Depression in black and white women. The role of marriage and socioeconomic status.

The degree to which the relationship between race and depression in US black and white women is modified by socioeconomic and marital status was investigated. Data on 534 black and 836 white women, 25 to 64 years old, obtained from the 1986 Americans' Changing Lives national survey were utilized. Depression was measured by the Centers for Epidemiologic Studies Depression scale. Poverty status and education were used as indicators of socioeconomic status (SES). For both black and white women, the prevalence of depression was higher among those with lower as compared to higher SES, and among the unmarried as compared to the married. The unstratified, age-adjusted odds of depression for black women was twice that for white women (odds ratio (OR) = 2.2; 95% confidence interval (CI), 1.7 to 2.8); however, when stratified by poverty status, race effects were observed for nonpoor (OR = 2.2; 95% CI, 1.6 to 3.0) but not for poor women (OR = 1.3; 95% CI, 0.7 to 2.1). Race effects were also more pronounced among married (OR = 2.0; 95% CI, 1.4 to 2.9) than unmarried women (OR = 1.6; 95% CI, 1.1 to 2.4). Controlling for known confounders did not alter these results. Additional analyses revealed that the black excess risk for depression was concentrated among higher SES, married women, with marital difficulties appearing to pay a major role in their elevated depression scores.