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Coping While Black: Chronic Illness, Mastery, and the Black-White Health Paradox

  • Eundria A. Hill-JosephEmail author
Article
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Abstract

Prior research indicates that there is a black-white paradox in the relationship between physical health and mental health among American adults. However, none have considered black-white differences in psychosocial coping and depressive symptoms during the transitional stages from health to chronic illness. Using a nationally representative sample of chronically ill adults from the American Changing Lives study, this study builds on literature on chronic illness and the black-white paradox to examine if (1) growth in depressive symptoms across 16 years differs for black and white adults as they transition from healthy to chronically ill and (2) if the protective coping resource, mastery, provides an equal benefit to black and white chronically ill adults during that transition. Findings indicate that among chronically ill adults, not only do black-white disparities exist in how much mastery each group possesses, but that mastery’s utility as a protective resource against depressive symptoms differs by race, with black ill adults experiencing a poorer return on their mastery than white adults. Moreover, findings that black adults maintain the same level of depressive symptoms as white adults despite this mastery disadvantage provide additional support for Minorities’ Diminishing Returns Theory and some support for an emerging theory of collective resilience with regard to black American mental health.

Keywords

Chronic illness Depressive symptoms Racial disparities Mastery Collective resilience 

Notes

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The author declares no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Compliance with Ethical Standards

Ethical Approval

The Ethics Review Board at Biola University (the site at which the data analysis was conducted) does not require ethics approval for the use of publicly available secondary data, the type of data used in the submitted paper.

Conflict of Interest

The author declares no conflict of interest.

Ethics

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) with the Helsinki Declaration of 1975, as revised in 2000.

Animal Studies

No animal studies were conducted in completion of this study.

References

  1. 1.
    Buttorff C, Ruder T, Bauman M. Multiple chronic conditions in the United States. Santa Monica: RAND Corporation; 2017. Retrieved 1 Dec 2018 https://www.rand.org/pubs/tools/TL221.html
  2. 2.
    Williams DR. The health of U.S racial and ethnic populations. J Gerontol. 2005;60B:53–62.CrossRefGoogle Scholar
  3. 3.
    Mezuk B, Rafferty JA, Kershaw KN, Hudson D, Abdou CM, Lee H, et al. Reconsidering the role of social disadvantage in physical and mental health: stressful life events, health behaviors, race, and depression. Am J Epidemiol. 2010;172(11):1238–49.  https://doi.org/10.1093/aje/kwq283.
  4. 4.
    Phelan JC, Link BG, Tehranifar P. Social conditions as fundamental causes of health inequalities: theory, evidence, and policy implications. J Health Soc Behav. 2010;51(1_suppl):S28–40.  https://doi.org/10.1177/0022146510383498.CrossRefPubMedGoogle Scholar
  5. 5.
    Chen J, Vargas-Bustamante A, Mortensen K, Ortega AN. Racial and ethnic disparities in health care access and utilization under the affordable care act. Med Care. 2016;54(2):140–6.CrossRefGoogle Scholar
  6. 6.
    Williams DR, Yu Y, Jackson JS, Anderson NB. Racial differences in physical and mental health, socio-economic status, stress and discrimination. J Health Psychol. 1997;2:335–51.CrossRefGoogle Scholar
  7. 7.
    Hudson DL, Bullard KM, Neighbors HW, Geronimus AT, Yang J, Jackson JS. Are benefits conferred with greater socioeconomic position undermined by racial discrimination among African American men. J Men's Health. 2012;9:127–36.CrossRefGoogle Scholar
  8. 8.
    Bury M. Chronic illness as biographical disruption. Sociol Health Illn. 1982;4(2):167–82.CrossRefGoogle Scholar
  9. 9.
    Charmaz K. The body, identity and, the self: adapting to impairment. Sociol Q. 1995;36(4):657–80.CrossRefGoogle Scholar
  10. 10.
    Bury M. The sociology of chronic illness: a review of research and prospects. Sociol Health Illn. 1991;13:451–68.CrossRefGoogle Scholar
  11. 11.
    Hays RD, Wells KB, Donald C, Sherbourne WR, Spritzer K. Functioning and well-being outcomes of patients with depression compared with chronic general medical illnesses. Arch Gen Psychiatry. 1995;52(1):11–9.CrossRefGoogle Scholar
  12. 12.
    Stroup KT, Kinney ED, Kniesner TJJ. Chronic illness and health insurance-related job lock. J Policy Anal Manage. 2001;20(3):525–44.CrossRefGoogle Scholar
  13. 13.
    Simoni JM, Huang B, Goodry EJ, Montoya HD. Social support and depressive symptomatology among HIV-positive women: the mediating role of self-esteem and mastery. Women Health. 2006;42(4):1–15.CrossRefGoogle Scholar
  14. 14.
    Kanner AM, Palac S. Depression in epilepsy: a common but often unrecognized comorbid malady. Epilepsy Behav. 2000;1(1):37–51.CrossRefGoogle Scholar
  15. 15.
    Turner RJ, Noh S. Physical disability and depression: a longitudinal analysis. J Health Soc Behav. 1988;29(1):23–37.CrossRefGoogle Scholar
  16. 16.
    Liew HP. Depression and chronic illness: a test of competing hypotheses. J Health Psychol. 2011;17(1):100–9.CrossRefGoogle Scholar
  17. 17.
    MacDonald L. The experience of stigma: living with rectal cancer. In: Anderson R, Bury M, editors. Living with chronic illness: the experience of patients and their families. London: Unwin Hyman; 1988. p. 177–202.Google Scholar
  18. 18.
    Cott CA, Gignac MAM, Badley EM. Determinants of self-rated health for Canadians with chronic disease and disability. J Epidemiol Community Health. 1999;53:731–6.CrossRefGoogle Scholar
  19. 19.
    Dickson A, Knussen C, Flowers P. That was my old life; it’s almost like a past-life now’: identity crisis, loss and adjustment amongst people living with chronic fatigue syndrome. Psychol Health. 2008;23(4):459–76.CrossRefGoogle Scholar
  20. 20.
    Turner RJ, Lloyd DA. The stress process and the social distribution of depression. J Health Soc Behav. 1999;40:374–404.CrossRefGoogle Scholar
  21. 21.
    Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.CrossRefGoogle Scholar
  22. 22.
    Pudrovska T. Cancer and mastery: do age and cohort matter? Soc Sci Med. 2010;71(7):1285–91.CrossRefGoogle Scholar
  23. 23.
    Graff LA, Walker JR, Clara I, Lix LM, Miller N, Rogala L, et al. Stress coping, distress, and health perceptions in inflammatory bowel disease and community controls. Am J Gastroenterol. 2009;104:2959–69.Google Scholar
  24. 24.
    Turner RJ, Wood DW. Depression and disability: the stress process in a chronically strained population. Res Community Ment Health. 1985;5:77–109.Google Scholar
  25. 25.
    Yang Y. How does functional disability affect depressive symptoms in late life? The role of perceived social support and psychological resources. J Health Soc Behav. 2006;47:355–72.CrossRefGoogle Scholar
  26. 26.
    Pudrovska T, Schieman S, Pearlin LI, Nguyen K. The sense of mastery as a mediator and moderator in the association between economic hardship and health in late life. J Aging Health. 2005;17(5):634–60.CrossRefGoogle Scholar
  27. 27.
    Mirowsky J, Ross CE. Social causes of psychological distress. Second ed. New York: Aldine de Gruyter; 2003.Google Scholar
  28. 28.
    Mirowsky J, Ross CE. Life course trajectories of perceived control and their relationship to education. Am J Sociol. 2007;112(5):1339–82.CrossRefGoogle Scholar
  29. 29.
    Assari S, Lankarani MM. Reciprocal associations between depressive symptoms and mastery among older adults: black-white differences. Front Aging Neurosci. 2017;8:279.CrossRefGoogle Scholar
  30. 30.
    McGuire TG, Miranda J. New evidence regarding racial and ethnic disparities in mental health: policy implications. Health Aff (Project Hope). 2008;27(2):393–403.CrossRefGoogle Scholar
  31. 31.
    Cook BL, Trinh NH, Li Z, Hou SS, Progovac AM. Trends in racial-ethnic disparities in access to mental health care, 2004-2012. Psychiatr Serv. 2016;68(1):9–16.CrossRefGoogle Scholar
  32. 32.
    Keyes CL. The black–white paradox in health: flourishing in the face of social inequality and discrimination. J Pers. 2009;77:1677–706.  https://doi.org/10.1111/j.1467-6494.2009.00597.x.CrossRefPubMedGoogle Scholar
  33. 33.
    Assari S, Burgard S, Zivin KJ. Long-term reciprocal associations between depressive symptoms and number of chronic medical conditions: longitudinal support for black–white health paradox. Racial Ethn Health Disparities. 2015;2:589–97.  https://doi.org/10.1007/s40615-015-0116-9.CrossRefGoogle Scholar
  34. 34.
    Barnes DM, Bates LM. Do racial patterns in psychological distress shed light on the black–white depression paradox? A systematic review. Soc Psychiatry Psychiatr Epidemiol. 2017;52:913–28.  https://doi.org/10.1007/s00127-017-1394-9.CrossRefPubMedGoogle Scholar
  35. 35.
    Assari S. Neuroticism predicts subsequent risk of major depression for whites but not blacks. Behav Sci (Basel). 2017a;7(4):64.  https://doi.org/10.3390/bs7040064.CrossRefGoogle Scholar
  36. 36.
    Assari S. Unequal gain of equal resources across racial groups. Int J Health Policy Manag. 2017b;7(1):1–9.  https://doi.org/10.15171/ijhpm.2017.90.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Assari S, Moazen-Zadeh E, Lankarani MM, Micol-Foster V. Race, depressive symptoms, and all-cause mortality in the United States. Front Public Health. 2016;4(40).  https://doi.org/10.3389/fpubh.2016.00040.
  38. 38.
    Ryff CD, Keyes CLM, Hughes DL. Status inequalities, perceived discrimination, and eudaimonic well-being: do the challenges of minority life hone purpose and growth. J Health Soc Behav. 2003;44:275–91.CrossRefGoogle Scholar
  39. 39.
    Assari S, Lankarani MMJ. Association between stressful life events and depression: intersection of race and gender. Racial Ethn Health Disparities. 2016;3:349–56.  https://doi.org/10.1007/s40615-015-0160-5.CrossRefGoogle Scholar
  40. 40.
    Lincoln KD, Taylor RJ, Watkins DC, Chatters L. Correlates of psychological distress and major depressive disorder among African American men. Res Soc Work Pract. 2011;21:278–88.CrossRefGoogle Scholar
  41. 41.
    Assari S. Health disparities due to diminished return among black Americans: public policy solutions. Soc Issues Policy Rev. 2018;12(1):112–45.CrossRefGoogle Scholar
  42. 42.
    Assari S, Thomas A, Caldwell CH, Mincy RB. Blacks’ diminished health return of family structure and socioeconomic status; 15 years of follow-up of a national urban sample of youth. J Urban Health. 2018a;95:21–35.CrossRefGoogle Scholar
  43. 43.
    Assari S, Lapeyrouse L, Neighbors H. Income and self-rated mental health: diminished returns for high income black Americans. Behav Sci. 2018b.Google Scholar
  44. 44.
    Levine SZ. Evaluating the seven-item Center for Epidemiologic Studies Depression Scale Short-Form: a longitudinal US community study. Soc Psychiatry Psychiatr Epidemiol. 2013;48:1519–26.CrossRefGoogle Scholar
  45. 45.
    Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.CrossRefGoogle Scholar
  46. 46.
    Hughes AK, Woodward AT, Velez-Ortiz D. Chronic illness intrusion: role impairment and time out of role in racially and ethnically diverse older adults. The Gerontologist. 2013;54(4):661–9.CrossRefGoogle Scholar
  47. 47.
    Thombs BD, Hudson M, Schieir O, Taillefer SS, Baron M. Reliability and validity of the Center for Epidemiologic Studies Depression scale in patients with systemic sclerosis. Arthritis Care Res. 2008;59(3):438–43.CrossRefGoogle Scholar
  48. 48.
    Boutin-Foster C. An item-level analysis of the Center for Epidemiologic Studies Depression Scale (CES-D) by race and ethnicity in patients with coronary artery disease. Int J Geriatr Psychiatry. 2008;23:1034–9.  https://doi.org/10.1002/gps.2029.CrossRefPubMedGoogle Scholar
  49. 49.
    Pearlin LI, Nguyen KB, Schieman S, Milkie MA. The life-course origins of mastery among older people. J Health Soc Behav. 2007;48:164–79.CrossRefGoogle Scholar
  50. 50.
    Jang Y, Borenstein-Graves A, Haley WE, Small BJ, Mortimer JA. Determinants of a sense of mastery in African American and white older adults. J Gerontol B Psychol Sci Soc Sci. 2003;58(4):S221–4.CrossRefGoogle Scholar
  51. 51.
    Oates GL, Goode J. Racial differences in the effects of religiosity and mastery on psychological distress: evidence from national longitudinal data. Soc Ment Health. 2013;3:40–58.CrossRefGoogle Scholar
  52. 52.
    Riolo SA, Nguyen TA, Greden JF, King CA. Prevalence of depression by race/ ethnicity: findings from the National Health and nutrition examination survey III. Am J Public Health. 2005;95(6):998–1000.  https://doi.org/10.2105/AJPH.2004.047225.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Lankarani M, Assari S. Association between number of comorbid medical conditions and depression among individuals with diabetes: race and ethnic variations. J Diabetes Metab Disord. 2015;14(56).  https://doi.org/10.1186/s40200-015-0171-0.
  54. 54.
    Mouzon DM. Religious involvement and the black-white paradox in mental health. Race Soc Probl. 2017;9(1):63–78.  https://doi.org/10.1007/s12552-017-9198-9.CrossRefGoogle Scholar

Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.Department of SociologyBiola UniversityLa MiradaUSA

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