Feature

Several large national studies have long indicated that although African Americans are at greater risk for many health problems than whites, and despite large and unfavorable disparities in access to and utilization of high-quality mental health services, the prevalence of certain mental health disorders--including major depression, panic disorder, social phobia, agoraphobia, generalized anxiety disorder and chronic mild depression--is no greater among African Americans than among whites.

What accounts for this perplexing pattern? University of Michigan psychologist James S. Jackson, PhD, speculates that the answer may rest in black Americans' strategies for coping with discrimination, racism and social inequality. He suggests that such coping strategies--"self-medicating" efforts such as drinking, smoking and eating "comfort foods"--may be effective in preserving black mental health, but may contribute, along with social inequalities, to health disparities.

Now, a major national study of health disparities--the largest to date--may bolster support for Jackson's notion. The National Survey of American Life, directed by Jackson and colleagues at the University of Michigan, will measure white and minority participants' physical and mental health problems, psychological resources, health-care service utilization, religion, employment and economic circumstances, ethnic and personal identity, and neighborhood and family structures.

The survey, expected to be completed this summer, will enable researchers to "understand the nature of African-American mental health at the beginning of the 21st century, and to do it in a way that will allow us to look at the heterogeneity among the African-American population," says Jackson.

Funded by the National Institute of Mental Health, the survey will include a nationally representative sample of 7,000 African-American, Afro-Caribbean and non-Hispanic white adults. In addition, 1,500 African-American and Afro-Caribbean adolescents ages 13 to 17 will participate, and their data will be linked with parent data from the main study, allowing researchers to examine intergenerational factors that may shape young people's ethnic identities and responses to discrimination, indirectly influencing physical and mental health.

The national survey is the first to separately examine African Americans and Afro-Caribbeans--groups that often fare differently in health and achievement but are commonly lumped together in research. The study follows up on the smaller National Survey of Black Americans, completed in 1980. That study, which Jackson also directed, demonstrated that understanding and eliminating health disparities will require deeper knowledge of the diversity of American minorities' experiences.

"It's impossible to understand what good psychological health means if we don't understand the economic, social, biological and physical context in which people live," Jackson argued, speaking in a lecture at the National Institutes of Health on Jan. 23.

Toward that end, the survey is closely coordinated with several other large national and international studies. Together, the studies will address health and mental health questions within and across different ethnic groups and will examine the intergenerational factors that affect physical and mental health.