Life course predictors and consequences of major depressive disorder among disadvantaged African American men

Major depressive disorder (MDD) is one of the most common and debilitating disorders in the United States. While research suggests lower rates of MDD among African American men compared to other racial/ethnic groups and to women, evidence suggests that they may experience worse outcomes, with reduced access to and poorer quality treatment leading to a more disabling course of illness, especially for those living in disadvantaged communities. Despite the need for more insight into risk factors for MDD in African American men, few longitudinal studies have examined early factors affecting its onset in this population. This study uses life course data from the Woodlawn Project, a longitudinal study of urban African Americans followed from age 6 to 42 (N=1242) providing an in-depth exploration of a wealth of early risk factors for MDD. With 16% of Woodlawn men meeting criteria (high compared to national studies), we examine factors in childhood and adolescence that predict age of onset of MDD using Kaplan Meier Survival analysis. In preliminary analyses, childhood socioeconomic resources, family practices and background, behavioral problems, perceived racial discrimination, and delinquency are statistically significant predictors of MDD onset. Identifying modifiable risk factors early in the life course for disadvantaged African American men informs prevention efforts, important for this prevalent mental health problem, particularly given that depressed African American men experience poor outcomes, including self-medicating in harmful ways. In fact, our results will show that depressed Woodlawn men have high rates of crime, substance use, and unemployment and low rates of treatment.