Abstract 142: Latino Stroke Survivors More Likely to Experience Depression
Background: Literature suggests that White Americans experience more depression in general, and post-stroke depression than non-White Americans, but depression disparities have not been well-explored. We aimed to characterize this association by applying a novel ‘Rank and Match’ secondary analytic method, based on the Institute of Medicine’s disparity framework to a multi-racial/ethnic stroke cohort.
Methods: We recruited a cohort of community-dwelling adults who had a stroke in the past 5 years, from Harlem and the South Bronx in New York City, to a recurrent stroke prevention intervention. At baseline, we measured depression using the PHQ-8 scale and patients’ health status, demographics, comorbidities and socioeconomic status (SES), including income and education. We used multivariate logistic regression to evaluate the impact of race/ethnicity, after adjusting for health status and SES, on having depression (using a score ≥ 10 as depressed). Then based on the IOM’s disparity framework, we used our "Rank and Match" method to assess racial/ethnic differences in depression after matching Latinos and non-Latinos by their health status rank.
Results: The cohort included 600 participants, with a mean of 1.9 years after stroke, mean age of 63 years, 42% were Black, 39% Latino, 60% female, 56% lived below poverty, 29% had Medicaid and 31% had less than a high school degree. Participants with depression (n=178; 30%) were more likely young (p=0.002), Latino (p<0.0001), receiving Medicaid (p<0.001), and had more comorbidities (p=0.004) than non-depressed participants. The adjusted odds of depression for Latinos was 3.45 (95% CI: 1.48 - 8.07) times higher than for Whites and 2.22 (95% CI: 1.45 - 3.38) times higher than for Blacks. After applying the “Rank and Match” method, the difference between Latinos and Whites became stronger (OR=4.65; 95% CI: 1.91 - 11.30), and the difference between Latinos and Blacks sustained (OR=2.19; 95% CI: 1.41 - 3.40).
Conclusion: This study newly reveals a high depression burden among Latino stroke survivors, particularly in comparison with non-Latinos. Future research is needed to further study this disparity, and to address depression in this population.
- © 2012 by American Heart Association, Inc.