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Is blood thicker than water? Social support, depression and the modifying role of ethnicity/nativity status
  1. J Almeida1,2,
  2. S V Subramanian2,
  3. I Kawachi2,
  4. B E Molnar2
  1. 1Institute on Urban Health Research, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
  2. 2Department of Society, Human Development and Health, Harvard School of Public Health, Boston, Massachusetts, USA
  1. Correspondence to Dr Joanna Almeida, Institute on Urban Health Research, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA 02115-5000, USA; Jalmeida{at}


Background Social support may be particularly important in countering depression among systematically disadvantaged groups. Latino immigrants are an example of a disadvantaged population that has better than expected mental health outcomes. One explanation put forth for this pattern is strong social support from kin networks. Studies on the effect of social support on mental health often assess the quantity of social ties rather than the quality of the support they provide. In addition, such studies rarely specify the source of support and how support from family versus friends may differentially impact mental health.

Methods In this study, data from the Project on Human Development in Chicago Neighbourhoods were used to disaggregate the effects of source-specific emotional support on risk of depression. Second, the relationship between ethnicity/nativity status and risk of depression was examined. Finally, whether the relationship between family-based and friend-based social support and depression differed across ethnic/nativity status was explored.

Results Support from both family and friends had protective effects on risk of depression; however, when mutually adjusted, only kin support remained statistically significant. At higher levels of family support, foreign-born Mexicans and African Americans had decreased risk of depression than at low levels of family support.

Conclusion This study provides evidence that family support may be more important than non-kin support for mental health. Findings also suggest that the effects of family support on risk of depression vary by ethnicity and nativity status. Preservation of naturally occurring support resources among some groups may be a way to maintain mental health.

  • Social support
  • depression
  • ethnicity
  • nativity status
  • immigrants
  • ethnic minorities
  • migration & health
  • social support

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  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Harvard School of Public Health Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.