LAUSR

Depression is a leading cause of disability in the United States, but its impact on mortality among racially diverse, low-socioeconomic populations is largely unknown. Using data from the Southern Community Cohort Study, 2002-2015, we prospectively evaluated the associations of depressive symptoms with all-cause and cause-specific mortality in 67,781 black (72.3%) and white (27.7%) adults, predominantly with a low-socioeconomic status. Baseline depressive symptoms were assessed using the ten-item Center for Epidemiological Studies Depression Scale. The median follow-up time was 10.0 years. Multivariate Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality in association with depressive symptoms. Mild/moderate/severe depressive symptoms were associated with increased all-cause (HR=1.12, 95%CI: 1.03-1.22; HR=1.17, 95%CI: 1.06-1.29; HR=1.15, 95%CI: 1.03-1.28, respectively) and cardiovascular disease mortality (HR=1.23, 95%CI: 1.05-1.44; HR=1.18, 95%CI: 0.98-1.42; HR=1.43, 95%CI: 1.17-1.75, respectively) in whites but not in blacks (Pinteraction< 0.001, for both). Mild/moderate/severe depressive symptoms were associated with increased external cause mortality in both races (HR=1.24, 95%CI: 1.05-1.46; HR=1.31, 95%CI: 1.06-1.61; HR=1.42, 95%CI: 1.11-1.81, respectively; for all subjects, Pinteraction=0.48). No association was observed for cancer mortality. Our study showed that depression-mortality associations differed by race and cause of death in individuals with a low-socioeconomic status.