Elderly blacks are more likely than their white counterparts to feel overwhelmed by daily life, but at the same time are more inclined to view depression as a condition they can overcome through personal or religious strength rather than a medical one, a new University of Florida study finds. ”This sense of being overwhelmed may be associated with an incessant feeling among many older African-Americans that even in late life they continue to struggle for survival because of the lingering effects of racism and the cumulative effect of a lifetime of limited opportunities.”From University of Florida :
UF STUDY: BLACKS MORE LIKELY TO REPORT BEING OVERWHELMED BY DAILY LIFE
Elderly blacks are more likely than their white counterparts to feel overwhelmed by daily life, but at the same time are more inclined to view depression as a condition they can overcome through personal or religious strength rather than a medical one, a new University of Florida study finds.
”This sense of being overwhelmed may be associated with an incessant feeling among many older African-Americans that even in late life they continue to struggle for survival because of the lingering effects of racism and the cumulative effect of a lifetime of limited opportunities,” said Terry Mills, a UF sociologist who did the study.
Depression in elderly Americans often goes undiagnosed, but is a public health concern that is important to detect since it can signal the onset of heart disease or other kinds of vascular disease, Mills said. ”Since heart disease continues to be a leading cause of death among older persons, it is important that we gain better knowledge about its association with depression and depressive symptoms,” he said.
The connection between physical health and depressive symptoms is particularly significant for blacks, who have higher incidences of heart disease and stroke, he said. About 35 million adults in the United States are 65 or older, and their life expectancies have increased dramatically. In 1900, life expectancy was about 49 years, increasing by 1997 to 79 for women and 74 for men, he said.
Thirty-three percent of older blacks in the study, compared with 22 percent of whites, indicated that ”everything is an effort,” which could include getting out of bed in the morning, handling daily responsibilities or even just day-to-day living, Mills said.
In addition, considerably more older blacks in the survey — 57 percent — viewed depression as a personal weakness compared with 36 percent of their white counterparts, he said. The attitude that depression is a weakness may relate to blacks’ strongly held religious beliefs, which suggest that through faith one can endure and overcome life’s burdens, Mills said. Depression may be interpreted as a sign a person’s faith is weak, suggesting a character flaw, he said.
”Because many African-Americans are religious or spiritually grounded, they’re more likely to say, ‘The Lord won’t put more on me than I can bear,’ and fall back on Scripture or a sense of religiosity to try to cope with feelings of psycho-social distress,” Mills said. ”That means if they can’t bear it, somehow their faith is not strong, which is often seen as having a personality flaw.”
The results of the study, published in the August issue of the Community Mental Health Journal, came from a telephone survey of randomly selected Florida residents — 180 whites and 224 blacks ranging in age from 60 to 95. A demographic chart was developed to show U.S. Census tract areas with a black population of 50 percent or more.
Respondents were asked to report whether they had experienced over the past week certain feelings, including loneliness and sadness, whether they were having difficulty sleeping and or were finding everything was an effort, using an eight-item version of a questionnaire developed in the 1970s that detects major or clinical depression. In addition, participants were asked ”Do you believe that depression is a medical condition?” and ”Do you believe depression is a personal weakness?” as well as if they had ever taken medication for depression.
This role of religiosity suggests mental health professionals may need to work more closely with the clergy in identifying and getting treatment for blacks who show symptoms of depression, Mills said. ”The clergy may be the first line of defense for elderly blacks who suffer from depression,” he said.
A comparable proportion of the older blacks and whites surveyed — 15 percent and 12 percent respectively — reported being depressed. The proportion of black and white older adults who reported feeling depressed in Mills’ study is nearly comparable to national averages for individuals aged 65 and over. According to the National Mental Health Association, depressive symptoms occur in about 15 percent of community residents over 65 years of age, he said.
Three-quarters of whites said they considered depression to be a medical condition, compared with 65 percent of blacks, Mills said.
This disparity may relate to whites having a greater level of knowledge about depression, Mills said. Studies have shown that whites who seek medical care for a physical problem are more likely than their black counterparts to be referred for evaluation of depression and diagnosed with depressive disorders, he said.
They also are more likely to be medically treated for depression. One-quarter of elderly whites surveyed reported having taken medication for depression, compared with 17 percent of their black counterparts, he said.
Ronald Angel, a sociology professor at the University of Texas at Austin and co-author of the book ”Who Will Care for Us? Aging and Long-Term Care in Multicultural America,” said Mills’ research is ”very important.”
”Dr. Mills’ research makes it clear that there is more to depression than brain chemistry,” Angel said. ”The lifelong disadvantages and social stresses that older African-Americans have experienced place them at great risk of poor health and depression. Dr. Mills’ work clearly documents that increased risk, but it also provides useful insights into how social factors, including religious identification, provide older African-Americans with ways of understanding and dealing with their feeling.”