Racial/ethnic disparities in prevalence of major depression among community-dwelling older women

Background: Major depression is a serious public health problem among older adults, especially among women. Few studies have examined racial/ethnic disparities in depression prevalence and associated factors among older women.

Objective: To estimate racial/ethnic disparities in prevalence of major depression and explore associated factors among community-dwelling older women using a nationally-representative sample.

Design: A cross-sectional study using the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (2001-02).

Participants: 4,875 female Medicare beneficiaries age 65+.

Methods: A structured clinical interview was used to make a DSM-IV diagnosis of major depression during the past year. Racial/ethnic groups included non-Hispanic whites, non-Hispanic blacks, Hispanics, and others. The Chi-square test and multivariate logistic regression were utilized. All estimates were adjusted by sampling weights and study design effects.

Results: Bivariate analyses indicated that a significantly higher proportion of Hispanics (6.8%, OR=1.8, p=0.06) and non-Hispanic blacks (5.7%, OR=1.5, p=0.09) were identified with major depression, compared to non-Hispanic whites (3.9%). After controlling for sociodemographic characteristics and health status, no significant difference was found between Hispanics and non-Hispanic whites (p = 0.14) or between non-Hispanic blacks and non-Hispanic whites (p = 0.73). Urban residence, psychosocial events, comorbidies and smoking were significant correlates.

Conclusion: Among community-dwelling older women, minorities were at higher risk of major depression than non-Hispanic whites. Health status and behavior, psychosocial events and urban residence explained these differences. Early health behavior intervention and timely healthcare treatment may help decrease prevalence of major depression and associated racial/ethnic disparities among older women.