High socioeconomic status increases discrimination, depression risk in black young adults

December 18, 2014

An investigation into factors related to disparities of depression in young adults has found that higher parental education - which has a protective effect for white youth - can also increase the risk of depression for black youth. The MassGeneral Hospital for Children (MGHfC) study published online in the Journal of Pediatrics also found that, among high-socioeconomic-status black youth, greater perceptions of being discriminated against cancelled out the protective effects of parental education.

"High socioeconomic status (SES) - particularly higher parent education - is known to be protective against depressive symptoms in young adults," says Elizabeth Goodman, MD, of the MGHfC Division of General Academic Pediatrics, senior author on the paper. "But the relationship between higher SES and reduced depression is not consistent for black individuals, and our key finding helps explain this inconsistency. For black youth, we found that higher parental education is a double-edged sword, buffering against the development of depression but also leading to increased discrimination, which in and of itself causes depression. Overall, the protective effects of high parent education are zeroed out by the negative effects of increased discrimination experienced because of that high socioeconomic status."

The investigators examined data from the Princeton School District study, a nine-year study led by Goodman, which enrolled a biracial group of 5th to 12th graders from a Midwestern suburban school system in the 2001-2002 school year. The current study analyzed information from 545 participants who were followed into young adulthood, when they were from 21 to 25 years old, and were surveyed about both perceived lifetime ethnic discrimination and recent depressive symptoms using well validated measures of both.

Among the 296 participants who identified themselves as non-Hispanic white, perceptions of lifetime discrimination steadily decreased as levels of parental education increased. But among the 249 participants identifying themselves as non-Hispanic black - who reported more lifetime discrimination overall - the relationship between education and discrimination was more complex. While black participants whose parents had a high school education or less experienced more discrimination than those from families in which a parent had some college or vocational training, those whose parents had advanced or professional degrees reported the greatest perceived discrimination of all - almost twice as high as white young adults from similarly educated families and 1.2 times higher than black participants whose parents had a high school education or less.

"Among all participants, whether black or white, we found that, the more discrimination young adults reported feeling, the more likely they were to report symptoms of depression," says study lead author Erika Cheng, PhD, MPA, MGHfC Center for Child and Adolescent Health Research and Policy. "Taken together, our findings suggests that high socioeconomic status black young adults - who typically might not be thought of as being at increased risk for discrimination and depression - are actually at risk for both."

While the study did not examine why black young adults from highly educated families had greater perceived lifetime discrimination, Goodman notes some possible factors. "In this country, racial and ethnic minorities are more likely to have lower socioeconomic status, so being a black youth from a highly educated family is less common than being a white youth from a highly educated family. These upper-SES black youth likely live in upper-SES, predominantly white communities where they may be made to feel out of place. That's discrimination, and if you talk to young people, black youth consistently report frequent experiences of discrimination - from being followed around in a store to being targeted by police - regardless of their socioeconomic status."

She adds, "As a country, we have long pushed to eliminate educational disparities between black and white youth, but we are just now beginning to dialog about the critically important issue of how race and socioeconomic status intersect. Our study suggests that, even if we do eliminate educational disparities, black youth will not reap the same health benefits as white youth until we confront these larger societal issues."
Goodman is a professor of Pediatrics, and Cheng a research fellow in Pediatrics at Harvard Medical School. The third author, Alyssa Cohen, is a medical student at the University of Rochester School of Medicine and Dentistry, who spent a summer with Goodman as an NIH-sponsored summer research intern at MGHfC. The Princeton School District study was sponsored by National Institutes of Health grants HD041527, DK59183, and William T. Grant Foundation grant 2151. Cheng's work was supported by NIH grant T32-HD075727, and Cohen was sponsored by NIH grant T35-HD07446.

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $785 million and major research centers in HIV/AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, reproductive biology, systems biology, transplantation biology and photomedicine.

Massachusetts General Hospital

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