This study aims to examine 3 groups of older (age 55 and over) African Americans--native-born, English Caribbean, French/Creole Caribbean--and a Caucasian comparison group, in order to: 1) Develop a model of factors that foster and moderate depression and anxiety among various aging African-American ethnic groups; 2) Develop a model of factors that predict utilization of formal and informal sources of mental health assistance among aging African-Americans with clinical psychiatric disorders who come from different ethnic groups; 3) Obtain prevalence data on the rates of depression and anxiety disorders with various African American ethnic groups in the community; 4) Determine if there are factors within each ethnic group that may influence the prevalence rates of depressive and anxiety disorders; 5) Obtain data on symptom presentation of depression and anxiety among various African American ethnic groups; 6) Determine if there are any factors within each ethnic group that may affect symptom and treatment patterns; 7) Examine potential biases in clinical screening instruments and to modify such instruments so that they are valid for use with the various Afro-American ethnic groups under examination. The study stresses the socio-cultural heterogeneity that is inherent in the African American populations, deliberately making use of within-group variability as a means of understanding differential risk and as a means of exploring naturally-occurring buffers to mental illness. The study draws on the fact that SUNY Health Science Center is situated in the heart of Brooklyn; the latter has a large Afro-American population, including the largest Afro-Caribbean population in the United States. Recent research indicates that there may be more within-group differences than between-group differences in the characteristics used to differentiate the races, and that earlier work has failed to identify the specific aspects of culture and related variable that are thought to influence behavior. The present project looks at structural variables such as income, education, and occupation, as well as variable most permeable to cultural influence namely, 1) patterns of affiliation and 2) cognitive dimensions such as beliefs and attitudes. Respondents come from both community and hospitals and mental health clinics in order to compare users and non- users of mental health resources, and thus can answer questions as to what are the formal and informal resources that affect mental illness among native-born and Caribbean-born elderly Afro-Americans. A total of 1000 community residents and 400 in- and out-patients, divided equally among the three Afro-American and the Caucasian comparison groups, will receive a 2-hour interview comprising 143 instruments. The project will be completed over a 5-year period. The findings will have important implications for health providers and policy-makers.
