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Article

The Race Paradox in Mental Health Among Older Adults in the United States: Examining Social Participation as a Mechanism

by
Fei Wang
1,*,
Shandra Forrest-Bank
1,
Yifan Lou
2,
Namrata Mukherjee
3 and
Yejin Heo
1
1
College of Social Work, University of Tennessee Knoxville, Knoxville, TN 37996, USA
2
School of Social Work, Virginia Commonwealth University, Richmond, VA 23284, USA
3
School of Social Work, Boise State University, Boise, ID 83725, USA
*
Author to whom correspondence should be addressed.
Soc. Sci. 2025, 14(7), 426; https://doi.org/10.3390/socsci14070426
Submission received: 16 April 2025 / Revised: 28 June 2025 / Accepted: 1 July 2025 / Published: 9 July 2025
(This article belongs to the Special Issue The Impact of Social Connectedness on Older Adults’ Wellbeing)
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Abstract

The race paradox in mental health refers to the phenomenon in which African Americans often demonstrate mental health outcomes that are comparable to or more favorable than those of non-Hispanic Whites, despite systemic socioeconomic disadvantage and disproportionate exposure to chronic stressors. Few studies have examined the mechanisms underlying this race paradox among older adults, and even fewer have explored the role of social participation. This study aims to examine whether social participation mediates the relationship between race and mental health. Longitudinal data were drawn from the National Social Life, Health, and Aging study Waves 1–3 (N = 1292). Race was dichotomized as African American and non-Hispanic White. Three types of social participation were assessed: volunteering, participating in organized groups, and attending religious services. Depressive symptoms were assessed as the mental health outcome. Path analyses were conducted to examine the aim. Results indicate that being African Americans predicted increased levels of religious attendance, which in turn, decreased the levels of depressive symptoms. Religious attendance is an underlying mechanism partially explaining the race paradox in mental health, and a modifiable factor that mitigates depressive symptoms. Culturally sensitive interventions promoting social participation are warranted.

1. Introduction

One of the most paradoxical findings in mental health research in the United States (U.S.) is the race paradox in mental health—a phenomenon in which African Americans generally experience better or similar mental health outcomes than non-Hispanic Whites, despite their marginalized social and economic status and disproportionate exposure to chronic stressors (Mouzon 2013, 2014). While racial discrimination is known to have detrimental impacts on mental health for many African Americans (Brown et al. 2000; Lewis et al. 2015), the mechanisms that explain the racial paradox are likely to hold crucial understandings for identifying modifiable factors associated with mental health problems and promoting resilience to these issues.
Previous research has mainly examined personal factors and social relationships as mechanisms that may explain the race paradox, such as self-esteem, religiosity, and family support (Louie and Wheaton 2019; Louie et al. 2022; Upenieks 2023). However, the findings have been non-significant or equivocal. Moreover, there is a lack of understanding of the role of social participation in the race paradox in mental health. Social participation refers to individuals actively taking part in collective and productive social activities, such as those related to leisure, volunteering, and religion (Lee et al. 2008). Among older adults, social participation is of paramount importance. Research has consistently shown that social participation confers many mental health benefits, including decreased depression (Choi et al. 2021) and psychological distress (Amagasa et al. 2017), as well as improved psychological and emotional well-being (Sharifian and Grühn 2019; Achdut and Sarid 2020). Yet, older adults are at risk for reduced social participation due to health limitations (Curtis et al. 2017; Wanchai and Phrompayak 2019) and narrowing social networks with age (Carstensen et al. 1999). Consequently, limited social participation is associated with increased depressive symptoms (Egeljić-Mihailović et al. 2022) and psychological distress (Choi 2020), as well as decreased psychological well-being (Wang et al. 2025).
This study is based on the Social Capital Theory (Bourdieu 1986) and the Minority Stress Theory (Meyer 2003). Bourdieu’s (1986) theory offers a critical framework for understanding how social participation, such as being involved in community groups, attending religious services, and volunteering, can affect individual well-being while accounting for structural barriers. According to Bourdieu (1986), social capital is defined as “the aggregate of the actual or potential resources which are linked to possession of a durable network of more or less institutionalized relationships of mutual acquaintance and recognition”. Through participating in various social activities, individuals develop social networks that can yield emotional, informational, and material resources (Bolin et al. 2003). These resources, also known as social capital, can enhance social integration, create a sense of belonging and identity, and increase access to opportunities, which contribute to mental health and overall well-being (Nyqvist et al. 2013). However, Bourdieu (1986) emphasized that well-being is not just the result of individual attributes or behaviors, but is deeply shaped by the social structures in which individuals are embedded. Therefore, the benefits of social participation are not evenly distributed; individuals with limited resources and restricted networks, such as those found in racial minority or socioeconomic marginalized groups, often experience poorer mental health and well-being (Smyth et al. 2015).
While Social Capital Theory highlights how differences in access to social resources can affect individual well-being, Minority Stress Theory (Meyer 2003) focuses on the experiences of those with limited access to valued social capital due to their marginalized status. Minority Stress Theory posits that individuals from minority groups (e.g., sexual and gender minorities, racial and ethnic minorities) experience chronic, socially driven stressors stemming from discrimination, stigmatization, and social exclusion (Meyer 2003; Velez et al. 2017). These stressors compound everyday life stress and disproportionately compromise mental health across the life course (Meyer 2003). However, these disadvantaged social and historical circumstances may necessitate the development of coping resources among minority groups (Gayman et al. 2014; Louie and Wheaton 2019). In the context of the current study, African Americans experience a wide range of stressors throughout their lives, including structural racism, socioeconomic disadvantage, and daily microaggressions. These challenges may require African Americans to develop coping resources to navigate adversity to a greater extent than non-Hispanic Whites (Gayman et al. 2014). These differential coping resources between African Americans and non-Hispanic Whites may be the mechanism underlying the race paradox in mental health. Given the important mental health benefits of social participation in older adults, social participation can be seen as a coping resource for African Americans to overcome difficulties and improve mental health. Therefore, it is important to examine whether social participation serves as a mechanism accounting for the race paradox in mental health. Existing research on the race paradox in mental health among older adults is limited and mainly cross-sectional. This study aims to address these research gaps by investigating the mediating effect of social participation on the association between race and mental health in a nationally representative longitudinal sample of older adults in the U.S.

1.1. The Race Paradox in Mental Health

Existing research has primarily examined social relationships as a potential mechanism underlying the race paradox in mental health. This body of research indicates that although African Americans have better family relationships, friendships, and fictive kin relationships, as well as receive greater family support, none of these factors explain their mental health advantage (Mouzon 2013, 2014; Thomas Tobin et al. 2022; Louie et al. 2022). Moreover, an emerging body of research has investigated personal factors as potential mechanisms accounting for racial differences in mental health outcomes, with mixed findings. For example, LaMotte et al. (2023) found that African Americans exhibited higher levels of self-esteem compared to Whites, which mitigated their psychological distress and depressive symptoms. However, Hill-Joseph’s (2019) study revealed that African Americans maintained the same level of depressive symptoms as Whites despite the fact that they experienced lower levels of mastery than Whites. Additionally, past research consistently documented higher levels of religiosity among African Americans than Whites. Further, Louie et al. (2022) discovered that religious attendance accounted for a substantial portion of the paradox, while Mouzon (2017) did not identify any differences in religious involvement or the importance of religiosity that can account for better mental health among African Americans.
Taken together, existing studies on the race paradox in mental health have mainly focused on social relationships and personal factors, demonstrating non-significant or mixed findings. Furthermore, these studies utilized cross-sectional data. There is limited knowledge about whether social participation can longitudinally explain the race paradox in mental health.

1.2. Social Participation Among Older Adults

A handful of studies have documented the benefits of social participation on mental health, including predicting well-being (Santini et al. 2018), protecting against depressive symptoms (Li et al. 2018), and fostering a sense of belonging (Haslam et al. 2015). Among older adults, social participation is associated with reduced loneliness (Niedzwiedz et al. 2016), depression (He et al. 2017; Amagasa et al. 2017), and psychological distress (Mackenzie and Abdulrazaq 2021). Moreover, participating in various social activities can improve older adults’ life satisfaction (Lee and Choi 2020) and self-efficacy (Bourassa et al. 2017).
Despite the positive impacts of social participation on older adults’ well-being, the most frequently observed trajectory of social participation is the identification of diminished social participation among older age groups (Pinto and Neri 2017). Research has generally identified that levels of social participation are inversely proportional to the advancement of age (Agahi et al. 2013; Hughes et al. 2013). Compared to their younger counterparts, older adults are at a greater risk of compromising their participation in social activities due to common events in older age, such as widowhood, functional decline, and chronic conditions (Griffith et al. 2017). Additionally, as people age, they tend to restrict their social networks to fewer individuals, usually those with whom older adults share the closest ties (e.g., spouse, close friend; (Carstensen et al. 1999). Consequently, the social networks of older adults may become smaller, reducing their participation in social activities. Research shows that limited engagement in social activities among older adults is associated with elevated levels of cognitive decline (Buchman et al. 2016), depression (Choi 2023), and psychological distress (Wang et al. 2025), along with a decrease in psychological well-being (Irani et al. 2024).

1.3. Social Participation in Older African Americans

Overall, older African Americans appear to engage in fewer social activities and spend fewer hours in social activities than older non-Hispanic Whites (Hinterlong 2006; Mendes de Leon et al. 2003). However, studies also suggest that this pattern varies depending on the specific type of social participation. For example, research has found that older non-Hispanic Whites participate in club meetings at higher rates than older African Americans (Bertera and Bailey-Etta 2001), and that older Whites consistently demonstrate higher participation in volunteering compared to older African Americans (Gonzales et al. 2016; Tang et al. 2012). Conversely, older African Americans attend church services more frequently and are more likely to participate in church activities outside of church than older Whites (Bertera and Bailey-Etta 2001; Chatters et al. 2014). In addition, socioeconomic status significantly predicts social participation, especially in older African Americans (Thomas Tobin et al. 2022). For example, Gonzales et al. (2016) found that higher income increased the odds of older African Americans volunteering by 8 percent, whereas higher income older Whites were 2.8 percent more likely to volunteer than those with lower income.

1.4. Social Participation and Mental Health Among Older African Americans

Research on the mental health effects of social participation for older African Americans has generally found positive effects. For instance, attending church services is associated with a reduced likelihood of psychological distress (Chatters et al. 2015) and lifetime mood disorder (Chatters et al. 2008), but not depression among older African Americans (Chatters et al. 2015). Another study revealed that older African Americans who actively engaged in community activities experienced better well-being (Tiernan et al. 2013). Furthermore, participating in organized activities and pursuing enjoyable outings predicts lower odds of depressive symptoms (Guo et al. 2021). Despite the positive mental health effects of social participation identified in these studies, one study found that volunteering was not significantly associated with depressive symptoms and psychological well-being among older African Americans, as it was among older Whites (Gonzales et al. 2016).

1.5. The Current Study

Using a longitudinal, nationally representative sample of older adults in the U.S., the current study aims to examine how social participation serves as a mechanism explaining the race paradox in mental health. Figure 1 depicts a mediation model that illustrates this aim. We expect that, compared to older non-Hispanic Whites, older African Americans attend religious services more frequently, which in turn decreases their levels of depressive symptoms. We also expect that volunteering and attending meetings of organized groups will not contribute to explaining the race paradox in mental health, given older African Americans’ lower levels of engagement in these social activities compared to older non-Hispanic Whites found in prior research.

2. Materials and Methods

Data were drawn from the National Social Life, Health, and Aging (NSHAP) study Waves 1–3. The NSHAP study is a nationally representative probability sample of community-dwelling persons, 57 to 85 years of age, from households across the U.S., with oversampling of African-Americans, Hispanics, men, and the oldest persons (75 to 84 years of age at the time of screening). The data cover various aspects, including demographic characteristics, social networks, and social network change, social and cultural activity, physical and mental health, and history of sexual and intimate partnerships. The data were collected using biological sample collection, in-person interviews, and a leave-behind questionnaire. The overall response rate for the baseline survey was 75.5%. Wave 1 data were obtained from 2005 to 2006, Wave 2 from 2010 to 2011, and Wave 3 from 2015 to 2016. The current study included 1292 participants aged 60 and above in Wave 1 who had completed all three waves of surveys (base sample). This cut-off age is commonly used in gerontological literature (Vaingankar et al. 2016; Longacre et al. 2017) and by a number of major national and international organizations (Administration for Community Living 2021; National Center for Injury Prevention and Control 2020; United Nations, Department of Economic and Social Affairs, Population Division 2019). The final sample consisted of 710 participants who had valid data on focal variables and covariates.

2.1. Measures

2.1.1. Dependent Variable

Depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale (CES-D; Radloff 1977) at Wave 3 (2015–2016). Participants reported on the frequency of experiencing depressive symptoms in the past week on a 4-point Likert scale (1 = rarely or none of the time, 2 = some of the time, 3 = occasionally, 4 = most of the time). Examples of depressive symptoms included feeling lonely, having restless sleep, feeling sad, and not getting going. A total score was computed, with higher scores indicating higher levels of depressive symptoms. The range is from 11 to 44. The Cronbach’s alpha of the CES-D for the current sample was 0.79.

2.1.2. Independent Variable

Race as a time-invariant variable was dichotomized as non-Hispanic White (0) and African American (1) based on participants’ self-reports.

2.1.3. Mediators

Social participation variables were retrieved from the Wave 2 data (2010–2011), including: (1) volunteering, (2) participating in meetings of organized groups (e.g., a choir, committee or board, support group, sports or exercise group, hobby group, or professional society), and (3) attending religious services. Participants were asked to rate how often they took part in each of these social activities during the past year on a four-point Likert scale (0 = never, 1 = once a year, 2 = once a month, 3 = once a week). Each social participation variable ranges from 0 to 3, with higher scores indicating higher levels of social participation.

2.1.4. Covariates

Covariates were retrieved from Wave 1 data (2005–2006), including gender (0 = male, 1 = female), marital status (0 = single/separated/divorced, 1 = married/cohabiting), annual household income (0 = less than 25,000, 1 = 25,000–49,999, 2 = 50,000–99,999, 3 = 100,000 or higher), and self-rated physical health (0 = poor to fair, 1 = good, 2 = very good to excellent).

2.2. Analysis Strategy

Data were analyzed using Stata 18.0. Frequencies and descriptive statistics were conducted for all variables. First, bivariate statistics, including the chi-square test and independent samples t-test, were conducted to examine the differences in all variables between the African American and White samples. We then used multiple linear regression to examine racial differences in change in depressive symptoms across three waves without the presence of social participation, net of covariates. The result from this regression analysis would indicate whether the race paradox in mental health exists in the current sample across three waves. Lastly, using path analyses, we constructed path models to examine the mediating effect of social participation on the association between race and depressive symptoms.
Model fit of the path analysis was evaluated using the coefficient of determination (CD) and the standardized root mean square residual (SRMR). The SRMR is an absolute measure of fit representing the difference between the predicted and observed correlations (Holman et al. 2020). It is appropriate for survey data with sampling weights; an SRMR value less than 0.08 indicates good fit (Bollen et al. 2013; Hu and Bentler 1999). The CD is analogous to the R2 in linear regression and is the percentage of variance the model explains (StataCorp 2013). These fit indices were used rather than other commonly used indices, such as the comparative fit index, Tucker–Lewis index, and root mean square error of approximation, given that the latter are often unstable and biased in complex weighted survey data analysis (Bollen et al. 2013).
The “sem” command was used to conduct the path analyses. Stata’s SEM program allows us to use survey sampling weights, which are important when making population-based estimates using representative samples. In the current study, we used sampling weights at Wave 1. Moreover, using the “estat teffects” command, a Sobel test (Sobel 1987) was conducted to estimate a mediating effect in each path model, which would be significant at p < 0.05. Sobel test of mediation is a relatively conservative test that is appropriate for a large sample size (Warner 2012, p. 657). In the current study, race is a time-invariant variable. To better estimate the longitudinal mediating effects of social participation, we used the social participation variables from Wave 2 and the depressive symptoms variable as the outcome from Wave 3. Following previous longitudinal studies (Santini et al. 2020), we selected the sociodemographic and health covariates at the baseline (Wave 1). To account for the variations of the baseline mental health status, such that older African Americans may have significantly higher depressive symptoms than older non-Hispanic Whites (Louie et al. 2022), we also controlled for depressive symptoms at Waves 1 and 2.

3. Results

3.1. Univariate and Bivariate Analyses

Table 1 presents the descriptive statistics for all the measures at baseline, for the total sample, and by race. More than half (55.62%) of the older adults in our sample are female, and a majority (72.28%) of them are married. More than one-fourth (26%) of our sampled participants were living with a household income lower than USD 25,000 per year. Bivariate statistics show that the percentage of participants who reported poor-to-fair health was higher in the African American sample than in the non-Hispanic White sample. Older African Americans were less likely to be married compared to their White counterparts. On average, older African Americans had higher levels of depressive symptoms and attended religious services more frequently than older non-Hispanic Whites. There were no significant differences observed in gender, annual household income, and frequencies of volunteering or participating in meetings of organized groups between older African Americans and non-Hispanic Whites.

3.2. Main Analyses

Table 2 and Figure 2 show both the direct and indirect associations between race and depressive symptoms. The analyses were based on 710 participants who had valid data on race, depressive symptoms, social participation, and covariates. Model 1 examined racial differences in changes in depressive symptoms without the presence of social participation, while controlling for gender, marital status, annual household income, perceived physical health, depressive symptoms (T1), and depressive symptoms (T2). The result shows that, on average, older African Americans show a greater decrease in depressive symptoms across three waves compared to their non-Hispanic White counterparts (β = −0.07, p < 0.01). This result indicates that the race paradox in mental health exists in the current sample consistently across three waves.
Models 2–4 present the results from the path analyses, which identified direct and indirect associations between race and depressive symptoms with the presence of social participation, while controlling for gender, marital status, annual household income, perceived physical health, and depressive symptoms at previous waves. Each model has a good model fit, with an SRMR = 0.022. The CD for the path analysis that examined race and depressive symptoms via volunteering was 0.358. This suggests that the model explained 35.8% of the variation in depressive symptoms. The CD for the path analysis that examined race and depressive symptoms via attending meetings of organized groups was 0.364, indicating that this model accounted for 36.4% of the variation in depressive symptoms. The CD for the path analysis that examined race and depressive symptoms via attending religious services was 0.372, indicating that this model accounted for 37.2% of the variation in depressive symptoms.
As Models 2 and 3 show, volunteering and attending meetings of organized groups did not significantly mediate the relationship between race and depressive symptoms. However, model 4 demonstrates that attending religious services significantly mediated 14% of the association between race and depressive symptoms (indirect effect β = −0.01, p < 0.05). Specifically, being African Americans predicted increased frequencies of attending religious services (β = 0.10, p < 0.001), which in turn, decreased the level of depressive symptoms (β = −0.11, p < 0.001). Figure 2 illustrates the mediating effect of attending religious services on the association between race and depressive symptoms.

4. Discussion

This study used longitudinal panel data from a probability sample of older adults in the U.S. to examine whether various types of social participation can explain the race paradox in mental health. As a first important finding, being older African Americans significantly predicted lower levels of depressive symptoms than being older non-Hispanic Whites. This finding not only supports the notion of the race paradox in mental health but also demonstrates its long-term effect.
Consistent with our hypothesis, religious attendance partially contributes to the race paradox in mental health. Specifically, older African Americans had higher levels of religious attendance than older Whites, which reduced their levels of depressive symptoms. The importance and benefits of religious involvement are well-documented in research on African Americans. Compared to younger African Americans, older African Americans are more likely to attribute greater importance to religion in their lives and have a stronger religious identity (Chatters et al. 1999). Religion is both a psychological and social resource that can be used to cope with stressors among African Americans. Religious activities, including prayer and worship, can promote positive emotions, directly leading to better mental health (Upenieks 2023; Nguyen 2020). Religious involvement can also encourage healthy behaviors, such as abstaining from drugs and alcohol (Lin et al. 2020). The use of clergy can address serious personal problems for older African Americans (Chatters et al. 2011). Additionally, religious involvement plays an important role in shaping African Americans’ racial identity. Racial identity refers to one’s feelings and attitudes related to membership in a racial group (Yip 2018), as well as one’s behavior and participation in activities characteristic of their racial group (Phinney 2010). The church provides opportunities for African Americans to occupy important and respected positions that they may be denied in wider society; it also creates experiences and relationships that strengthen racial identity and bolster self-respect for African Americans (Hughes and Demo 1989). As a result, the benefits of religious attendance help mitigate depressive symptoms among African Americans, which may explain their lower depressive symptoms compared to non-Hispanic Whites.
Additionally, we found no support that racial differences in mental health were attributed to older African Americans volunteering or participating in meetings of organized groups more frequently than non-Hispanic Whites. These findings are in line with our hypotheses. Prior research generally indicates that older African Americans participate less in volunteering and organized group meetings compared to their White counterparts (Bertera and Bailey-Etta 2001; Gonzales et al. 2016; Tang et al. 2012). This is possibly due to African Americans having limited resources at both the individual level (e.g., financial assets, health) and the community level (e.g., social and built environment; Gonzales et al. 2016; Johnson and Lee 2017) compared to Whites, which could restrict their opportunities to volunteer or participate in organized group meetings. Consequently, volunteering and attending meetings of organized groups do not account for the better mental health of older African Americans relative to older Whites.
There are limitations to be considered when interpreting the findings. First, the assessment of mental health was based on participants’ self-reports, which are prone to biases like social desirability and memory recall. Therefore, it is crucial to incorporate objective evaluations, such as reports from mental health professionals, to obtain a comprehensive evaluation of the participants’ mental health. Second, social participation variables included volunteering, participating in meetings of organized groups (e.g., a choir, committee, or board, support group, sports or exercise group, hobby group, or professional society), and attending religious services. There may be other social activities that older adults participate in. Future research should employ qualitative approaches (e.g., focus groups, in-person interviews) to include additional social activities that can be considered as indicators of social participation among older adults and provide a more comprehensive assessment of social participation in this population. Third, some social participation variables assessed in this study may overlap in their meanings, such as volunteering and attending meetings of organized groups. Nonetheless, participants were given examples of organized groups, including a choir, committee, board, support group, sports or exercise group, hobby group, or professional society. With these specific examples, participants may be able to better differentiate between volunteering and attending meetings of organized groups. Fourth, participants only indicated the frequency of participating in social activities. Future research can explore participants’ motivation to choose certain activities and their satisfaction with the activities. Fifth, a limitation of longitudinal research with older adults is that the morbidity and mortality of the sample increase with aging. It may be that the most impaired physically and mentally are also the ones who die younger, causing the overall findings to show lower levels of depressive symptoms in the total sample. It is also possible that older adults’ level of participation decreases over time as they age, which could affect their depressive symptoms. This potential change may introduce bias into our findings. Sixth, the study focuses on older adults residing in the U.S., which limits the generalizability of the findings to older populations in other countries.
Despite the limitations, this study has several strengths and contributions. To start with, in examining the mechanisms accounting for the race paradox in mental health, our study moved beyond personal and social relational factors to social participation, a factor that has a tremendous impact on the well-being of older adults, including racial/ethnic minority older adults. Furthermore, we examined various types of social participation and identified that religious attendance may partially explain the race paradox within the older population in the U.S. The other two forms of social participation, volunteering and attending meetings of organized groups, while not demonstrating significant mediating effects, underscore the crucial role of religious involvement in shaping mental health outcomes among older adults. By examining volunteering and attendance at meetings of organized groups, we contribute to the limited body of research that has rarely explored these forms of social participation among non-Hispanic White and African American older adults in the race paradox research. Therefore, our study offers important preliminary insights and lays the groundwork for future research on broader pathways underlying mental health disparities. Additionally, using a longitudinal dataset, our study sheds light on the relationship between race, social participation, and mental health over time in the older adult population. Last, this study used a nationally representative sample, which allows for population estimates.

Implications

Our findings suggest that facilitating social participation may provide a critical intervention for older adults who suffer from mental health problems. Since reduced functioning and social connection are likely to occur in late adulthood, offering opportunities and enhancing access to social participation activities is an important focus for intervention and resource allocation. By conducting focus groups and gathering more details about the nature of the activities and what motivated older adults to choose those activities, practitioners can better discern which aspects of social participation are most beneficial for participants. This can help in developing strategies and programs to effectively engage older adults in social participation.
Another implication of the current study is that for older African Americans who have religious affiliation but are not involved with congregations, it may be beneficial to help them find a religious congregation. Practitioners can engage older adults in conversations about the possibility of finding social contacts in congregations and make direct linkages and facilitate transportation. However, it is equally important not to impose religiosity on older adults who may not want to participate in religious activities. Instead, programs that build on understandings of the importance of group identity might develop new innovations that help foster community and belonging that are directly relevant to the motivations and values of the people who are drawn to those activities.
Moreover, intervention research is needed to promote culturally sensitive programs that enhance social participation among older adults and examine the effectiveness of these programs, while taking into account older adults’ unique cultural backgrounds and preferences. For example, while racial and cultural commonalities are often presented in African American communities, an individual sense of altruism is more common among non-Hispanic White Americans. In light of this, White communities might respond positively to initiatives that highlight individualized expressions of altruism and community service.
When designing programs for African Americans, it is important to recognize the important role of religious attendance in enhancing social participation within this population. To start with, transportation services should be provided to increase access to religious services for older African Americans. Moreover, religious institutions (e.g., churches) offer opportunities for social interaction, civic engagement, and social integration, all of which strengthen social ties. Therefore, programs can collaborate with churches to host community events, health fairs, and educational workshops so older adults can engage socially in ways that feel supportive and beneficial. Offering hybrid models of participation, including livestreamed services and online church events, allows for greater flexibility and helps reach older adults who are homebound (Hayes 2020). Additionally, using an intergenerational lens (Rogers-Jarrell 2018), programs that connect older adults with youth through mentoring, storytelling sessions, or collaborative service projects can also help strengthen social bonds.
Furthermore, given the important role of religious attendance in improving mental health, hosting mental health workshops and wellness classes within church settings can help increase awareness for older African Americans who may not recognize their symptoms and provide immediate, accessible support for those who recognize their symptoms but may not otherwise seek help. Integrating mental health topics into sermons and Bible study discussions (Lehmann et al. 2022) can help normalize conversations about mental health and reduce stigma, especially when delivered by respected faith leaders in a familiar and trusted environment. Additionally, training clergy and lay leaders to recognize signs of psychological distress equips them to offer resources at an early stage, make appropriate referrals, and provide spiritual support that complements professional mental health care (Aten et al. 2013).

5. Conclusions

Although systemic racism remains a threat to African American mental well-being, this study aligns with the notion of the race paradox in mental health by demonstrating that African Americans experience lower depressive symptoms compared to non-Hispanic Whites. In examining social participation as a mechanism underlying the race paradox in mental health, our study identifies that religious attendance can be a modifiable factor associated with better mental health outcomes in older African Americans and provides implications for intervention development.

Author Contributions

Conceptualization, F.W.; methodology, F.W., Y.L.; software, F.W., Y.L.; formal analysis, F.W., Y.L.; writing—original draft preparation, F.W., S.F.-B., Y.L.; writing—review and editing, F.W., S.F.-B., N.M., Y.H.; visualization, F.W. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

The original data presented in the study are openly available at https://www.icpsr.umich.edu/web/NACDA/series/706 (accessed on 30 June 2025).

Conflicts of Interest

The authors declare no conflicts of interest.

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Socsci 14 00426 g001
Figure 1. Conceptual model illustrating potential pathways between race, social participation, and depressive symptoms.
Figure 1. Conceptual model illustrating potential pathways between race, social participation, and depressive symptoms.
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Figure 2. Results on the direct association between race and depressive symptoms and the indirect association via attending religious services from Model 4. * p < 0.05.
Figure 2. Results on the direct association between race and depressive symptoms and the indirect association via attending religious services from Model 4. * p < 0.05.
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Table 1. Demographic characteristics of the sample and distribution of study variables (N = 1292).
Table 1. Demographic characteristics of the sample and distribution of study variables (N = 1292).
Total SampleAfrican
American		Whitep-Value
Gender 0.62
  Men44.38% (582)41.22% (81)44.28% (422)
  Women55.62% (710)58.78% (130)55.72% (488)
Annual household income 0.08
  0–24,99926% (288)37.81% (68)22.09% (152)
  25,000–49,99928.36% (249)34.06% (38)28.81% (191)
  50,000–99,99930.75% (276)17.44% (26)32.95% (226)
  >100,00014.89% (114)10.68% (5)16.15% (100)
Marital status <0.001
Not Married27.72% (420)43.82% (112)25.79% (258)
Married72.28% (872)56.18% (99)74.21% (652)
Perceived physical health <0.001
  Poor to fair17.28% (239)24.98% (54)15.08% (132)
  Good28.83% (375)37.49% (82)27.23% (234)
  Very good to excellent53.89% (673)37.53% (73)57.68% (542)
Volunteering (0–3)1.29 (1.14)1.33 (1.16)1.36 (1.13)0.74
Organized groups (0–3)1.52 (1.17)1.61 (1.19)1.58 (1.15)0.73
Religious services (0–3)1.92 (1.22)2.29 (1.04)1.82 (1.26)<0.001
Depressive symptoms (11–44)15.78 (4.77)16.51 (4.65)15.46 (4.57)<0.01
Notes. Percents and frequencies (in parentheses) are presented for categorical variables, and Means and Standard Deviations (in parentheses) are presented for continuous variables. Percentages are weighted, and frequencies are unweighted. p-values are from bivariate analyses of demographic characteristics by race.
Table 2. Standardized regression coefficient estimates for race, social participation, and depressive symptoms.
Table 2. Standardized regression coefficient estimates for race, social participation, and depressive symptoms.
Model 1Model 2Model 3Model 4
β (SE)β (SE)β (SE)β (SE)
Depressive SymptomsVolunteeringDepressive SymptomsOrganized
Groups		Depressive SymptomsReligious
Services		Depressive Symptoms
Race (ref = White)
  African American−0.07 (0.47) **−0.04 (0.03)−0.08 (0.03) **−0.03 (0.04)−0.08 (0.02) ***0.10 (0.03) ***−0.07 (0.03) *
Covariates
Gender (ref = Male)
  Female0.05 (0.35)0.02 (0.05)0.07 (0.04) *0.08 (0.04)0.07 (0.04)0.09 (0.05)0.08 (0.04) *
Marital status (ref = not married)
  Married−0.01 (0.39)−0.10 (0.04) *−0.01 (0.04)−0.09 (0.04) *−0.01 (0.04)0.13 (0.04) **0.01 (0.03)
Household income (ref = <25,000)
  25,000–49,9990.02 (0.49)−0.01 (0.05)0.00 (0.06)−0.03 (0.05)−0.00 (0.06)−0.12 (0.05) *−0.01 (0.06)
  50,000–99,9990.06 (0.50)0.03 (0.06)0.03 (0.07)0.08 (0.06)0.03 (0.07)−0.08 (0.06)0.02 (0.07)
  >100,0000.03 (0.60)0.03 (0.05)0.00 (0.06)0.10 (0.06)0.01 (0.06)−0.19 (0.06) **−0.02 (0.05)
Perceived physical health (ref = poor to fair)
  Good−0.03 (0.59)0.17 (0.05) ***−0.08 (0.05)0.14 (0.06) *−0.08 (0.05)0.11 (0.06) *−0.07 (0.05)
  Very good to excellent−0.14 (0.56) **0.26 (0.05) ***−0.22 (0.05) ***0.20 (0.06) **−0.22 (0.05) ***0.14 (0.06) *−0.21 (0.05) ***
Depressive symptoms (T1)0.29 (0.06) ***−0.07 (0.05)-−0.08 (0.05)-−0.09 (0.04) *-
Depressive symptoms (T2)0.36 (0.06) ***-0.49 (0.04) ***-0.49 (0.04) ***-0.49 (0.04) ***
Mediators
Volunteering--−0.06 (0.03)----
Organized groups----−0.07 (0.03) *--
Religious services------−0.11 (0.02) ***
Total effect-−0.08 (0.48) **−0.08 (0.48) **−0.08 (0.48) **
Indirect effect-0.00 (0.04)0.00 (0.03)−0.01 (0.08) *
Proportion of total effect mediated---14%
Complex design df50505050
N710710710710
Note. Model 1: Race, depressive symptoms. Model 2: Race, volunteering, depressive symptoms. Model 3: Race, organized groups, depressive symptoms. Model 4: Race, religious services, depressive symptoms. β = standardized regression coefficient. SE = standard error. Volunteering, organized groups, and religious services were selected from T2. Depressive symptoms were selected from T3 unless otherwise indicated. * p < 0.05; ** p < 0.01; *** p < 0.001.
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Wang, F.; Forrest-Bank, S.; Lou, Y.; Mukherjee, N.; Heo, Y. The Race Paradox in Mental Health Among Older Adults in the United States: Examining Social Participation as a Mechanism. Soc. Sci. 2025, 14, 426. https://doi.org/10.3390/socsci14070426

AMA Style

Wang F, Forrest-Bank S, Lou Y, Mukherjee N, Heo Y. The Race Paradox in Mental Health Among Older Adults in the United States: Examining Social Participation as a Mechanism. Social Sciences. 2025; 14(7):426. https://doi.org/10.3390/socsci14070426

Chicago/Turabian Style

Wang, Fei, Shandra Forrest-Bank, Yifan Lou, Namrata Mukherjee, and Yejin Heo. 2025. "The Race Paradox in Mental Health Among Older Adults in the United States: Examining Social Participation as a Mechanism" Social Sciences 14, no. 7: 426. https://doi.org/10.3390/socsci14070426

APA Style

Wang, F., Forrest-Bank, S., Lou, Y., Mukherjee, N., & Heo, Y. (2025). The Race Paradox in Mental Health Among Older Adults in the United States: Examining Social Participation as a Mechanism. Social Sciences, 14(7), 426. https://doi.org/10.3390/socsci14070426

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