HISTORICAL AND INTERGENERATIONAL TRAUMA DRIVERS

Structural racism is evidenced by limited access to opportunities through macrolevel systems, including health care, criminal justice, housing, education, employment, and income. A focus on structural racism lends itself to an analysis of how policies and systems affect specific groups and suggests topics on which to intervene ( 9, 25). It is vital to note that structural racism as defined by Alvidrez and Tabor affects many populations (e.g., LGBTQ populations, American Indians, Latinx, women, and people with low income). In light of the profoundly different experiences of African Americans who are depressed (i.e., more persistent course of illness and greater disability) ( 2), it is critical to examine whether intergenerational transmission of depression due to structural racism is an emerging explanation for some of these differences.įor this review, we adopted Alvidrez and Tabor’s ( 24) recent definition of structural racism: “Macro-level societal conditions that limit opportunities, resources, and well-being of less privileged groups on the basis of race/ethnicity and/or other statuses, including but not limited to, gender identity, sexual orientation, disability status, social class or socioeconomic status (SES), religion, geographic residence, national origin, immigration status, limited English proficiency, physical characteristics, or health conditions.” We propose that understanding risk factors for depression, particularly its intergenerational reach, requires accounting for structural racism that is routinely experienced by racially and ethnically minoritized individuals ( 23).

HISTORICAL AND INTERGENERATIONAL TRAUMA DRIVERS

The purpose of this review is to conceptualize how structural racism and cumulative trauma can be fundamental drivers of the intergenerational transmission of depression.

Although researchers have described how social determinants affect depression along the life course ( 22), little attention has been paid to how structural racism and its consequences may contribute to the intergenerational transmission of depression. Similar to those among adults, factors associated with the increase in depressive sequelae among African American youths are multifactorial ( 18– 21). Further, the suicide death rate among Black children ages 5–12 years is increasing faster than among any other racial/ethnic group in the United States ( 16, 17). high school students found that from 1991 to 2017 African American adolescents experienced a 73% increase in suicide attempts, while the suicide attempt rate decreased 9% among White youths during the same period ( 15). A study with a nationally representative sample of U.S. Other contributors to this treatment gap include underdetection by providers ( 10), unreliable medical systems ( 11), and treatment settings perceived as punitive and inaccessible ( 12– 14).įrequency of suicidal thoughts and behaviors, which are often associated with depression, is increasing among African American youths. These inequities are increasingly linked to social, economic, and environmental determinants such as low income, underresourced educational opportunities, inadequate housing, and lack of access to quality mental health treatment ( 6– 9). In sum, the burden of depression appears to be higher among African Americans compared with White Americans ( 2).Īfrican American adults are less likely to receive depression treatment than are their White counterparts ( 4, 5). For example, African American adults with depression rate their symptoms as more severe, have a longer course of illness, and experience greater disability ( 2, 3). In light of the profoundly different experiences of African Americans who experience depression (i.e., a more persistent course of illness and greater disability), it is critical to examine whether an emerging explanation for some of these differences is the intergenerational transmission of this disorder due to structural racism.ĭepression among individuals who have been racially and ethnically minoritized in the United States can be vastly different from that seen in White Americans ( 1). The authors propose that understanding risk factors for depression, particularly its intergenerational reach, requires accounting for structural racism. The purpose of this review was to conceptualize how structural racism and cumulative trauma can be fundamental drivers of the intergenerational transmission of depression.

For example, African American adults who have depression rate their symptoms as more severe, have a longer course of illness, and experience more depression-associated disability.

Depression among individuals who have been racially and ethnically minoritized in the United States can be vastly different from that of non-Hispanic White Americans.

Historical and intergenerational trauma