Understanding the Association of Depressive Symptomology, Race-Related Stress, and Chronic Kidney Disease among African Americans Open Access

Pustinger, Maggie (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/9p290b60n?locale=en


Introduction: African Americans have an increased likelihood of progression through the stages of chronic kidney disease (CKD) more quickly than their White counterparts. Studies have assessed possible explanations, and there is no clear reason for this difference in status. While a number of studies have assessed the effect of race-related stress and depression on other health outcomes, few known quantitative studies have thoroughly assessed the role of race-related stress and depression on CKD status. The purpose of this study is to understand how depressive symptomology and race-related stress are associated with CKD stage.


Methods: This study applied the Brondolo et al. (2011b) framework through a secondary analysis of data originally collected for the study “A Randomized Trial of Race-Related Stress among African Americans with Chronic Kidney Disease” (n=68). Logistic regressions produced odds ratios (ORs) for perceived race-related stress and depressive symptomology. 


Results: A chi-square test was conducted to examine the association between chronic experiences of discriminatory stress and depressive symptomology. Results suggest that there is a statistically significant association (=8.873; df=1; p=0.003) with those with more frequent experiences of discriminatory stress reporting depressive symptomology (n=18, 81.8%) compared to those reporting less frequent experiences of discriminatory stress (n=4, 18.2%). To address aim one, the association between depressive symptomology and CKD, a bivariate analysis was conducted. Results to test aim one did not suggest a statistically significant association (p=0.601). A bivariate test was run to address aim two, the association between perceived race-related stress and CKD. Results to test aim two did not suggest a statistically significant association (p=0.354). The multivariate logistic conducted to test for the independent effects between depressive symptomology (p=0.959) and perceived race-related stress (p=0.726) in chronic kidney disease status showed no significant results.


Discussion: Given the exploratory nature of the grant used to fund this study and the nature of this research, the sample size was small. The small sample size may have been a reason that the findings of this study were nonsignificant. However, given the significance in the analysis between chronic experiences of discrimination and depressive symptomology, there is indication that frameworks such as the Brondolo et al. (2011b) framework should be applied to more research on health outcomes that may be adversely impacted by racism.  


Table of Contents

Table of Contents

Chapter 1: Introduction



Racism and CKD

Stress and Health Outcomes

Linking Stress and Depression

Problem Statement

Theoretical Framework

Purpose of the Study

Research Question


Chapter 2: Literature Review


Racism and Health

Stress and Health Outcomes

Race-Related Stress and Health

Stress and Depression

Race-Related Stress and Chronic Kidney Disease

Theoretical Framework


Long term Impact of Ethnicity-Related Maltreatment

Summary of the Problem

Chapter 3: Methods


Study Purpose

Research Aims

Human Subjects Approval

Study Population and Sample

Target Population and Sample

Sampling and Recruitment

Survey Administration and Procedures

Eligibility Requirements


Outcome Measures

Personal Demographic Characteristics

Depressive Symptomology

Chronic Discriminatory Stress

Data Analysis Methodology

Preliminary Analyses

Assessment of Research Aims

Chapter 4: Results

Data Analysis

Preliminary Analyses

Summary of Results

Chapter 5: Discussion


Summary of Study

Discussion of Key Results

Research Aim 1

Research Aim 2

Research Aim 3

Overall Findings

Strengths and Limitations

Implications for Anti-Racist Sentiment

Future Directions




Appendix A

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