Why do African American elders consistently report lower rates of depression than White elders although they have poorer health and higher rates of chronic illness?

Research from the past 15 years has consistently shown health disparities between Whites and minorities in the United States. African Americans in particular are at higher risk than Caucasians for serious health conditions such as stroke, diabetes, cancer, cardiovascular disease and mild cognitive impairment. These chronic conditions typically contribute to depression in elders as a whole group, but for African American elders the rates of depression are much lower than their White counterparts.

This discrepancy in depression rates is the basis for a newly funded project at Thomas Jefferson University's Center for Applied Research on Aging and Health (CARAH). The National Institute of Mental Health awarded a five-year, $2.2 million grant to CARAH and Center in the Park (CIP), a nationally accredited community senior center in the Philadelphia region which has received numerous awards for its innovative programming. CARAH and CIP have previously collaborated on a research program to improve chronic disease self-management in older African Americans. This newly funded project, In Touch: Mind, Body and Spirit, is a collaborative partnership that will explore perspectives on health and well-being among a population of African American elders. In the process, the partners aim to create a sustainable infrastructure for systematic mental health research and health professional training.

To explore why older African Americans have lower rates of depression than Whites of the same age group, CARAH will interview CIP clients with a range of physical and functional difficulties to find out about their lifestyles, health habits and quality of life. Located in the Germantown section of Philadelphia, CIP serves more than 6,000 community-living urban elders, the majority of whom is African American.

“We want to change the landscape of mental health research and care for African American elders,” explains Laura N. Gitlin, PhD, the director of CARAH and principal investigator of the project. “With this project we hope to advance clinical research that examines the relationship between depression and physical disability and to identify effective and innovative approaches to promote positive aging and mental health in African American older adults.”

One of the first activities of the grant will involve developing an electronic membership database at CIP to track the health and well-being of CIP clients. CARAH researchers will interview CIP clients about topics such as their mood, health status or perceived benefits of specific CIP programs. CIP will use this information to evaluate health trends among its membership, identify those at risk, and tailor programming. Additionally, CARAH will implement three different research projects which collectively examine the adaptive coping styles of African American elders, mental health treatment preferences, and test innovative interventions that promote positive aging.

Based on the research, CARAH will be able to recommend new activities for the Center to offer its clients. “We plan to develop and test mental health interventions that are far-reaching, creative, and that impact the immediate community,” explains Dr. Gitlin. “Additionally, we plan to develop training opportunities for health professionals in community-based clinical mental health research.” In addition to traditional mental health activities like counseling, researchers will incorporate new ideas from recent literature, as well as more far-reaching methods such as creative arts and travel.

“This partnership is important to CIP for several reasons,” shares Lynn Fields Harris, executive director of Center in the Park. “It provides the opportunity to do important research in an area that has been largely overlooked in our community, while building upon our previous successes in implementing evidence-based programs and demonstrating with hard facts and figures the positive outcomes of doing this type of work in a community-based setting.”

Previous collaborations with CARAH have already had a big impact on CIP. This new project is expected to do the same. “Working with CARAH has increased our awareness and reinforced our commitment to addressing the importance and relevance of underpinning the services and programs that the Center provides with interventions that look at serious emotional, physiological and social issues which have historically and disproportionately affected older adults in the community we serve,” Ms. Harris says.

Another component of the In Touch project is research training opportunities for health professionals from a variety of fields. By working together to design collaborative-based clinical research, health professionals—including geriatric fellows and students in medicine, nursing, occupational therapy, and physical therapy—will identify culturally relevant research questions, carry out clinical research and translate their findings into evidence-based programs for the target group.

“This project is multi-faceted,” says Dr. Gitlin. “As we conduct this research and share our findings over the next five years, we will be advancing our general knowledge about best models for developing living laboratories or research infrastructures with community settings and learning how we can positively impact the mental health of elderly African Americans. The results will have an impact beyond our partnership. That's very exciting.”

For more information as In Touch: Mind, Body and Spirit progresses, please refer to CARAH's website.

CONTACT: Jane A. Clinton, 215-503-9865

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