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Poverty, race/ethnicity, and psychiatric disorder: a study of rural children
E J Costello1, G P Keeler, A Angold
1Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, USA. jcostell@psych.mc.duke.edu
Objectives:
This study examined the effect of poverty on the prevalence of psychiatric disorder in rural Black and White children.
Methods:
A representative sample of 541 Black children and 379 White children aged 9 to 17 was drawn from 4 predominantly rural counties. Structured interviews with parents and children collected information on psychiatric disorders, absolute and relative poverty, and risk factors for psychiatric disorder.
Results:
Three-month prevalence of psychiatric disorder was similar to that found in other community samples (20%). Federal criteria for poverty were met by 18% of the White and 52% of the Black families. Black and White children were exposed to equal numbers of risk factors overall, but the association between poverty and psychopathology was stronger for White children (odds ratio [OR] = 2.1; 95% confidence interval [CI] = 1.1, 4.2) than for Black children (OR = 1.5; 95% CI = 0.9, 2.6). Family history of mental illness, poor parenting, and residential instability mediated this association in both groups.
Conclusions:
In this rural sample, poverty was only weakly associated with child psychiatric disorders. Risk factors for both racial/ethnic groups were family mental illness, multiple moves, lack of parental warmth, lax supervision, and harsh punishment.
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