Puerto Rican depression rates can be alarming

It’s no longer practical to group Hispanics under one umbrella term when it comes to health care. Research has continually demonstrated that Hispanic subgroups vary significantly in regards to disease rates, some featuring better numbers compared to non-Hispanic whites while other have far worse statistics.

Anxiety and depression are no exception to this rule. According to the latest data released from Albert Einstein College of Medicine of Yeshiva University and the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), depressive/anxiety symptom rates among Hispanic subgroups ranged from 22.3 percent (Mexican Americans) to 38 percent (Puerto Ricans).

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“Various studies have looked at the mental health of Hispanics and Latinos, but most have focused on people of Mexican background or looked only at broad groupings of nationalities,” said lead author Sylvia Wassertheil-Smoller, Ph.D, said in a press release. “Our study has found that mental health problems differ among the various groups comprising this population, suggesting that healthcare workers should look more closely at subgroups of Hispanics and Latinos to deliver appropriate mental health services.”

Overall, Hispanics in the study, which included 16,000 Cubans, Puerto Ricans, Mexicans, Dominicans, and Central and South Americans, had a rate of depressive symptoms at 27 percent.

Despite this high incident rate, only 5 percent of the study sample used antidepressants, with insurance status playing the most important role in whether or not someone was taking appropriate medication. The data indicated 8.2 percent of insured people used antidepressants vs. 1.8 percent of uninsured, two numbers still considered low when compared to numbers among non-Hispanic whites.

In 2011, the years from which the most recent data on non-Hispanic whites is available, Psych Central reported on research indicating 14 percent of non-Hispanic whites in the United States took antidepressant medication. Compared to 20 years ago, that’s a 400 percent increase for that particular medication usage.

Anxiety medication usage among Hispanic subgroups was even lower at 2.5 percent, with the group utilizing such treatments the most being those with cardiovascular disease. Anti-anxiety medications were used by 20.3 percent of people who had suffered strokes; 19.5 percent of people who had undergone revascularization procedures such as coronary artery bypass graft surgery; and 14.4 percent of people who’d had heart attacks.

“This is a significant concern, as it suggests that depression and anxiety may not be adequately treated in the Hispanic/Latino community,” said Dr. Wassertheil-Smoller. “The main message of this study is that physicians need to pay more attention to depression and anxiety among Hispanics and Latinos. Our findings also have important implications for managing cardiovascular disease. When patients already have cardiovascular disease, we know that being depressed worsens their prognosis.”

Other important findings of the study included:

• Individuals ages 45 to 64 were 21 percent more likely to have symptoms of depression compared to individuals ages 25 to 44.
• Women were two-times as likely as men to experience high levels of depressive symptoms.
• First-and second-generation Hispanics were had significantly more symptoms of depression than foreign-born Hispanics.
• A history of cardiovascular disease (heart attack, stroke, or revascularization/stenting) increased the likelihood of depression by 77 percent.
• The higher the number of cardiovascular risk factors, the greater the likelihood that a person was depressed.
• Anxiety prevalence followed a pattern similar to depression.

“The findings presented here are from the largest, most comprehensive study to date of the mental health of Hispanics/Latinos of different national backgrounds,” wrote researchers in conclusion of their study. “The results show that certain background groups have considerably higher rates of depression and anxiety than those of Mexican background, which is the group most studied.”

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They added that prevalence of depression and anxiety varies with age, sex, time residing in the U.S., and presence of cardiovascular risk factors or history of cardiovascular events. The relatively lower rate of use of antidepressant medications may represent under treatment, particularly among Hispanic subgroups with no insurance. Although genetic and environmental factors could be linked to depression and anxiety, chronic health issues and socioeconomic stressors are also likely aggravating factors.

Increasing awareness and reducing the burden that undiagnosed or untreated depression and anxiety cause to health of Hispanics and the U.S. population must be part of the national public health agenda.