title: Does depression and substance abuse co-morbidity affect socioeconomic status? Evidence from a prospective study of urban African Americans.
abstract: Studies have established a graded association between mental health and socioeconomic status (SES). However, scarce research has examined the impact of substance use disorders (SUD) and depression comorbidity on SES. We use data from the Woodlawn Study, a longitudinal cohort study, which recruited a cohort of first graders from Chicago starting 1966-1967 (N=1242). Analyses focus on those interviewed in young adulthood and followed up through midlife. Regression analyses adjusting for childhood confounders showed that young adults with depression and SUD comorbidity had higher likelihood of having any periods of unemployment, higher likelihood of being unemployed for 3 or more months, and lower household income in midlife than those with neither disorder. Moreover, young adults with SUD without depression had higher odds of having any periods of unemployment and higher odds of being unemployed for 3 or more months than those with neither disorder. Findings point to the possibility of social selection where depression and SUD comorbidity contributes to a downward drift in SES. Clinical interventions that integrate the treatment of SUD and depression may be more effective at reducing socioeconomic disparities among minority populations.
authors.affiliation: University of Maryland School of Public Health, Department of Health Services Administration, 3310B SPH Building, College Park, MD 20742, United States. Electronic address: rdagher1@umd.edu.
authors.forename: Rada K
authors.initials: RK
authors.lastname: Dagher
authors.affiliation: University of Maryland School of Public Health, Department of Behavioral and Community Health, 2375 SPH Building, College Park, MD 20742, United States. Electronic address: greenkm@umd.edu.
authors.forename: Kerry M
authors.initials: KM
authors.lastname: Green
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000818:Animals; D002641:Chicago / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D012923:Social Class; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology* / Q000523:psychology; D014478:Unemployment / Q000523:psychology / Q000706:statistics & numerical data; D014505:Urban Population; D055815:Young Adult
keywords: African American; Depression and substance use disorders; Longitudinal data; Psychiatric comorbidity; Social selection