We conducted extensive analyses in a population-based sample of Latino and Non-Latino White adolescents to examine associations between depressive symptoms and socio-demographic variables (age, gender, ethnicity, income, one parent versus two parent household type), acculturation, and social support at home and at school. Crude analyses suggested that the risk of depressive symptoms was twice as high among Latinos as compared to Non-Latino Whites (10.5% versus 5.5 %). Other risk factors included female gender, low household income, one parent household, and low support at home and at school. All of these factors have been reported as risk factors for depressive symptoms among Latinos and other ethnic groups [6
However, when all risk factors were considered simultaneously in a multivariate analysis, only four independent risk factors emerged: having low support at school, being female, being classified as low acculturation Latino and coming from a one parent household. In a stratified analysis, risk factors that were unique to males were low support at home and coming from a one parent household. Ethnicity was not a risk factor in this stratified analysis, suggesting that these risk factors are similar among both Non-Latino White and Latino male adolescents regardless of ethnic background. Almost one third of children less than 18 years of age in California (29%) live in one parent households: 21% live in mother only households and 7% in father only households [20
]. Thus, boys are more likely than girls to live in a one parent household with a parent of the opposite gender. It may be that males growing up without a father in the household are either experiencing something or lacking something, such as for example a male role model, that increases their risk of depressive symptoms. Patten and colleagues [8
] analyzed data of a large sample of California adults and also found higher rates of depressive symptoms among adolescents living in one parent households than in those living in two parent households. Their study showed highest rates of depressive symptoms among girls living in father only households (25.1% vs. 19.35 in mother only households), whereas the rates of depressive symptoms for boys were around 16% for both father or mother only households [8
]. The relative effect of single parent household (which are predominantly single mother households) was stronger for boys than for girls in our analysis. Further analyses by Patten and colleagues [8
] revealed that household type has to be considered in conjunction with parental support, as even in a two parent household risk of depression was increased if the adolescents perceived that they were not able to talk to either parent about their problems. Clearly, the complex relationship between depression, household type and parental support and the mechanisms of how these variables may relate to depression need to be further studied.
Risk factors of depressive symptoms that were unique to females in our sample were Latino ethnicity, age 14–15 and low household income. Latino females emerged as risk group for depressive symptoms in both a gender stratified analysis and in an analysis limited to the Latino subsample. Interestingly, the age group 14–15 years had the highest risk of depressive symptoms among females, but the lowest risk for males. Thus, in the combined analysis, the risk estimates were averaged and age did not emerge as a risk factor for depressive symptoms. Our findings suggest that boys and girls show different profiles of correlates and probable risk factors for depressive symptoms. Others have suggested that risk factors for depression such as stress and social support may have a greater impact among girls than among boys [9
]. Future studies need to further evaluate gender differences in rates and risk factors of depression as gender specific intervention programs may be needed.
In our sample, low support at school was the strongest risk factor for depressive symptoms for both males and females. This variable captured respondents' perceptions of the availability of a teacher or other adult at school who "noticed when they were not there, listened to them when they had something to say, told them when they did a good job, always wanted them to do their best, and noticed when they were in a bad mood". Thus, teachers and school counselors are important sources of support, and need to be trained to recognize symptoms and risk factors of depression. They also need to be given the time to pay attention to individual students.
A multivariate analyses taking into account existing interactions between socio-economic status, perceived support and ethnicity provided a profile of depressive symptoms that was even more detailed. When we examined different strata of household income and support, either at home or at school, Latino ethnicity emerged as risk factor for depressive symptoms only among the strata with higher income and high support at home and at school. While this finding is counterintuitive at first, it suggests that high economic status and social support are protective factors only among Non-Latino Whites. We have not been able to find any literature that is investigating this hypothesis. An alternative interpretation relates to the association between depressive symptoms and perceived discrimination. Several studies suggest that higher income is associated with more perceived discrimination and that discrimination is a risk factor for depression [21
]. Since CHIS does not assess perceived discrimination, we were not able to examine this relationship. We found no ethnic differences between Latino and Non-Latino Whites in the prevalence of depressive symptoms in the strata with low income or low social support at home
Although our data suggest several correlations between socio-demographic characteristics, social support and depressive symptoms, the causal nature of these relationships is ambiguous given the cross sectional study design. As pointed out by others [8
], depressed adolescents may be less inclined to form supportive relationships with parents, teachers or peers, and less likely to perceive relationships as supportive, and to report supportive relationships. Another limitation of our data set is that several variables that have been shown to be risk factors for depression, such as stressful life events [9
], perceived discrimination and low self esteem [21
], being involved in bullying either as a perpetrator or as a victim [5
], affiliation with high-versus low status peer crowd, negative or positive qualities of friendships, and presence or absence of romantic relationships [24
] were not available. Finally, as in many other studies, our measure of acculturation may not have captured aspects of the acculturation process that are related to depression. Although we attempted to include all data related to the acculturation experience that were available in this data set in developing an acculturation scale, and although we used a method that has the advantage of not making inappropriate statistical assumptions, the dichotomized acculturation variable that we created was almost identical to a simple dichotomization based on country of birth (US versus other). Finally, our sample of low acculturation Latino respondents was relatively small and given that most Latinos living in California are from Mexico, findings may not be generalizable to those with different heritage. However, despite these limitations, our analysis adds some information to the sparse literature on depression among ethnically diverse adolescents.