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Journals of Gerontology: Psychological Sciences
cite as: J Gerontol B Psychol Sci Soc Sci, 2017, Vol. 00, No. 00, 1–11
doi:10.1093/geronb/gbx076
Advance Access publication June 27, 2017
Special Issue: Psycho-social Influences of African Americans Men’s Health: Special
Article
Risk and Protective Factors for Depressive Symptoms
Among African American Men: An Application of the
Stress Process Model
Mathew D. Gayman, Ben Lennox Kail, Amy Spring, and George R. Greenidge Jr
Department of Sociology, Georgia State University, Atlanta.
Correspondence should be addressed to: Mathew D. Gayman, PhD, Associate Professor, Department of Sociology, Partnership for Urban Health
Research Affiliate, Gerontology Institute Affiliate, Georgia State University, P.O. Box 5020, Atlanta, GA 30302–5020. E-mail: mgayman@gsu.edu
Received: September 29, 2016; Editorial Decision Date: May 20, 2017
Decision Editor: Roland Thorpe, PhD
Abstract
Objectives: This study employs the stress process model (SPM) to identify risk/protective factors for mental health among
adult African American men.
Method: Using a community-based sample of Miami, FL residents linked to neighborhood Census data, this study identifies risk/protective factors for depressive symptomatology using a sample of 248 adult African American men.
Results: The stress process variables independently associated with depressive symptoms were family support, mastery, selfesteem, chronic stressors, and daily discrimination. While mastery and self-esteem mediated the relationship between neighborhood income and depressive symptoms, perceived family support served as a buffer for stress exposure. Collectively, the
SPM explains nearly half of the variability in depressive symptoms among African American men.
Discussion: The SPM is a useful conceptual framework for identifying psychosocial risk/protective factors and directing
health initiatives and policies aimed at improving the psychological health of African American men.
Keywords: Coping resources—Depressive symptoms—Stressors
Although African Americans are less likely to meet criteria
for major depressive disorder than whites (Kessler et al.,
2005), they are at increased risk for depressive symptoms
(Gilster, 2014; Jang, Borenstein, Chiriboga, & Mortimer,
2005; Plant & Sachs-Ericsson, 2004; Skarupski et al., 2005;
Turner et al., 2004). Given their unique and disadvantaged
social position (Williams & Sternthal, 2010), research
identifying factors that contribute to depressive symptoms
among African American men is warranted (Lincoln, Taylor,
Watkins, & Chatters, 2011; Watkins, 2012). Such research is
particularly important since depressive symptoms are linked
to increased risk for suicidality (O’Connor & Nock, 2014).
Few studies have focused on African American men
to identify risk and protective factors for psychological
well-being (Gilbert et al., 2016; Watkins, Hudson,
Caldwell, Siefert, & Jackson, 2011), particularly depressive
symptoms (Hammond, 2012). However, there is a growing
body of evidence demonstrating the role of factors such as
socioeconomic status, social stressors (including discrimination), and psychosocial coping resources for depressive
symptoms among African American men (Watkins, Green,
Rivers, & Rowell, 2006). Collectively, these factors constitute what Stress Process researchers recognize as key risk
and protective factors for health and health inequalities.
The basic tenet of the stress process model (SPM) is that
health problems are not randomly distributed across society but rather systematically biased against those with lower
social status (Pearlin, 1999). One important social status is
© The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
For permissions, please e-mail: journals.permissions@oup.com.
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an individual’s location within dimensions of socioeconomic
status (SES). One dimension is individual SES, which represents the resources available to individuals. Another dimension is neighborhood SES, which reflects one’s exposure to
everyday contextual forces that can be beneficial (or harmful)
for mental health (Phelan, Link, & Tehranifar, 2010; Ross
& Mirowsky, 2001). High SES may promote good mental
health but the role of SES for depressive symptoms is unclear
for African American men, a population heavily impacted by
race disparities in both individual and neighborhood SES.
Thus, in addition to their status as a racial minority, African
American men may be at high risk for poor psychological
health due to lower individual and neighborhood SES.
Research on the relationship between individual-level
SES and depressive symptoms among African American
men is mixed and some evidence indicates that African
American men may not reap the same benefits from SES as
whites (Williams, 2003). Additionally, little is known about
the role of neighborhood-level SES for depressive symptoms among African American men.
Minority status and low SES experienced by African
American men can also translate into poor health outcomes through increased stress exposure and limited psychosocial coping resources (Pearlin, 1999). Minority status
and low SES are associated with higher social stress and
lower psychosocial resources such as perceived social
support, mastery, and self-esteem (Turner, Taylor, & Van
Gundy, 2004; Turner, Wheaton, & Lloyd, 1995). Although
these factors have been shown to be particularly important for psychological well-being of African American
men (Watkins, 2012), it is unclear which SPM variables
independently contribute to depressive symptoms among
African American men, and which of these factors mediate
the SES—depression relationship.
Also within the SPM framework, understanding the
potential stress-buffering (or moderating) effects of psychosocial coping resources is important for understanding factors that contribute to depressive symptoms among
African American men. Specifically, the stress-buffering
hypothesis states that the negative mental health consequences of stress exposure are weakened at higher levels of
coping resources and/or is magnified at low levels of coping
resources. Because few studies have tested the stress-buffering effects of coping resources by (or within) race (Gayman,
Cislo, Goidel, & Ueno, 2014), this study advances prior
research by assessing the stress-buffering effects of various
psychosocial coping resources known to be associated with
mental health among African American men.
Despite considerable evidence demonstrating the utility of the SPM for understanding depressive systems in the
general population (Turner 2010), this is one of the few
investigations to apply the model specifically to African
American men. This study considers a wide range of SPM
variables to evaluate the (a) overall explanatory power of
the SPM and identify the SPM factors that contribute independently to depressive symptomatology, (b) mediating
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
effects of social stress and coping resources for the SES—
depressive symptom relationship, and (c) stress-buffering
effects of psychosocial coping resources.
Background
African American men are at greater risk for depressive
symptoms than their White counterparts (Gilster, 2014;
Jang et al., 2005; Skarupski et al., 2005; Turner et al.,
2004). Although African American men report fewer symptoms than African American women (Miller & Taylor,
2012), possibly due to gender differences in symptom
expression (Walton & Shepard, 2016) or risk/protective
factors (Griffith, Ellis, & Allen, 2013), more than 6%
of African American men report 16 or more symptoms
(Lincoln et al., 2011). Sixteen or more symptoms is often
used to determine clinical-level depression (Lewinsohn,
Seeley, Roberts, & Allen, 1997) and this underscores the
importance of research identifying factors that contribute
to depressive symptoms among African American men
(Ward & Mengesha, 2013).
The SPM has been shown to be a powerful framework
for understanding risk and protective factors for depressive symptomatology, as well as race disparities in depressive symptoms. Indeed, an estimated one-third to one-half
of the variability in depressive symptoms, and all of the
Black-White disparity in depressive symptoms, is explained
by the SPM (Turner & Lloyd, 1999; Turner et al., 2004).
Although few studies have applied the SPM to understand
the psychological well-being of African American men,
there are reasons to anticipate that SPM variables will contribute to depressive symptoms among African American
men. For example, low SES and greater discrimination
may be particularly important for depressive symptoms
among African American men. Conversely, high levels of
self-esteem consistently reported by African Americans
(Taylor & Turner, 2002; Turner et al., 2004) may serve as
an important protective coping resource for the psychological health of African American men.
In one of the first studies examining risk/protective
factors for depressive symptoms among older African
American men, income was associated with depressive
symptoms at the bivariate level but not after adjusting for
psychosocial coping resources such as mastery and social
support, which highlights the mediating role of psychosocial resources for the SES—depression relationship (Weaver
& Gary, 1994). In a separate analysis examining social
stressors, both major life events and chronic stressors were
independently linked to depressive symptoms, but did not
mediate the SES—depression relationship (Weaver & Gary,
1994). However, because psychosocial coping resources
and social stressors were not modeled simultaneously, the
independent contribution of these SPM variables for the
psychological health of African American men is unclear.
This study also does not include self-esteem or neighborhood-level SES, both factors known to be associated with
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
depressive symptoms and race minority status. Despite
these limitations, this study provides important insight and,
to date, remains one of the few studies to comprehensively
account for various SPM variables when predicting depressive symptoms among African American men. However,
there is growing research demonstrating the importance
of elements of the SPM for depressive symptoms among
African American men.
Socioeconomic Status
Higher levels of both individual- and neighborhood-level
SES are associated with fewer depressive symptoms (Turner
& Lloyd, 1999; Roux & Mair, 2010). People with higher
SES are better positioned to avoid health risks and problems through the deployment of knowledge, money, power,
support networks, and psychosocial coping resources
(Phelan, Link, & Tehranifar, 2010). Thus, individual SES
influences mental health not only through education and
economic resources but also through the availability of psychosocial coping resources and the ability to avoid and/or
overcome life hardships. Consistent with this perspective,
almost all (91%) of the relationship between individual SES
and depressive symptoms is explained by the SPM, which
includes psychosocial coping resources, chronic stressors
and discrimination (Turner & Lloyd, 1999).
Although higher SES is associated with fewer depressive
symptoms among adult African Americans (Ida & ChristieMizell, 2012; Marshall-Fabien & Miller, 2016), findings
on the relationship between individual SES and depressive
symptoms among African American men are mixed. Some
studies have found that African American men reporting
higher earnings experience fewer depressive symptoms
(Lincoln et al., 2011; Mizell, 1999; Weaver & Gary, 1994)
and other studies have found no relationship between individual SES and depressive symptoms (Hoard & Anderson,
2004; Kogan & Brody, 2010). African American men may
not experience the same mental health benefits from higher
SES as their White counterparts (Williams, 2003), possibly
due to increased exposure to discrimination among higher
SES African Americans compared to those with lower SES
(Hudson, Neighbors, Geronimus, & Jackson, 2016).
Lower neighborhood SES is associated with greater exposure to concentrated poverty, unemployment, and social stressors (Ross & Mirowsky, 2001). Although such exposures are
related to depressive symptoms (Kim & von dem Knesebeck,
2016; Najman et al., 2010; Turner & Lloyd, 1999), little is
known about the role of neighborhood SES for depressive
symptoms among African American men. Neighborhood SES
may be particularly important for African American men as
they are at increased risk for residing in predominantly lowincome neighborhoods that involve high levels of crime and
disorder (Massey & Denton, 1993), which are psychologically noxious (Roux & Mair, 2010).
The current study builds on prior research by considering the contribution of both individual and neighborhood
3
SES for the psychological health of African American men.
Additionally, this study assesses the potential mediating
effects of social stress and psychosocial coping resources in
the SES—depressive symptom relationship.
Social Stressors
Exposure to social stress, especially chronic stressors, has
deleterious mental health effects and nearly one-third of the
variability in depressive symptoms is explained by stress
exposure (Turner & Lloyd, 1999). Although everyone
experiences life stressors, socially marginalized groups are
exposed to a disproportionately higher number of stressors
(Turner 2010). Indeed, even after adjusting for SES, African
Americans experience significantly more exposure to
chronic stressors and recent life events than whites (Turner
& Avison, 2003).
Chronic stressors are recognized as important factors
shaping the psychological well-being of African American
men (Griffith et al., 2013). For instance, among older
African American men, those reporting more chronic hassles and major life events were at increased risk for depressive symptoms (Weaver & Gary, 1994). Among young
adult African American men, those reporting greater
parent-young adult conflict experienced more depressive
symptoms (Kogan & Brody, 2010) and, among African
American fathers, greater parenting stress was linked to
more depressive symptoms (Baker, 2013). In a sample of
low-income, predominantly African American fathers,
those reporting more chronic stressors also reported higher
levels of depressive symptoms (Hoard & Anderson, 2004).
Although social stressors are recognized as significantly
contributing to African American men’s mental health
(Watkins, 2012), the independent contribution of various
sources of social stressors for the psychological well-being
of African American men is unclear.
Additionally, while there is some evidence demonstrating
that social stress partially mediates the association between
income and depression among African American women
(Schulz et al., 2006), little is known about the potential
mediating role of social stressors for the SES—mental health
relationship among African American men. This is particularly important given that low SES is linked to greater
stress exposure (Turner & Avison, 2003) and the disadvantaged socioeconomic position experienced by many African
American men. There is also a paucity of research evaluating
the potential stress-buffering effects of psychosocial coping
resources predicting depressive symptoms among African
American men, which will be discussed shortly.
Daily Discrimination
As a social stressor, discrimination is also linked to poor
mental health (Paradies, 2006). Although there is evidence
indicating African American men report greater discrimination than women, it is unclear whether this gender disparity
4
is due to differences in lived experiences or measurement
bias (see Ifatunji & Harnois, 2016). Nevertheless, daily
discrimination is important for the psychological health of
African Americans (Taylor & Turner, 2002) and African
American men experiencing more discrimination report
worse mental health (Hammond, 2012; Watkins et al.,
2011). Additionally, the mental health benefits associated
with higher SES may be mitigated by experiences of racial
discrimination among African American men (Hudson
et al., 2012). Although these findings underscore the mental health significance of discrimination, few studies have
assessed the independent contribution of discrimination for
mental health net of other sources of social stress (Taylor
& Turner, 2002), as well as the potential meditating effects
of discrimination in the SES—depressive symptom relationship or the stress-buffering effects of psychosocial coping
resources among African American men.
Perceived Social Support
Perceived social support refers to the feeling that one is loved,
valued, and esteemed, and able to count on others should
the need arise (Cobb, 1976). According to the SPM, perceived support serves as an important factor contributing
both directly to mental health and indirectly as a mediator in
the SES—depressive symptom relationship (Turner & Lloyd,
1999). Although African Americans report lower perceived
social support than non-Hispanic whites (Gayman et al.,
2014), social support is important for the mental health of
African American men (Kogan & Brody, 2010). For example, among low-income, predominantly African American
fathers, those perceiving more support report fewer depressive symptoms (Hoard & Anderson, 2004). Additionally,
although some research has shown that social support does
not mitigate the psychological harm stemming from financial
stress among African Americans (Lincoln, 2007), perceived
support has been shown to partially mediate the association
between income and depression among African American
women (Schulz et al., 2006). However, the independent contribution of perceived support for depressive symptoms and
its potential mediation effect on the SES—mental health relationship, among African American men remains unanswered.
In addition to direct and mediating effects, this study also
assesses the stress-buffering effects of perceived social support. As with prior research (Gayman et al., 2014), we anticipate that perceived social support will condition the negative
mental health consequences stemming from chronic stress
exposure; whereby the negative impact of stress exposure on
depressive symptoms will be weakened at higher levels of perceived support.
Mastery
Mastery refers to the sense that one has control over life
circumstances and/or outcomes (Pearlin & Schooler,
1978), which is associated with fewer depressive symptoms
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
(Turner & Lloyd, 1999). Although African Americans
report less mastery than whites (Gilster, 2014; Turner
et al., 2004), mastery is associated with fewer depressive
symptoms among African American men (Jang et al., 2005;
Mizell, 1999; Watkins et al., 2011; Weaver & Gary, 1994).
Mastery has also been shown to mediate the relationship
between SES and depressive symptoms (Turner & Lloyd,
1999), including among African Americans (Lincoln, 2007;
Miller, Rote, & Keith, 2013). To date, however, few studies have assessed the additive, mediating and moderating
effects of mastery for depressive symptoms among African
American men.
Self-Esteem
Self-esteem refers to one’s sense of self-worth (Rosenberg,
1979), which is inversely associated with depressive symptoms (Gayman et al., 2010). Unlike with perceived social
support and mastery, African Americans report higher
levels of self-esteem than whites (Turner et al., 2004) and
self-esteem serves as an important coping resource for
African American men. Indeed, African American men
with greater self-esteem report fewer depressive symptoms
(Ida & Christie-Mizell, 2012; Mizell, 1999). However, little
is known about the mediating role of self-esteem for the
SES—depressive symptom relationship or the stress-buffering effects of self-esteem among African American men.
To date, few studies have focused on African American
men to identify risk and protective factors for depressive
symptoms (Hammond, 2012; Lincoln et al., 2011; Watkins,
2012). Depicted in Figure 1a–c, this study considers a wide
range of SPM variables to evaluate the (a) independent contributions of SPM variables for depressive symptoms, (b)
mediating effects of social stressors and psychosocial coping resources for the SES—depressive symptom relationship, and (c) stress-buffering effects of psychosocial coping
resources.
Method
Sample
Data are from a community-based study of Miami-Dade
County residents including a substantial oversampling of
individuals with a self-identified physical disability (Turner,
Lloyd, & Taylor, 2006). A total of 10,000 randomly
selected households were screened based on gender, age,
ethnicity, disability status, and language preference. Using
this sampling frame, the sample was drawn to include an
equivalent number of women and men, self-identified physical disability and no disability, and each of the four major
ethnic groups comprising more than 90% of Miami-Dade
County residents (non-Hispanic Whites, Cubans, nonCuban Hispanics, and African Americans).
From 2000 to 2001, 1,986 interviews were completed (82% success rate). For purposes of this investigation, analyses are limited to only African American
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
5
Social stressors
Chronic stressors were measured using Wheaton’s (1994)
scale, modified to better capture the kinds of stressors
middle-aged to older adults are likely to experience. This
includes 39 dichotomous items relating to general experiences, (un)employment, intimate partnerships/no partners, children, recreation, and health concerns. Responses
to all 39 dichotomous items were summed (mean = 3.35,
SD = 4.25, range = 0–26). Recent life events were measured
using a 32-item index referring to past 12-month experiences ranging from a serious accident/injury to the death of
a loved one. Responses to all 32 dichotomous items were
summed (mean = 1.05, SD = 1.52, range = 0–9).
Figure 1. (a) Additive effects. (b) Mediation effects. (c) Moderation
effects.
men (n = 254). Among the African American men, we
excluded six respondents with missing data on any
study variable. The analytic sample includes 248 African
American men.
Measures
Depressive symptoms
Depressive symptomatology was assessed using the
highly reliable and widely used 20-item Center for
Epidemiologic Studies Depression scale (CES-D) (Radloff,
1977). Participants were presented with such statements
as “You felt depressed” and “You felt that you could not
shake off the blues” in the past month, with response categories of 0 “not at all” to 3 “almost all the time.” Items
were coded such that higher scores represent more symptoms and summed for analysis (mean = 7.87, SD = 7.80,
range = 0–47, α = 0.86).
Socioeconomic Status
Individual SES was based on a three-item composite score
equally weighing occupational prestige (Hollingshead,
1957), education, and household income of each participant. To avoid problems of missing data, scores on each
dimension were standardized, summed and divided by
the number of dimensions on which data were available.
Preliminary analysis also considered individual SES dimensions separately and the results were substantively identical
to those presented here. Neighborhood Income was measured using the median household income from the 2000
Census block-group data file.
Daily discrimination
Discrimination was measured using a 9-item index
(Williams, Yan Yu, Jackson, & Anderson, 1997). Items
include statements such as “You are treated with less courtesy than other people” and “People act as if they think
you are dishonest,” with response categories of 1 “Never,”
2 “Rarely,” 3 “Sometimes,” 4 “Often,” and 5 “Almost
Always.” The nine items were averaged (mean = 1.83,
SD = 0.63, range = 1–4.22, α = 0.86).
Perceived social support
Social support was measured using a modified and shortened version of the Provisions of Social Relations scale
(Turner, Frankel, & Levin, 1983). Family support (16items) and friend support (8-items) were based on statements such as “You feel very close to your family(friends)”
and “You feel that your friends really care about you,” with
responses ranging from 1 “Not at all true,” 2 “Somewhat
true,” 3 “Moderately true,” to 4 “Very true.” Items were
coded such that higher values represent greater support,
and averaged for family support (mean = 3.63, SD = 0.48,
range = 1–4, α = 0.87) and friend support (mean = 3.36,
SD = 0.83, range = 1–4, α = 0.95).
Mastery
Using an established scale (Pearlin & Schooler, 1978), mastery (7-items) was based on statements such as “I have little
control over the things that happen to me” and “I can do
just about anything I really set my mind to,” with responses
ranging from 0 “Strongly Disagree,” 1 “Mildly Disagree,”
2 “Neither Agree nor Disagree,” 3 “Mildly Agree,” to
4 “Strongly Agree.” Responses were coded such that higher
values represent greater mastery and averaged across the
seven items (mean = 2.88, SD = 0.92, range = 0.29–4.00,
α = 0.81).
Self-esteem
Using a six-item subset of Rosenberg’s (1979) measure, respondents were presented with statements such as
“You feel that you have a number of good qualities” and
“All in all, you are inclined to feel that you are a failure.”
Responses were coded such that higher values represent
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
6
greater self-esteem, ranging from 0 “Strongly Disagree,”
1 “Mildly Disagree,” 2 “Neither Agree nor Disagree,”
3 “Mildly Agree,” to 4 “Strongly Agree,” and averaged
across the six items (mean = 3.76, SD = 0.42, range = 1.67–
4.00, α = 0.69).
Controls
Age was measured in years. Disability status was measured
by asking respondents if they responded affirmatively to
having a condition or physical health problem that limits
the kind or amount of activity that they can carry out (coded
as 1 for disability and 0 for no disability). Marital status
was categorized as “Married,” “Separated,” “Divorced,”
“Widowed,” and “Never Married.”
Analysis Plan
First, descriptive statistics are shown in Table 1. Second,
ordinary least squared (OLS) regressions were used to
assess additive and mediation effects of SPM variables for
depressive symptoms (Table 2). Mediation analyses were
conducted using a Sobel test (Sobel, 1982). Third, moderation analyses were used to assess stress-buffering effects of
psychosocial coping resources (Table 3).
Although median household income was measured at
the neighborhood-level, it is appropriate to treat this variable as an individual-level variable because most respondents
reside in different neighborhoods and, as such, multilevel
models were not necessary. To arrive at the final models
presented in Table 2, we used an iterative forward-backward stepwise procedure until the most appropriate model
was determined via Akaike's Information Criterion (AIC)
and BIC statistics. Based on this procedure, several variables were excluded from the final models, which include:
age, disability status, individual SES, recent life events,
and friend support. This procedure also indicated that the
most parsimonious model involved collapsing widowed,
divorced, never married, and married into one category,
with “separated” as the reference group.
Results
Descriptives
As shown in Table 1, African American men report a mean
of 7.89 depressive symptoms (past month), with approximately 11% reporting 16 or more symptoms. The average
(mean) of median household income at the neighborhood
level is $34,409.84 (median average = $32,868). The average number of chronic stressors was 3.31 (SD = 4.21,
range = 0–26) and recent life events was 1.05 (SD = 1.53,
range 0–9). The mean friend and family support was 3.36
and 3.63 and, respectively, which fall between “moderately”
and “very” supportive. The average score for self-esteem was
2.88 (SD = 0.92, range = 0.29–4.00) and mastery was 3.76
(SD = 0.42, range = 1.67–4.00). Based on the oversampling of
persons with a physical disability, approximately one-third of
the sample reports a physical disability (32.66%). The majority of respondents were currently married (58.87%), with an
average age of 58.11 years (SD = 16.26, range = 18–86).
Multivariable—Mediation
In Table 2, standardized coefficients from OLS regressions are
presented to assess the (relative) strength of the association
Table 1. Descriptive Statistics for Depressive Symptoms and Stress Process Variables
Variable
Depressive symptoms
Sixteen or more symptomsa
Individual SESb
Neighborhood incomec
Chronic stressors
Recent life events
Daily discrimination
Family support
Friend support
Mastery
Self-esteem
Age
Physical disability (yes)
Never married
Married
Divorced
Widowed
Separated
Mean (SD)
Range
7.89 (7.79)
0.00–47.00
0.00 (1.00)
$34,409.84 (11,851.36)
3.31 (4.21)
1.05 (1.53)
1.82 (0.63)
3.63 (0.48)
3.36 (0.83)
2.89 (0.93)
3.76 (0.43)
58.11 (16.26)
−2.14–3.29
$9,231–99,921
0.00–26.00
0.00–9.00
1.00–4.22
1.19–4.00
1.00–4.00
0.29–4.00
1.67–4.00
18.00–86.00
% (N)
10.89 (27)
32.66 (81)
16.94 (42)
58.87 (146)
10.48 (26)
10.08 (25)
3.63 (9)
Note: N = 248. SES = Socioeconomic status.
a
Reporting 16 or more depressive symptoms. bIndividual-level income is standardized to have a mean of zero and an SD of 1. cRepresents the average median
household income based on block-group census data, with a median neighborhood level income of $32,868.
−0.09 (0.00)
0.17*** (0.10)
0.15** (0.68)
−0.29***
(0.91)
−0.17** (0.50)
0.17** (1.11)
0.12* (2.08)
0.42
1,630.25
1,602.14
−0.16* (0.00)
Model 1: Family Support × Chronic Stressors
Model 2: Family Support × Daily Discrimination
Model 3: Mastery × Chronic Stressors
Model 4: Mastery × Daily Discrimination
Model 5: Self-Esteem × Chronic Stressors
Model 6: Self-Esteem × Daily Discrimination
Note: N = 248. Standardized coefficients shown with standard errors in (). AIC = Akaike’s Information Criterion; BIC = Bayesian Information Criterion.
a
Reference is all other marital statuses.
*p ≤ .05. **p ≤ .01. ***p ≤ .001.
0.18
1,689.79
1,679.25
0.26
1,663.98
1,653.44
0.13
1,702.15
1,691.61
Mastery
Self-esteem
Separateda
R2
BIC
AIC
0.03
1,724.78
1,717.75
0.14
1,699.09
1,688.55
−0.48*** (0.89)
0.34*** (0.73)
0.17
1,691.09
1,680.55
0.39*** (1.07)
0.38*** (0.49)
−0.12 (0.00)
−0.12* (0.00)
−0.11* (0.00)
−0.18** (0.00)
0.32*** (0.11)
−0.18*(0.00)
b (SE)
−0.42 (0.21)*
−2.39 (1.19)*
−0.13 (0.11)
−1.13 (0.79)
0.16 (0.29)
−0.62 (1.85)
Note: N = 248. Unstandardized coefficients shown with standard errors in ().
All first-ordered terms are included in the respective models.
*p ≤ .05.
−0.17** (0.00)
Neighborhood income
Chronic stressors
Daily discrimination
Family support
7
Table 3. Depressive Symptoms Regressed on Coping
Resource × Social Stress Interactions (Moderation)
0.18** (2.58)
0.06
1,721.58
1,711.04
8
3
2
1
Table 2. Depressive Symptoms Regressed on Stress Process Variables (Mediation)
4
5
6
7
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
between the SPM variables and depressive symptoms. Model
1 indicates that a one standard deviation increase in neighborhood level income is associated with a 0.17SD decrease
in depressive symptoms (SE = 0.00, p ≤ .01). Models 2–7
step in each covariate separately to assess their contribution
for depressive symptoms, as well as their mediating effects
between neighborhood income and depressive symptoms.
When entered individually, family support has the strongest
correlation with depressive symptoms (β = −0.48, SE = 0.89,
p ≤ .001), explaining approximately one-quarter of the variability in depressive symptoms (R2=.26).
For the most part, the association between neighborhood income and depressive symptoms is robust to
additional covariates, underscoring its significance for
the psychological health of African American men. One
exception, when self-esteem is included, the association
between neighborhood income and depressive symptoms is reduced to nonsignificance (β = −0.12, SE = .00,
p ≤ .051). Comparing Models 1 and 4, mediation analysis
reveals a significant reduction (29%) in the neighborhood
income coefficient after controlling for self-esteem (Sobel:
z = −2.12, p = .03). Mastery also significantly mediates the
relationship between neighborhood income and depressive
symptoms (32%, z = 2.12, p = .03).
Reflecting conceptual Figures 1a and b, results in Model
8 indicate that both measures of stress and each coping
resource are independently associated depressive symptoms. Collectively, comparing Models 1 and 8, stress exposure (chronic stressors and discrimination) and coping
resources (family support, mastery, and self-esteem) explain
approximately half (47%) of the relationship between
neighborhood SES and depressive symptoms. In addition,
almost half of depressive symptoms are explained by the
full model (R2 = 42%).
Multivariable—Moderation
Table 3 presents interaction results, with all six models
including the first-ordered terms that make up each interaction term (not shown). Reflecting conceptual Figure 1c,
findings indicate that perceived family support significantly
8
buffers the negative mental health consequences of stress
exposure. Specifically, increased depressive symptoms associated with higher levels of chronic stressors (and daily discrimination) are relatively lower among African American
men who report more family support.
Discussion
Approximately 11% of African American men reported 16 or
more symptoms, a cutoff often used as a proxy estimate for
clinical-level depression (Lewinsohn et al., 1997). Although
larger than the 6.37% recently reported in a national sample
of African American men (Lincoln et al., 2011), this difference
may stem from the shortened 12-item scale used by Lincoln
and colleagues. It should also be noted that depressive symptoms among African American men may be underreported
due to gendered differences in the expression of depression
(Watkins, Abelson, & Jefferson, 2013). Nevertheless, the findings underscore the importance of research identifying risk/
protective factors for depressive symptoms among African
American men (Ward & Mengesha, 2013).
Consistent with prior research of African American men
(Hoard & Anderson, 2004; Kogan & Brody, 2010), individual SES was not associated with depressive symptoms.
This has led some researchers to conclude that SES may
not be as important for mental health, as well as physical
health (see Turner, Brown, & Hale, 2017), among African
Americans compared to Whites. Individual-level SES may
be less likely to contribute to the well-being of African
American men compared to others, due to the often-unrealized rewards associated with higher income and education among African Americans, such as residing in safe
and desirable neighborhoods (Williams, 2003). However,
we found those residing in lower SES neighborhoods experienced significantly more depressive symptoms, underscoring the significance of neighborhood-level SES for the
psychological health of African American men. Thus, it is
important to include neighborhood SES in research examining the role of SES for mental and physical health among
African American men.
Residing in low-income neighborhoods may not only
increase risk for poor mental health due to high rates of
crime, poverty, and unemployment (Ross & Mirowsky,
2001) but living in such contexts may also indirectly translate into more depressive symptoms due to fewer psychosocial coping resources. A strong sense of mastery and
self-esteem are recognized as important factors for the psychological well-being of African American men (Watkins,
2012). Indeed, consistent with prior research (Weaver &
Gary, 1994), we found that mastery and self-esteem play
an important role in mitigating the negative psychological harm associated with lower-income neighborhoods.
The findings highlight the significance of intrapersonal
coping for the psychological health of African American
men (Weaver & Gary, 1994), whereby self-reliance is an
important coping strategy of African American men (Ellis,
Griffith, Allen, Thorpe, & Bruce, 2015; Hammond, 2012).
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
Although intra-personal coping may be important in
the link between neighborhood SES and depressive symptoms, our findings revealed that when coping with social
stress, it was perceived family support, rather than mastery
and self-esteem, that moderated the negative mental health
consequences of social stress. Specifically, increased depressive symptoms linked to greater chronic stressors and daily
discrimination were relatively lower among those reporting
more family support. Building on prior research highlighting that social support is important for the mental health of
African American men (Hoard & Anderson, 2004; Kogan
& Brody, 2010; Watkins, 2012), this study demonstrates the
importance of perceived family support for buffering the
deleterious mental health effects of stress exposure among
African American men. Thus, while self-reliance through
mastery and self-esteem may be important for mitigating the
psychological consequences associated with residing in relatively poor neighborhoods, the ability to perceive support
from one’s family is important for minimizing the negative
mental health consequences of stress exposure for African
American men. In addition to the importance of African
American men’s involvement (and presence) for families
(Baker, 2013), our findings highlight the mental health significance perceived family support for African American
men managing stress exposure.
African American men are at increased risk for chronic
stressors and daily discrimination (Williams, 2003). Griffith
and colleagues (2013) highlight the importance of chronic
stressors associated with home and work for the health of
African American men. Although we did not find that social
stress mediated the SES—depressive symptom relationship,
which is consistent with prior research (Weaver & Gary,
1994), both chronic stressors and daily discrimination
independently contributed to depressive symptoms among
African American men, underscoring the importance of
addressing everyday hardships to address the psychological
well-being of African American men.
There are a few noteworthy limitations. First, given the
localized nature of the sample, it is unclear whether the
results are generalizable to other U.S. locales. However, the
fact that many of the patterns in this study are consistent
with prior research in various locales, including the level
of depressive symptoms among African American men, the
concern of generalizability is somewhat tempered. Second,
as with any cross-sectional study, neither temporality nor
causality can be determined. Given that the relationships
between SES, stress exposure, coping resources, and mental
health are likely reciprocal in nature, longitudinal studies
are needed to better understanding the temporal order of
SPM variables among African American men.
Conclusion
Given that African American men are disproportionately
more likely than their White counterparts to reside in
lower-income neighborhoods (Massey & Denton, 1993),
public health policies aimed at addressing poor mental
Journals of Gerontology: PSYCHOLOGICAL SCIENCES, 2017, Vol. 00, No. 00
health among African American men should account for
neighborhood conditions. Indeed, individual-level SES,
stress exposure, and coping resources among African
American men must be situated within broader economic
and sociopolitical contexts (Enyia, Watkins, & Williams,
2016). Within this broader contextual framework, social
stress and psychosocial resources play an important role
in understanding depressive symptoms among African
American men. On the one hand, mastery and self-esteem
serve as linking mechanisms between neighborhood SES
and depressive symptoms and, on the other hand, perceived family support serves as a buffer for chronic stressors and daily discrimination. Collectively these factors
explain nearly half the variability in depressive symptoms,
underscoring the utility of the stress process model for
understanding the psychological well-being of African
American men.
Funding
This study was supported by grant R01DA13292 to R. Jay Turner
from the National Institute on Drug Abuse.
Conflict of Interest
The authors declare no conflict of interest.
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