There is a paradox at the heart of Darrell Hudson’s research: Despite lower average socioeconomic status, greater exposure to stress and more challenging contexts due to deeply entrenched racial segregation, data show that African Americans have lower rates of depression than white Americans. Hudson, associate professor at the Brown School, is trying to uncover why.
Using a social epidemiologic lens — a subfield of public health that focuses on the impact of social-structural factors on health — he makes use of focus groups, surveys, interviews and statistical analyses to investigate this issue and other related problems, such as how stress affects immune system functioning and the potential mental health costs of upward social mobility.
One of Hudson’s priorities is to help the public see that there shouldn’t be a divide between mental and physical health. “Associations exist between mental health and cardiovascular disease, mental health and diabetes, as well as with a number of chronic conditions, such as arthritis and lupus and other autoimmune diseases.”
Yet mental health conditions often go undiagnosed. And even though underdiagnosis affects patients across race, it is markedly more prevalent for Black Americans.
In a 2013 study, Hudson found that diabetes patients who are racial/ethnic minorities are less likely to be clinically recognized for depression than their white counterparts.
Therefore, instead of an encouraging finding, the data pointing to lower rates of depression among African Americans might reveal clinical biases or symptoms manifesting differently across culture.
Another aspect of health inequity that Hudson studies is how upward social mobility affects the physical and mental health of people of color. Upwardly mobile people of color, he explains, are often integration pioneers in overwhelmingly white spaces, which exposes them to greater levels of interpersonal racial discrimination.
“Initially, I theorized that Black Americans with greater amounts of education, income and occupational prestige would be exposed to more racial discrimination,” he says. “And that’s certainly true in terms of the frequency of exposure.”
While a complete picture of the impact of these disparities is not yet drawn, Hudson’s research is ongoing. His nuanced findings don’t always yield clear-cut narratives.
“I always try to be very even-handed in how I describe results. Often, the story is more gray than it is black and white.”— Darrell Hudson
But Hudson is certain about ways to take action now. Racial health disparities can be traced back to fundamental causes such as disparities in education quality between school districts and unequal access to health-promotive resources in neighborhoods. “We need to address inequities from a fundamental cause perspective so that we can disrupt those fundamental causes,” Hudson explains.
Considering the stakes of his research, Hudson finds the incremental nature of science to be the most challenging aspect of his work. “It is difficult to know people are suffering, mentally and physically, and not be able to speed up the solutions that can bring relief.”