Separate and Combined Effects of Anxiety, Depression and Problem Drinking on Subjective Health among Black, Hispanic and Non‑Hispanic White Men

Background: The current study examined race and ethnic differences in the separate and combined (additive) effects of anxiety, depression and problem drinking on the baseline and trajectory of subjective health among adult men in the United States. Methods: This longitudinal study used data from the Fragile Families and Child Well‑being Study. We included 4,655 men, composed of 2,407 Blacks, 1,354 Hispanic Whites and 894 non‑Hispanic Whites. The dependent variable was subjective health, measured four times (i.e., baseline, year 1, year 3 and year 5). Latent growth curve modeling was used for data analysis. When controlling for socio‑economics, we tested separate effects of anxiety and depression. Then we tested combined effects of anxiety, depression and problem drinking. Results: Among all race and ethnic groups, anxiety and problem drinking were associated with baseline and trajectory of subjective health. Combined (additive) effects of anxiety and depression, however, varied based on race and ethnicity. Among Blacks, depression and anxiety were associated with a worse trajectory of subjective health. Among non‑Hispanic Whites, anxiety was associated with a better baseline and worse trajectory of subjective health, while depression was associated with worse baseline subjective health. Among Hispanic Whites, anxiety was associated with a worse trajectory of subjective health, while depression was not associated with subjective health. Conclusions: Although separate effects of anxiety and problem drinking were similar among race and ethnic groups, race and ethnicity seemed to modify the combined effects of different mental health problems. These results warrant further exploration of these complex links.