Despite equivalent or lower lifetime and past-year prevalence of mental disorder among
racial/ethnic minorities compared to non-Latino Whites in the United States, evidence
suggests that mental disorders are more persistent among minorities than non-Latino
Whites. But, it is unclear how nativity and socioeconomic status contribute to observed
racial/ethnic differences in prevalence and persistence of mood, anxiety, and substance
disorders. Data were examined from a coordinated series of four national surveys that
together assessed 21,024 Asian, non-Latino Black, Latino, and non-Latino White adults
between 2001 and 2003. Common DSM-IV mood, anxiety, and substance disorders were assessed
using the Composite International Diagnostic Interview. Logistic regression analyses
examined how several predictors (e.g., race/ethnicity, nativity, education, income)
and the interactions between those predictors were associated with both 12-month disorder
prevalence and 12-month prevalence among lifetime cases. For the second series of
analyses, age of onset and time since onset were used as additional control variables
to indirectly estimate disorder persistence. Non-Latino Whites demonstrated the highest
unadjusted 12-month prevalence of all disorder types ( p <.001), though differences
were also observed across minority groups. In contrast, Asian, Latino, and Black adults
demonstrated higher 12-month prevalence of mood disorders among lifetime cases than
Whites ( p <.001) prior to adjustments Once we introduced nativity and other relevant
controls (e.g., age, sex, urbanicity), US-born Whites with at least one US-born parent
demonstrated higher 12-month mood disorder prevalence than foreign-born Whites or
US-born Whites with two foreign parents (OR=0.51, 95% CI=[0.36, 0.73]); this group
also demonstrated higher odds of past-year mood disorder than Asian (OR=0.59, 95%
CI=[0.42, 0.82]) and Black (OR=0.70, 95% CI=[0.58, 0.83]) adults, but not Latino adults
(OR=0.89, 95% CI=[0.74, 1.06]). Racial/ethnic differences in 12-month mood and substance
disorder prevalence were moderated by educational attainment, especially among adults
without a college education. Additionally, racial/ethnic minority groups with no more
than a high school education demonstrated more persistent mood and substance disorders
than non-Latino Whites; these relationships reversed or disappeared at higher education
levels. Nativity may be a particularly relevant consideration for diagnosing mood
disorder among non-Latino Whites; additionally, lower education appears to be associated
with increased relative risk of persistent mood and substance use disorders among
racial/ethnic minorities compared to non-Latino Whites.