Does Mental Health Differ by Ethnicity and Income in Middle-Aged Females?

Abstract Purpose: There is conflicting research surrounding how mental health in middle-aged women differs by ethnicity and income. Therefore, the purpose of this study was to examine whether mental health differs by ethnicity and income in middle-aged women in the general population. Methods: This cross-sectional analysis used 2016 BRFSS data for middle-aged women from Alabama (N=1455), Mississippi (N=1082), North Carolina (N=1215), South Carolina (N=2277), and Tennessee (N=1263). Ordered logistic regression analysis by state was used to assess the relationship between mental health and ethnicity and income, while controlling for age, marital status, educational level, employment status, physical health status, tobacco use, and alcohol use. Results: About half of the middle-aged women reported low to moderate mental health (39-48%), half to most reported being white (52-81%), and about half reported an income of less than 50,000 per year (52-67%). The results of this study indicated that mental health did not differ significantly by income, but did differ significantly by ethnicity after controlling for health-related and demographic factors. In addition, mental health was consistently and significantly related to age, tobacco use, and physical health. Conclusion: Overall, ethnicity was found to be related to mental health in general population samples of middle-aged women ages 40-64; however, income was not found to be related to mental health. Limitations of this study include underrepresentation of particular ethnicities and a lack of more in-depth measures that may affect mental health. Providers can expect a moderate (38-45%) proportion of patients with low to moderate mental health. It is recommended that practitioners in a primary care setting screen all middle-aged women for mental health; taking special care to screen white patients, smokers, those with low to moderate physical health, and those under the age of 55. It is recommended that providers treat, educate, and refer these patients as necessary.