Depressive symptoms and psychological distress among rural African Americans: The role of material hardship and self-rated health

Background: Despite experiencing conditions associated with higher risk for depression and psychological distress, the mental health of rural African Americans remains understudied. This brief report examines the association between sociodemographic characteristics, self-rated health, and material hardship, and depressive symptoms and psychological distress among rural African Americans. Method: Data are from the rural African American subsample (N = 250) of the National Survey of American Life (NSAL; 2001-2003). The Center for Epidemiological Studies-Depression Scale (CES-D) was used to assess depressive symptoms. Psychological distress was measured using the Kessler 6 (K6). Negative binominal regression analyses were performed. Results: Rural African Americans reporting more material hardship and poorer self-rated physical health had higher levels of depressive symptoms and psychological distress compared to counterparts with less hardship and better self-rated health. Findings also suggest rural African American women had more depressive symptoms compared to male peers. Older rural African Americans and African Americans with fewer years of education had more symptoms of psychological distress than their respective counterparts. Limitations: Though the NSAL represents the only national probability survey on African Americans' mental health; the timeliness of the data, collected between 2001 and 2003 is a limitation. Conclusions: Material hardship and worse self-rated health emerged as risk factors for depression and psychological distress among this population. This suggests the need for systems of care and integrated healthcare models across service providers within rural African American communities to promote adequate screening, intervention, and referrals related to economic, physical, and mental health needs.