Review Keywords African American men Black men Risk factors Mental health Depression Depressive symptoms Stress Daphne C. Watkins, PhD Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA B. Lee Green, PhD, MEd Center for the Study of Health Disparities, Texas A&M University, Texas, USA Brian M. Rivers, PhD, MPH Center for the Study of Health Disparities, Texas A&M University, Texas, USA Kyrel L. Rowell, MPH Center for the Study of Health Disparities, Texas A&M University, Texas, USA E-mail: daphnew@umich.edu Online 28 August 2006 Depression and black men: implications for future research Daphne C. Watkins, B. Lee Green, Brian M. Rivers and Kyrel L. Rowell Abstract Recent studies indicate that the health gap between Black men and men of other racial/ethnic groups in the US is widening, with Black men experiencing poorer health. Because mental health is an indelible component of overall health, addressing the health issues of Black men requires a critical examination of factors that influence the mental health of this population. Prior research suggests that Black men have more adverse life experiences than men of other racial/ethnic groups and, consequently, experience more depressive symptoms. However, limited research exists regarding depression and Black men. Therefore, the purpose of this review is to organize available evidence systematically, while examining the factors that lead to depression in Black men. Results from over two decades of literature suggest that psychosocial coping, economic status/income, and racism/discrimination are the major factors that contribute to depression and depressive symptoms in Black men. Although the first two factors are listed as factors for depression across races/ethnicities, the third, racism/discrimination, carries major implications for public health and, ultimately, for improving the health status of Black men. ß 2006 WPMH GmbH. Published by Elsevier Ireland Ltd. Introduction Black men in the US face a disproportionate burden of preventable morbidity and mortal- ity rates compared to other groups [1]. Weighed against other racial/ethnic groups, Black men experience higher mortality rates in every single leading cause of death [2,3], die approximately 7 years sooner, and have higher rates of poverty and unemployment [1,4]. The exposure of Blacks to greater inequalities within social and economic environments includes an increased exposure to racism and discrimination, violence, and poverty, fac- tors that adversely impact mental health [5], and may potentially lead to psychological dis- tress (i.e. depression, anxiety). According to the American Psychological Association, depression is the result of psycho- social stressors that include both biochemical and social components [6]. Depression occurs when feelings of extreme sadness or despair last for at least 2 weeks or longer and interfere with activities of daily living, such as working, eating, or sleeping. Depressed individuals tend to feel helpless and hopeless and blame them- selves for these feelings. Some may even have thoughts of death or suicide [6]. Major depres- sive disorders can begin at any age; however, the average age of onset is the mid-20s. Depres- sion is recurrent by nature and although some individuals may experience an isolated inci- dent of major depression, the vast majority of people experience clusters of depression with increasingly frequent episodes as they age [6]. When a person has a number of depressive symptoms consistently over 2 weeks or more, they may be diagnosed as having a depressive illness. In any given 1-year period, 9.5% of the US population, or about 18.8 million American adults, suffer from a depressive illness [7]. According to the World Health Organization, depression is projected to become the leading cause of disability and the second leading contributor to the global burden of disease ß 2006 WPMH GmbH. Published by Elsevier Ireland Ltd. Vol. 3, No. 3, pp. 227–235, September 2006 227