Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women
Abstract
:1. Introduction
Aims
2. Methods
2.1. Design and Setting
2.2. Institutional Review Board (IRB)
2.3. Process and Data Collection
2.4. Participants
2.5. Measures
2.5.1. Dependent Variable
2.5.2. Mediator
2.5.3. Independent Variable
2.5.4. Confounders
2.5.5. Moderator
2.6. Statistical Analysis
3. Results
3.1. Descriptive Statistics
3.2. Bivariate Correlations
3.3. Structural Equation Modeling (SEM) in the Pooled Sample
3.4. Structural Equation Modeling (SEM) in African American (AA) Men
3.5. Structural Equation Modeling (SEM) in African American (AA) Women
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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All n = 740 | African American Men n = 262 | African American Women n = 474 | ||||
---|---|---|---|---|---|---|
Mean | SD | Mean | SD | Mean | SD | |
Age * | 71.73 | 8.37 | 70.79 | 8.32 | 72.26 | 8.36 |
Educational Attainment * | 12.74 | 2.24 | 12.42 | 2.51 | 12.93 | 2.06 |
Number of CMCs (Multimorbidity) * | 3.86 | 1.86 | 3.58 | 1.88 | 4.03 | 1.83 |
Depression | 2.47 | 2.77 | 2.53 | 2.76 | 2.43 | 2.79 |
Self-Rated Health (SRH) | 3.13 | 1.02 | 3.12 | 1.09 | 3.14 | 0.97 |
n | % | n | % | n | % | |
Married * | ||||||
No | 640 | 86.5 | 215 | 80.8 | 425 | 89.7 |
Yes | 100 | 13.5 | 51 | 19.2 | 49 | 10.3 |
Living Alone * | ||||||
No | 294 | 39.7 | 121 | 45.5 | 173 | 36.5 |
Yes | 446 | 60.3 | 145 | 54.5 | 301 | 63.5 |
Characteristics | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
---|---|---|---|---|---|---|---|---|
All | ||||||||
1 Gender (Female) | 1 | 0.08 * | 0.11 ** | −0.12 ** | 0.09 * | 0.12 ** | −0.02 | 0.01 |
2 Age | −0.18 ** | −0.00 | 0.06 | −0.02 | −0.25 ** | −0.22 ** | ||
3 Education | 1 | 0.06 | −0.04 | −0.09 * | −0.07 | −0.03 | ||
4 Married | 1 | −0.41 ** | −0.02 | −0.07 | −0.08 * | |||
5 Living alone | 1 | 0.09 * | 0.12 ** | 0.08 * | ||||
6 Number of CMCs (Multimorbidity) | 1 | 0.32 ** | 0.27 ** | |||||
7 Depression | 1 | 0.37 ** | ||||||
8 Self-Rated Health (SRH) | 1 | |||||||
AA Men | ||||||||
2 Age | 1 | −0.25 ** | 0.01 | −0.04 | −0.06 | −0.23 ** | −0.28 ** | |
3 Education | 1 | 0.16 ** | −0.10 | −0.07 | −0.06 | −0.04 | ||
4 Married | 1 | −0.48 ** | −0.03 | −0.10 | −0.11 | |||
5 Living alone | 1 | 0.10 | 0.15 * | 0.12 | ||||
6 Number of CMCs (Multimorbidity) | 1 | 0.38 ** | 0.19 ** | |||||
7 Depression | 1 | 0.30 ** | ||||||
8 Self-Rated Health (SRH) | ||||||||
AA Women | ||||||||
2 Age | 1 | −0.16 ** | 0.00 | 0.10 * | −0.01 | −0.27 ** | −0.19 ** | |
3 Education | 0.01 | −0.02 | −0.12 ** | −0.07 | −0.03 | |||
4 Married | 1 | −0.35 ** | 0.02 | −0.05 | −0.06 | |||
5 Living alone | 1 | 0.06 | 0.11 * | 0.05 | ||||
6 Number of CMCs (Multimorbidity) | 1 | 0.29 ** | 0.32 ** | |||||
7 Depression | 1 | 0.41 ** | ||||||
8 Self-Rated Health (SRH) | 1 |
Characteristics | Estimate (S.E.) | p |
---|---|---|
→ Depression | ||
Gender (female) | −0.19 (0.20) | 0.340 |
Marital status (married) | −0.17 (0.30) | 0.559 |
Number of CMCs (multimorbidity) | 0.45 (0.05) | <0.001 |
Living alone | 0.57 (0.21) | 0.006 |
Age | −0.09 (0.01) | <0.001 |
Education | −0.10 (0.04) | 0.022 |
→ Self-Rated Health (SRH) | ||
Gender (female) | 0.02 (0.07) | 0.795 |
Age | −0.02 (0.00) | <0.001 |
Number of CMCs (multimorbidity) | 0.10 (0.02) | <0.001 |
Depression | 0.10 (0.01) | <0.001 |
Characteristics | Estimate (S.E.) | p | Estimate (S.E.) | p |
---|---|---|---|---|
Men | Women | |||
→ Depression | ||||
Marital status (married) | −0.25 (0.44) | 0.571 | −0.13 (0.41) | 0.752 |
Number of CMCs (multimorbidity) | 0.51 (0.08) | <0.001 | 0.41 (0.06) | <0.001 |
Living alone | 0.45 (0.35) | 0.193 | 0.65 (0.26) | 0.012 |
Age | −0.07 (0.02) | <0.001 | −0.10 (0.01) | <0.001 |
→ Self-Rated Health (SRH) | ||||
Education | −0.09 (0.06) | 0.162 | −0.10 (0.06) | 0.078 |
Age | −0.03 (0.01) | <0.001 | −0.01 (0.01) | 0.021 |
Number of CMCs (multimorbidity) | 0.06 (0.04) | 0.115 | 0.12 (0.02) | <0.001 |
Depression | 0.09 (0.03) | <0.001 | 0.11 (0.02) | <0.001 |
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Assari, S.; Smith, J.; Bazargan, M. Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women. Int. J. Environ. Res. Public Health 2019, 16, 1670. https://doi.org/10.3390/ijerph16101670
Assari S, Smith J, Bazargan M. Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women. International Journal of Environmental Research and Public Health. 2019; 16(10):1670. https://doi.org/10.3390/ijerph16101670
Chicago/Turabian StyleAssari, Shervin, James Smith, and Mohsen Bazargan. 2019. "Depression Fully Mediates the Effect of Multimorbidity on Self-Rated Health for Economically Disadvantaged African American Men but Not Women" International Journal of Environmental Research and Public Health 16, no. 10: 1670. https://doi.org/10.3390/ijerph16101670