This secondary analysis of a clinical trial housed within Washington D.C.’s Prime Time Sister Circles intervention found that both socioeconomic status (SES) and heart health may be connected to depression in middle-aged Black women.
What Did the Study Show?
This study focused on 316 Black women between the ages of 40-75 who had been diagnosed with hypertension. For the purposes of this study, high blood pressure is defined as ~140 mmHg systolic or ~ 90 mmHg diastolic. The results of this study showed that 57% of low-SES Black women with hypertension also had depression. The women with higher levels of depressive symptoms were less likely to have a postsecondary education and more likely to smoke cigarettes and have additional chronic conditions.
Racial Disparities
In order to assess the reasoning for the racial disparity within these correlations, it is imperative to consider the effect that both economic insecurity and discrimination-based trauma can have on an individual’s health. Studies have shown that trauma has a very tangible link to physical symptoms, including the prevalence of chronic diseases, and data support discrimination serving as trauma for marginalized communities, whether or not it is chronic. Krystal Jagoo, MSW/RSW, says, “This research only serves to confirm what the most oppressed folks probably already know from lived experience, i.e. that there are physical and mental health repercussions to surviving the generational impacts of poverty, white supremacy, sexism, etc. The results of this study align with other research that demonstrates how the chronic stress of oppression disproportionately harms BIPOC folks.” For the situations where the trauma is recurrent and an individual is forced to live in a state of hypervigilance, there is an increased chance of developing chronic conditions due to the high levels of cortisol present for a duration of time throughout the body. In terms of economic impact, the concept of a food desert highlights the very stratified availability of fresh and healthy food choices in urban and rural areas. Jagoo says, “Findings [like this study] highlight why intersectional approaches are needed to combat oppression, as we know that African American households often continue to reside in food deserts as they survive the long-term impacts of redlining, which have ensured an ever growing racialized wealth gap in the U.S.” Additionally, because of the ever-changing job market, securing employment that pays a living wage is extremely difficult for individuals with less education. This difficulty leads to either a lack of health insurance coverage, difficulty making it to appointments due to transportation or childcare, or stress around payment premiums, copays, deductibles, or medication. All of these factors contribute to the difficulty of diagnosis and mismanagement of hypertension within the Black community, including:
Substandard insurance coveragePoor access to health careLower rates of medication adherencePotential differences in the disease processDifferences in blood pressure control
A More Holistic Approach
The importance of this data is two-fold. First, physicians must recognize the psychological risks associated with physical conditions such as hypertension and make recommendations for mental health services when appropriate. Conversely, mental health practitioners must be thorough regarding an individual’s health history and primary care situation to better treat the whole person. If gone untreated, hypertension can cause serious issues such as:
Heart attack or strokeAneurysmHeart failureMetabolic syndromeWeakened blood vessels in kidneysVision issues
It is imperative that all aspects of your health are addressed and not ignored, as the correlation between physical and mental health conditions can have lasting effects on your overall wellness.
