"You don't go tell white people nothing": African American women's perspectives on the influence of violence and race on depression and depression care

Christina Nicolaidis, Vanessa Tlmmons, Mary Jo Thomas, A. Star Waters, Stephanie Wahab, Angle Mejia, S. Renee Mitchell

Research output: Contribution to journalArticle

74 Scopus citations

Abstract

Objectives. We sought to understand how African American women's beliefs regarding depression and depression care are influenced by racism, violence, and social context. Methods. We conducted a focus group study using a community-based participatory research approach. Participants were low-income African American women with major depressive disorder and histories of violence victimization. Results. Thirty women participated in 4 focus groups. Although women described a vicious cycle of violence, depression, and substance abuse that affected their health, discussions about health care revolved around their perception of racism, with a deep mistrust of the health care system as a "White" system. The image of the "strong Black woman" was seen as a barrier to both recognizing depression and seeking care. Women wanted a community-based depression program staffed by African Americans that addressed violence and drug use. Conclusions. Although violence and drug use were central to our participants' understanding of depression, racism was the predominant issue influencing their views on depression care. Providers should develop a greater appreciation of the effects of racism on depression care. Depression care programs should address issues of violence, substance use, and racism.

Original languageEnglish (US)
Pages (from-to)1470-1476
Number of pages7
JournalAmerican journal of public health
Volume100
Issue number8
DOIs
StatePublished - Aug 1 2010

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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