Association Between Self-Esteem and Depressive Symptoms Is Stronger Among Black than White Older Adults

Background Although poor self-esteem is a core component of depression, we still do not know if racial and ethnic groups differ in the magnitude of this link. This study compared Black and White older adults on the association between self-esteem and depressive symptoms. Methods With a cross-sectional design, this study enrolled 1493 older individuals (age 66 ormore) from the 2001 Religion, Aging, and Health Survey, a nationally representative study in the United States. Participants were either Blacks (n = 734) or Whites (n = 759). Depressive symptoms and self-esteem were measured using brief measures of the Center for Epidemiological StudiesDepression scale (CES-D) and the Rosenberg Self-Esteem Scale, respectively. Demographics, socioeconomics, and self-rated health (SRH) were covariates and self-identified race was the moderator. Linear regression models were used for data analysis. Results Low self-esteem was associated withmore depressive symptoms (B = 0.17, 95 % CI 0.15-0.28), above and beyond all covariates. We found a significant and positive interaction between race (Black) and poor self-esteem on depressive symptoms (B = 0.34, 95 % CI 0.17-0.36), suggesting a stronger association between self-esteem and depressive symptoms among Blacks compared to Whites. Although low self-esteem is associated with higher depressive symptoms in both Whites and Blacks (p < 0.05 for both races), the standardized coefficient was 0.25 (95 % CI = 0.20-0.43) for Blacks and 0.16 (95 % CI = 0.09-0.29) for Whites. Conclusions Low self-esteem and high depressive symptoms are more closely associated among Blacks than Whites. It is not clear whether depression leaves a larger scar on selfesteem for Blacks, or Blacks are more vulnerable to the effect of low self-esteem on depression.