For Black women, more education and social support may not offset mental health impact of early life disadvantage

October 27, 2023

By Amma Agyemang-Duah, Gillings School Communications Fellow

Studies have shown that people who are exposed to more early life disadvantages are more likely to report higher depressive symptoms in adulthood. Black adults are particularly at risk of high depressive symptoms because they have a greater likelihood of experiencing socio-economic disadvantages in childhood than any other racial or ethnic group in the United States.

Research shows that increases in education and social support in adulthood lead to a decreased risk of high depressive symptoms for people with early life disadvantages. However, this may not be the case for Black women, according to researchers at the UNC Gillings School of Public Health.

A recent study led by Gillings School epidemiologists found that, for Black women living in Detroit, Michigan, those who experienced high levels of disadvantage early in life (also known as “high early life disadvantage”) but had higher levels of educational or social support were at the highest risk of depression. Those disadvantages could go beyond finances and include things like food insecurity, neighborhood safety, parental education and even access to a quiet room for sleeping.

Of the Black women in the study, those with high early life disadvantage who had at least some college education or who had high social support had a 37% increased risk of depression.

Anissa Vines

Dr. Anissa Vines

The study also found that Black women with more disadvantages early in life had a 34% higher risk of depression regardless of education, financial or social support, which is consistent with results from previous studies.

“Ultimately, research on structural racism is needed to mitigate early life disadvantage and its impact on health in later life,” said Anissa I. Vines, MS, PhD, associate professor of epidemiology.

Dr. Chantel Martin

Dr. Chantel Martin

The study, published in the Journal of Racial and Ethnic Disparities, was led by Vines and Chantel Martin, PhD, assistant professor of epidemiology and co-authored by Lea Ghastine, former 2021 intrahealth-UNC Summer fellow. Additional co-authors include Ganesa Wegienka, PhD, a Gillings epidemiology alum from the Henry Ford Health System; Lauren A. Wise, ScD, professor of epidemiology at Boston University School of Public Health; and Donna D. Baird, PhD, senior epidemiology investigator at the National Institute for Environmental Health Sciences and adjunct epidemiology professor at the Gillings School.

 The researchers used data from the Study of Environment Lifestyle and Fibroids (SELF), which was collected from 2010 to 2012 from Black women ages 23 to 34. Participants answered questions regarding their home life growing up: if they had a quiet room to sleep in, enough food to eat, lived in a safe neighborhood and various other questions regarding their socioeconomic status. The answers to these questions allowed researchers to categorize participants into those who experienced higher levels of early life disadvantage and those who experienced lower levels. In a follow-up visit, participants’ depressive symptoms were assessed using a modified version of the Center for Epidemiologic Studies-Depression Scale (CES-D).

Participants also answered questions about their current level of education, social support and income. Researchers predicted that these adult social factors would act as mitigating factors for the participants’ depressive symptoms, but results showed that they did not.

The results of the study draw attention to potential stressors for Black women who have gained more education.

The researchers say in the study that, “For Black adults, higher education is often met with exposure to racial microaggressions that are psychologically and physiologically taxing. Additionally, Black women experience compounding forms of oppression being a woman and person of color.”

The Strong Black Woman/Superwoman Schema also contributes to these stressors, according to the study, by making Black women feel like persevering through struggle alone is not only expected of them but an innate ability they must utilize. This makes it difficult for some Black women to seek help when necessary. While Black women may have high social support, buying into the strong Black women schema could potentially inhibit them from utilizing this social support. Negative stereotypes about Black women also prevent some from speaking out against injustices out of worry of how they will be perceived by colleagues and how this may affect their future.

“Interventions that offer coping skills to Black women, especially those with higher education, could reduce the risk of depressive symptoms,” said Vines. “The findings from this study inform ongoing research seeking to understand the role of stress in uterine fibroid incidence and growth.”

Read the full study online.

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