International Journal of Epidemiology
Volume 36, Issue 4, 2007, Pages 751-758

Race and risk of schizophrenia in a US birth cohort: Another example of health disparity? (Article) (Open Access)

Bresnahan M.* , Begg M.D. , Brown A. , Schaefer C. , Sohler N. , Insel B. , Vella L. , Susser E.
  • a Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, United States, New York State Psychiatric Institute, New York, NY, United States
  • b Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, United States
  • c Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, United States, New York State Psychiatric Institute, New York, NY, United States, College of Physicians and Surgeons, Columbia University, New York, NY, United States
  • d Kaiser Permanente Division of Research, Oakland, CA, United States
  • e City College Medical School, CUNY, New York, NY, United States
  • f Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, United States
  • g Veterans Affairs Medical Center, San Francisco, CA, United States
  • h Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 W. 168th St., New York, NY 10032, United States, New York State Psychiatric Institute, New York, NY, United States, College of Physicians and Surgeons, Columbia University, New York, NY, United States

Abstract

Background: Immigrant groups in Western Europe have markedly increased rates of schizophrenia. The highest rates are found in ethnic groups that are predominantly black. Separating minority race/ethnicity from immigration in Western Europe is difficult; in the US, these issues can be examined separately. Here we compared rates of schizophrenia between whites and African Americans and evaluated whether the association was mediated by socioeconomic status (SES) of family of origin in a US birth cohort. Methods: Study subjects were offspring of women enrolled during pregnancy at Alameda County Kaiser Permanente Medical Care Plan clinics (1959-66) in the Child Health and Development Study. For schizophrenia spectrum disorders, 12 094 of the 19 044 live births were followed over 1981-97. The analysis is restricted to cohort members whose mothers identified as African American or white at intake. Stratified proportional hazards regression was the method of analysis; the robustness of findings to missing data bias was assessed using multiple imputation. Results: African Americans were about 3-fold more likely than whites to be diagnosed with schizophrenia [Rate Ratio (RR) = 3.27; 95% confidence interval (CI): 1.71-6.27]. After adjusting for indicators of family SES at birth, the RR was about 2-fold (RR = 1.92; 95% CI: 0.86-4.28). Using multiple imputation in the model including family SES indicators, the RR for race and schizophrenia was strengthened in comparison with the estimate obtained without imputation. Conclusion: The data indicate substantially elevated rates of schizophrenia among African Americans in comparison with whites in this birth cohort. The association may have been partly but not wholly mediated by an effect of race on family SES. © The Author 2007; all rights reserved.

Author Keywords

schizophrenia Socioeconomic status Birth cohort race

Index Keywords

Birth Rate Eurasia proportional hazards model regression analysis schizophrenia Proportional Hazards Models Caucasian Europe race difference health risk risk Health Status Disparities human risk assessment Ethnic Groups controlled study priority journal probability socioeconomic status Western Europe African American black population Confidence interval United States North America Humans Adolescent male female clinical evaluation Socioeconomic Factors risk factor socioeconomics pregnancy Mothers race child health paternal age Article major clinical study adult European Continental Ancestry Group Prejudice cohort analysis parity ethnicity disease association Child Development Body Mass Index ethnic minority medical care African Americans immigrant population
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-34548593472&doi=10.1093%2fije%2fdym041&partnerID=40&md5=d2e7d67af250cab4201608115cd19ab7
DOI: 10.1093/ije/dym041
ISSN: 03005771
Cited by: 131
Original Language: English