Black children are suffering higher rates of depression and anxiety. What’s going on?

The rates of anxiety, depression, and behavior disorders among black children doubled over the course of several decades, with prevalence rates among black Americans topping those of whites, found a recent study in the Journal of Epidemiology.

Previous research examining racial differences in rates of psychiatric disorders have typically found that black Americans show lower rates than whites, despite experiencing higher rates of social adversity and stressors.

The new study suggests that this may be changing for younger black Americans, at least with regard to psychiatric disorders that have their onset in childhood.

In it, researchers analyzed high-quality data sets from the National Comorbidity Survey Replication (NCS-R) and National Comorbidity Survey Adolescent Supplement (NCS-A), in which a nationally representative sample of thousands of adults and adolescents from the lower 48 states were administered structured diagnostic interviews by trained interviewers between 2001 to 2004. The researchers restricted their analysis to people who recalled first suffering from a psychiatric disorder during childhood—ages 4 to 18.

Participants were asked about four broad classes of psychiatric diagnoses: anxiety disorders, mood disorders such as depression and bipolar disorder, behavior disorders including ADHD, and substance use disorders. They were also asked at what age they first experienced any of these disorders.

The researchers found a gradual change in the racial patterning of rates of psychiatric disorders across three cohorts of black and white children. The results were especially striking for anxiety disorders. Specifically, blacks in the oldest cohort (born 1957 to 1969) reported lower rates of childhood anxiety disorders than whites. The black-white rates were similar in the middle group, those born 1957 to 1969. But in the youngest group, born between 1983 and 1991, black participants reported higher rates of childhood anxiety disorders.

Similar—though less distinct—patterns were found for mood disorders and behavior problems, with older blacks having lower rates of these disorders in childhood, and the trend reversing among the younger study participants.

The only exception: For all three age groups, blacks reported lower rates than whites of substance use disorders.

Patricia Louie, a doctoral candidate in the Department of Sociology at the University of Toronto and lead author of the study, said she believes that “racial differences in anxiety disorders are due to structured inequalities that arise from socially patterned differences in life circumstances.”

In the study, she and co-author Blair Wheaton described several trends between 1957 and 2004 that may have contributed to the findings, including rising income equality, increases in black imprisonment and single-parent households, and escalating child poverty. She also cited research showing that black children are exposed to more sources of traumatic stress than white children.

It might also be the case that younger black Americans are more willing to talk about and disclose psychological problems that their parents and grandparents suffered in silence. Indeed, previous research examining an older cohort from the original National Comorbidity Survey (NCS) showed lower rates of lifetime psychiatric disorders among blacks relative to whites. But it also documented that for blacks who are diagnosed with anxiety and depressive disorders, the conditions tend to last longer, perhaps due to stressors such as unequal access to quality mental health care.

That earlier finding of longer persistence and this latest study indicate more needs to be done. “Findings from our study underscore the pressing need to target public health interventions toward black children and adolescents. We know that the onset of mental illness in childhood and adolescence is associated with recurrence of mental health problems in later life. Thus, early intervention may prevent the proliferation of anxiety disorders in the black population,” Louie said.