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Abstract

Why do older African-Americans tend to report less depression than Whites although they have poorer health and higher rates of chronic illness?

Research from the past 15 years consistently shows health disparities between Whites and minorities in the United States. African-Americans, in particular, are at higher risk than Caucasians for serious health conditions such as stroke, diabetes, cancer, cardiovascular disease and mild cognitive impairment. These chronic conditions typically contribute to depression in elders as a whole. However, the rates of depression for African-Americans are unclear with many studies reporting lower depression than in Whites and others reporting the reverse.

This discrepancy and inconsistency in depression rates is the basis for a newly funded $2.2 million five-year grant from the National Institute of Mental Health to CARAH and Center in the Park (CIP), a nationally accredited community senior center in the Philadelphia region which has received numerous awards for its innovative programming. CARAH and CIP have previously collaborated on a research program to improve chronic disease self-management in older African-Americans (see the article on page 1). In Touch: Mind, Body and Spirit, is a collaborative partnership that will explore perspectives on health and well-being among African-American elders. In the process, the partners aim to create a sustainable infrastructure for systematic mental health research and health professional research training.

This project aims to change the landscape of mental health research and care for older African-Americans. The goal is to advance clinical research that examines the relationship between depression and physical disability and to identify effective and innovative approaches to promote positive aging and mental health in African-American older adults. One of the first activities of this program will involve developing an electronic database at CIP to describe and track the health and well-being of CIP members.

According to Lynn Fields Harris, executive director of Center in the Park, this partnership is important to CIP for several reasons. "It provides the opportunity to do important research in an area that has been largely overlooked in our community, while building upon our previous successes in implementing evidence-based programs and demonstrating with hard facts and figures the positive outcomes of doing this type of work in a community-based setting."

Previous collaborations with CARAH have already had a big impact on CIP as well as the direction of research at CARAH. This new project is expected to do the same. "Working with CARAH has increased our awareness and reinforced our commitment to addressing the importance and relevance of underpinning the services and programs that CIP provides with interventions that look at serious emotional, physiological and social issues which have historically and disproportionately affected older adults in the community we serve," Ms. Harris says.

Working with CIP has increased CARAH’s ability to frame research questions and develop and implement studies that are relevant to address the specific concerns of older, urban African-Americans. We share a common goal of supporting and improving the health and well-being of the older African-American, as well as understand needs within the context of the cultural underpinnings that have shaped aging for this group.

In addition to the CARAH-CIP partnership, other Jefferson-based collaborators include: Dr. Jack London (Kimmel Cancer Center) who is developing the electronic capacity for CIP; Dr. Barry Rovner (Dept. of Psychiatry, Farber Institute for Neurosciences) who will consult on development of depression interventions; Dr. Christine Arenson (Dept. of Family and Community Medicine), who will help coordinate integration of programs with medical school and geriatric fellowship training; Dr. Janice Burke (Dept. of Occupational Therapy) who will help direct qualitative research initiatives; Dr. Susan Toth-Cohen (Dept. of Occupational Therapy), who is helping to develop the student research component and will serve as the student preceptor; Drs. Winter and White, research psychologists (CARAH) who will provide on-going consultation on depression and aging processes, and Nancy Chernett, MPH (CARAH) who will assist with project oversight and partnership coordination.

As we conduct this exciting research and share our findings over the next five years, we will be advancing scientific knowledge as to best models for developing living laboratories and research infrastructures within community settings to facilitate translation of research into the real-world context. Our goal is that the results will have an impact beyond our partnership.

For more information about the In Touch: Mind, Body and Spirit program, please contact Nancy Chernett, Program Manager (Nancy.Chernett@jefferson.edu).

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