Black Women With Low Socioeconomic Mobility Report Greater Depressive Symptoms

Low and downward socioeconomic mobility was associated with high levels of depression among Black women, according to results of a cohort study published in Women’s Health Issues.

Investigators from the UNC Gillings School of Global Public Health in the United States sourced data for this study from the Study of Environment, Lifestyle and Fibroids (SELF). Black women (N=1612) aged 23 to 24 years were enrolled in SELF between 2010 and 2012 in Detroit, Michigan. At 5-year intervals, the study participants were reevaluated for socioeconomic indicators and symptoms of depression.

The women had a mean age of 31±3.5 years at follow-up, they had a median BMI of 33.09 (interquartile range [IQR], 26.9-40.0) kg/m², 45% were never married or lived as married, 81% had a high childhood supportive environment, 58% had high adult social support, 56% had a household income ≥$20,000, and 25% reported no difficulty paying expenses.

According to the Center for Epidemiological Studies Depression Scale (CES-D) instrument, 37% of the population had high and 64% low symptoms of depression. Fewer women with high CES-D scores reported favorable childhood and adult socioeconomic indicators.

Using the reported socioeconomic data, the investigators performed a latent class analysis to predict life-course socioeconomic position (SEP) mobility. The best fit model comprised 4 courses: persistently low (20%), downward (24%), upward (21%), and persistently high (35%) SEP.

Life courses were negatively related with CES-D scores, in which the average score was 9.2 points for those with persistently low SEP, 7.9 points for downward SEP, 7.1 points for upward SEP, and 6.2 points for persistently high SEP.

Compared with the persistently high group, those who were in the downward (adjusted risk ratio [aRR], 1.36; 95% CI, 1.14-1.63) and persistently low (aRR, 1.56; 95% CI, 1.31-1.86) SEP mobility classes were at increased risk for depressive symptoms. The association between depression and SEP groups was more pronounced among the subset of women who had high adult social support compared with low support (P =.01) among those in the downward (aRR, 1.46 vs 1.27) and persistently low (aRR, 2.26 vs 1.33) SEP, respectively.

The results of this study may have been biased, as latent class SEP is difficult to classify, and these estimates were vulnerable to over- or underestimation.

Study authors concluded, “This study among Black women suggests life-course SEP that is persistently low, downward, and upward from childhood to adulthood are associated with high depressive symptoms. There is value in examining childhood SEP in addition to adult SEP as it may identify those who may face the greatest risk of depressive symptoms in adulthood.”