The epidemiology of mental illness in Afro-Americans.

The epidemiologic study of mental illness among Afro-Americans has progressed since the antebellum period when the rate of mental illness among free Afro-Americans living in the North was inflated to justify continued slavery. Community-wide surveys conducted after World War II demonstrated that when socioeconomic variables were controlled, the rate of mental illness among Afro-Americans was no higher than that of other groups. The rates of mental illness and substance abuse of Afro-Americans vary according to socioeconomic class and are also related to differential family structure, early performance in school, and antisocial behavior of fathers. Despite progress, undersampling of middle-class Afro-Americans and poor, unemployed, young, urban Afro-American males are consistent deficiencies of surveys that even the ambitious NIMH Epidemiologic Catchment Area Program seems to share.