Social inequalities contribute to racial/ethnic disparities in depressive symptomology among men who have sex with men |
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Authors: | Barrett Benjamin W. Abraham Alison G. Dean Lorraine T. Plankey Michael W. Friedman M. Reuel Jacobson Lisa P. Teplin Linda A. Gorbach Pamina M. Surkan Pamela J. |
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Affiliation: | 1.Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA ;2.Department of Medicine, Medical Center, Georgetown University, Washington, DC, USA ;3.Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA ;4.Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA ;5.Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA ;6.Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA ; |
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Abstract: | Purpose Racial/ethnic minorities experience disproportionate rates of depressive symptoms in the United States. The magnitude that underlying factors—such as social inequalities—contribute to these symptoms is unknown. We sought to identify exposures that explain racial/ethnic differences in clinically significant depressive symptomology among men who have sex with men (MSM). MethodsData from the Multicenter AIDS Cohort Study (MACS), a prospective cohort study, were used to examine clinically significant symptoms of depression (Center for Epidemiologic Studies Depression Scale score ≥ 20) among non-Latinx White, non-Latinx Black, and Latinx MSM. We included 44,823 person-visits by 1729 MSM seen in the study sites of Baltimore/Washington, DC; Chicago; Pittsburgh/Columbus; and Los Angeles from 2000 to 2017. Regression models estimated the percentage of depressive symptom risk explained by social, treatment, and health-related variables related to race/ethnicity. Machine-learning methods were used to predict the impact of mitigating differences in determinants of depressive symptoms by race/ethnicity. ResultsAt the most recent non-missing MACS visit, 16% of non-Latinx White MSM reported clinically significant depressive symptoms, compared to 22% of non-Latinx Black and 25% of Latinx men. We found that income and social-environmental stress were the largest contributors to racial/ethnic disparities in risk for depressive symptoms. Similarly, setting the prevalence of these two exposures to be equal across racial/ethnic groups was estimated to be most effective at reducing levels of clinically significant depressive symptoms. ConclusionResults suggested that reducing socioeconomic inequalities and stressful experiences may be effective public health targets to decrease racial/ethnic disparities in depressive symptoms among MSM. |
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