torres M, Duan N, Adams T, Berglund P (2004). Sample designs and sampling methods for the Collaborative Psychiatric Epidemiology Studies (CPES). International Journal of Methods in Psychiatric Research 13, 221240.
Herd D, Grube J (1996). Black identity and drinking in the USA: a national study. Addiction 91, 845857.
Holzer C, Shea B, Swanson J, Leaf P, Myers J, George L, Weissman M, Bednarski P (1986). The increased risk for specific psychiatric disorders among persons of low socioeconomic status: evidence from the Epidemiologic Catchment Area Surveys. American Journal of Social Psychiatry 4, 259271.
Jackson J, Torres M, Caldwell C, Neighbors H, Nesse R, Taylor R, Trierweiler S, Williams D (2004). The National Survey of American Life: a study of racial, ethnic and cultural influences on mental disorders and mental health. International Journal of Methods in Psychiatric Research 13, 196207.
Kessler R (2003). Epidemiology of women and depression. Journal of Affective Disorders 74, 5–13.
Kessler R, Berglund P, Chui W, Demler O, Heeringa S, Hiripi E, Jin R, Pennell B, Walters E, Zaslavsky A, Zheng H (2004). The US National Comorbidity Survey Replication (NCS-R): design and field procedures. International Journal of Methods in Psychiatric Research 13, 6992.
Kessler R, Berglund P, Demler O, Jin R, Koretz D, Merikangas K, Rush J, Walters E, Wang P (2003). The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289, 30953105.
Kessler R, McGonagle K, Zhao S, Nelson C, Hughes M, Eshleman S, Wittchen H, Kendler K (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Archives of General Psychiatry 51, 8–19.
Kessler R, Merikangas K (2004). The National Comorbidity Survey Replication (NCS-R). International Journal of Methods in Psychiatric Research 13, 6068.
Kessler R, Ustun T (2004). The World Mental Health (WMH) survey initiative version of the World Health Organization Composite International Diagnostic Interview (CIDI). International Journal of Methods in Psychiatric Research 13, 93–121.
Kessler R, Zhao S, Blazer D, Swartz M (1997). Prevalence, correlates, and course of minor depression and major depression in the National Comorbidity Survey. Journal of Affective Disorders 45, 1930.
Leaf P, Weissman M, Myers J, Holzer C, Tischler G (1986). Psychosocial risks and correlates of major depression in one United States urban community. In Mental Disorders in the Community: Progress and Challenge (ed. Barrett and D.Rose R.), pp. 4766. Guilford Press: New York.
Lee B, Newberg A (2005). Religion and health: a review and critical analysis. Zygon 40, 443468.
Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M (2003). Socioeconomic inequalities in depression: a meta-analysis. American Journal of Epidemiology 157, 98–112
Lynch J, Kaplan G (2000). Socioeconomic position. In Social Epidemiology (ed. Berkman L. and Kawachi I.), pp. 1325. Oxford University Press: Oxford.
Mossakowski K (2003). Coping with perceived discrimination: does ethnic identity protect mental health? Journal of Health and Social Behavior 44, 318331.
Mutaner C, Borrell C, Chung H (2008). Class relations, economic inequality and mental health: why social class matters to the sociology of mental health. In Mental Health, Social Mirror (ed. Avison W., McLeod and J.Pescosolido B.), pp. 127141. Springer: New York.
Mutaner C, Eaton W, Miech R, O'Campo P (2004). Socioeconomic position and major mental disorders. Epidemiological Reviews 26, 5362.
Nestadt G, Bienvenu O, Cai G, Samuels J, Eaton W (1998). Incidence of obsessive-compulsive disorder in adults. Journal of Nervous and Mental Disease 186, 401406.
O'Campo P, Eaton WW, Muntaner C (2004). Labor market experience, work organization, gender inequalities, and health status: results from a prospective study of US employed women. Social Science and Medicine 58, 585594.
Reading R, Reynolds S (2001). Debt, social disadvantage and maternal depression. Social Science and Medicine 53, 441453.
Reiger D, Farmer M, Rae D, Myers J, Kramer M, Robins L, George L, Karno M, Locke B (1993). One-month prevalence of mental disorders in the United States and sociodemographic characteristics: the Epidemiologic Catchment Area study. Acta Psychiatrica Scandavica 88, 3547.
Ritsher J, Warner V, Johnson J, Dohrenwend B (2001). Inter-generational longitudinal study of social class and depression: a test of social causation and social selection models. British Journal of Psychiatry 178, s84s90.
Simon G, VonKorff M, Piccinelli M, Fullerton C, Ormel J (1999). An international study of the relation between somatic symptoms and depression. New England Journal of Medicine 341, 13291335.
Takeuchi D, Zane N, Hong S, Chae D, Gong F, Gee G, Walton E, Sue S, Alegria M (2007). Immigration-related factors and mental disorders among Asian Americans. American Journal of Public Health 97, 8490.
Varon S, Riley A (1999). Relationship between maternal church attendance and adolescent mental health and social functioning. Psychiatric Services 50, 799805.
Wallace J, Forman T (1998). Religion's role in promoting health and reducing risk among American youth. Health Education and Behavior 25, 721741.
Warr P (1987). Work, Unemployment, and Mental Health. Clarendon Press: Oxford.
Weissman M, Bruce M, Leaf P, Florio L, Holzer C (1991). Affective disorders. In Psychiatric Disorders in America (ed. Robins K. and Reiger D.), pp. 5380. Free Press: New York.
Williams D, Gonzalez H, Neighbors H, Nesse R, Abelson J, Sweetman J, Jackson J (2007 b). Prevalence and distribution of major depressive disorder in African Americans, Caribbean Blacks, and non-Hispanic Whites: results from the National Survey of American Life. Archives of General Psychiatry 64, 305315.
Williams D, Haile R, Gonzalez H, Neighbors H, Baser R, Jackson J (2007 a). The mental health of Black Caribbean immigrants: results from the National Survey of American Life. American Journal of Public Health 97, 5259.
Williams D, Neighbors W (2006). Social perspectives on mood disorders. In Textbook of Mood Disorders (ed. Kupfer D., Schatzber and A.Stein D.), pp. 145158. American Psychiatric Publishing Inc.: Arlington, VA.
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