Low-Income Black Women With Hypertension Show Signs of Depression, Study Shows

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Key Takeaways

  • Black women with lower incomes and hypertension may be more likely to struggle with depression, a new study shows.
  • Several factors contribute to these correlations, and more holistic care is needed to address these issues.

There have been many studies addressing the prevalence of chronic disease within the Black community. Additional research examines the rates of mental health complications such as depression and anxiety within communities of color. A recent study published in JAMA Psychiatry aimed to focus on how the two intersect.

This secondary analysis of a clinical trial housed within Washington D.C.’s Prime Time Sister Circles intervention found that both socioeconomic status (SES) and heart health may be connected to depression in middle-aged Black women.

What Did the Study Show?

This study focused on 316 Black women between the ages of 40-75 who had been diagnosed with hypertension. For the purposes of this study, high blood pressure is defined as ~140 mmHg systolic or ~ 90 mmHg diastolic.

The results of this study showed that 57% of low-SES Black women with hypertension also had depression. The women with higher levels of depressive symptoms were less likely to have a postsecondary education and more likely to smoke cigarettes and have additional chronic conditions.

Krystal Jagoo MSW/RSW

Findings [like this study] highlight why intersectional approaches are needed to combat oppression, as we know that African American households often continue to reside in food deserts as they survive the long-term impacts of redlining, which have ensured an ever-growing racialized wealth gap in the U.S.

— Krystal Jagoo MSW/RSW

Racial Disparities

In order to assess the reasoning for the racial disparity within these correlations, it is imperative to consider the effect that both economic insecurity and discrimination-based trauma can have on an individual’s health.

Studies have shown that trauma has a very tangible link to physical symptoms, including the prevalence of chronic diseases, and data support discrimination serving as trauma for marginalized communities, whether or not it is chronic.

Krystal Jagoo, MSW/RSW, says, "This research only serves to confirm what the most oppressed folks probably already know from lived experience, i.e. that there are physical and mental health repercussions to surviving the generational impacts of poverty, white supremacy, sexism, etc. The results of this study align with other research that demonstrates how the chronic stress of oppression disproportionately harms BIPOC folks."

For the situations where the trauma is recurrent and an individual is forced to live in a state of hypervigilance, there is an increased chance of developing chronic conditions due to the high levels of cortisol present for a duration of time throughout the body.

In terms of economic impact, the concept of a food desert highlights the very stratified availability of fresh and healthy food choices in urban and rural areas. Jagoo says, "Findings [like this study] highlight why intersectional approaches are needed to combat oppression, as we know that African American households often continue to reside in food deserts as they survive the long-term impacts of redlining, which have ensured an ever growing racialized wealth gap in the U.S."

Additionally, because of the ever-changing job market, securing employment that pays a living wage is extremely difficult for individuals with less education. This difficulty leads to either a lack of health insurance coverage, difficulty making it to appointments due to transportation or childcare, or stress around payment premiums, copays, deductibles, or medication. All of these factors contribute to the difficulty of diagnosis and mismanagement of hypertension within the Black community, including:

  • Substandard insurance coverage
  • Poor access to health care
  • Lower rates of medication adherence
  • Potential differences in the disease process
  • Differences in blood pressure control

A More Holistic Approach

The importance of this data is two-fold. First, physicians must recognize the psychological risks associated with physical conditions such as hypertension and make recommendations for mental health services when appropriate.

Conversely, mental health practitioners must be thorough regarding an individual's health history and primary care situation to better treat the whole person. If gone untreated, hypertension can cause serious issues such as:

  • Heart attack or stroke
  • Aneurysm
  • Heart failure
  • Metabolic syndrome
  • Weakened blood vessels in kidneys
  • Vision issues

What This Means For You

For Black women who navigate either hypertension or depression, these findings support the importance of managing them all adequately and advocating for what you need. If you are in need of assistance securing medical insurance or care, there are several options (state-based and otherwise) to help you get what you need.

It is imperative that all aspects of your health are addressed and not ignored, as the correlation between physical and mental health conditions can have lasting effects on your overall wellness.

5 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gabriel A, Zare H, Jones W, et al. Evaluating depressive symptoms among low-socioeconomic-status African American women aged 40 to 75 years with uncontrolled hypertension: a secondary analysis of a randomized clinical trialJAMA Psychiatry. 2021. doi:10.1001/jamapsychiatry.2020.4622

  2. Trent M, Dooley DG, Douge J. The impact of racism on child and adolescent health. Pediatrics. 2019;144(2):e20191765. doi:10.1542/peds.2019-1765

  3. Suarez JJ, Isakova T, Anderson CAM, Boulware LE, Wolf M, Scialla JJ. Food access, chronic kidney disease, and hypertension in the U.S. Am J Prev Med. 2015;49(6):912-920. doi:10.1016/j.amepre.2015.07.017

  4. Ferdinand KC, Yadav K, Nasser SA, et al. Disparities in hypertension and cardiovascular disease in blacks: the critical role of medication adherence. J Clin Hypertens. 2017;19(10):1015-24. doi:10.1111/jch.13089

  5. American Heart Association. Health threats from high blood pressure.