Chronic Medical Conditions and Major Depressive Disorder: Differential Role of Positive Religious Coping among African Americans, Caribbean Blacks and Non‑Hispanic Whites

Shervin Assari


Background: This study was aimed to investigate the main and buffering effects of positive religious coping on the association between the number of chronic medical conditions and major depressive disorder (MDD) among African Americans, Caribbean Blacks and Non‑Hispanic Whites.

Methods: This cross‑sectional study used data from the National Survey of American Life, 2001 and 2003. This study enrolled 3,570 African Americans, 1,438 Caribbean Blacks and 891 Non‑Hispanic Whites. Number of chronic conditions and positive religious coping were independent variables, 12‑month MDD was the outcome and socio‑economic characteristics were controls. We fitted the following three ethnic‑specific logistic regressions for data analysis. In Model I, we included the number of chronic conditions and controls. In Model II, we added the main effect of religious coping. In Model III, we included an interaction between religious coping and number of chronic conditions.

Results: Based on Model I, number of chronic conditions was
associated with higher odds of 12‑month MDD among all race/ethnic groups. Model II showed a significant and negative association between religious coping and MDD among Caribbean Blacks (odds ratio [OR] =0.55, 95% confidence Interval [CI] =0.39‑0.77), but not African Americans or Hispanic Whites. Model III suggested that, only among Caribbean Blacks, the effect of chronic medical conditions on MDD is smaller in the presence of high positive religious coping (OR for interaction = 0.73, 95% CI = 0.55‑0.96).

Conclusions: Although the association between multiple chronic conditions and MDD may exist regardless of race and ethnicity, race/ethnicity may shape how positive religious coping buffers this association. This finding sheds more light onto race and ethnic differences in protective effects of religiosity on mental health of populations.

Keywords: African Americans, Caribbean Blacks, chronic medical conditions, ethnicity, major depressive disorder, Non‑Hispanic Whites, positive religious coping

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