Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA.
J Urban Health. 2013 Feb;90(1):101-15. doi: 10.1007/s11524-012-9707-5.
Depression among African Americans residing in urban communities is a complex, major public health problem; however, few studies identify early life risk factors for depression among urban African American men and women. To better inform prevention programming, this study uses data from the Woodlawn Study, a well-defined community cohort of urban African Americans followed from age 6 to 42 years, to determine depression prevalence through midlife and identify childhood and adolescent risk factors for adult depression separately by gender. Results indicate that lifetime depression rates do not differ significantly by gender (16.2 % of men, 18.8 % of women) in contrast to findings of a higher prevalence for women in national studies. Furthermore, rates of depression in this urban African American population are higher than those found in national samples of African Americans and more comparable to the higher rates found nationally among Whites. Regarding early predictors, for both men and women, family conflict in adolescence is a risk factor for adult depression in multivariate regression models. For women, vulnerability to depression has roots in early life, specifically, low maternal aspirations for school attainment. Females displaying more aggressive and delinquent behavior and those growing up in a female-headed household and a household with low maternal education have elevated rates of depression. Males growing up in persistent poverty, those engaging in greater delinquent behavior, and those with low parental supervision in adolescence also have elevated rates of depression. Effective prevention programming for urban African Americans must consider both individual characteristics and the family dynamic.
非裔美国人居住在城市社区中，其抑郁问题是一个复杂的、主要的公共卫生问题；然而，很少有研究能够确定城市非裔美国男女青年时期抑郁的早期风险因素。为了更好地为预防计划提供信息，本研究利用了 Woodlawn 研究的数据，这是一个针对城市非裔美国人的明确社区队列，从 6 岁到 42 岁进行了随访，以确定中年时期的抑郁患病率，并分别按性别确定儿童和青少年时期成年抑郁的风险因素。结果表明，与全国研究中女性抑郁患病率较高的发现相反，在本项研究中，男性（16.2%）和女性（18.8%）的终生抑郁率并无显著性别差异。此外，该城市非裔美国人的抑郁率高于全国非裔美国人样本中的抑郁率，更接近全国范围内白人的较高抑郁率。至于早期预测因素，对于男性和女性，青春期的家庭冲突是多变量回归模型中成年抑郁的一个风险因素。对于女性，易患抑郁的根源在于早期生活，特别是母亲对学业成就的期望较低。表现出更具攻击性和越轨行为的女性，以及在女性为家长的家庭和母亲受教育程度较低的家庭中长大的女性，其抑郁率较高。长期生活在贫困中的男性、行为越轨行为较多的男性以及青春期父母监管较少的男性，其抑郁率也较高。对于城市非裔美国人，有效的预防计划必须同时考虑个体特征和家庭动态。
