Relations between negative affect and health behaviors by race/ethnicity: Differential effects for symptoms of depression and anxiety

Objective: Health behaviors, including smoking and fruit and vegetable consumption, are both associated with psychological distress and vary by race/ethnicity. The relation of global psychological distress to behavior also varies by race/ethnicity, but the specific negative affective states responsible for this effect are not known. This study examined how the relation of feelings of depression and anxiety to health behaviors differs by race/ethnicity.

Method: Secondary data analysis of the HINTS nationally representative population survey was conducted. Survey participants reported their current symptoms of depression and anxiety, as well as smoking status and fruit and vegetable consumption. Survey weighted linear and logistic regression analyses were used to assess whether race/ethnicity moderated the relation of symptoms of depression and anxiety to smoking and fruit and vegetable consumption.

Results: For symptoms of depression, but not anxiety, there was a significant interaction between race/ethnicity and psychological distress in predicting both smoking status and fruit and vegetable consumption. Greater depressive symptoms were related to a greater likelihood of smoking and lower fruit and vegetable consumption for White, but not Black respondents. For Hispanic respondents, depressive symptoms were associated with a greater likelihood of currently smoking, but were not associated with fruit and vegetable consumption.

Conclusion: The association between depressive symptoms and both smoking and fruit and vegetable consumption differs as a function of race/ethnicity. These findings have implications for understanding the extent to which negative affective states influence health behaviors across different racial/ethnic groups, and for developing interventions that effectively target smoking and fruit and vegetable consumption among different racial/ethnic subgroups.