Abstract
BACKGROUND: Canada's mental health crisis has worsened since the COVID-19 pandemic. Depression is particularly concerning due to its prevalence and significant effects, but racial differences in its occurrence and associated factors remain underexplored. This cross-sectional study aims to address this gap by (1) assessing the prevalence of depressive symptoms among Arab, Asian, Black, Indigenous, White, and mixed-race individuals in Canada, and (2) identifying the factors associated within these racial groups. METHODS: A nationally representative sample (N = 4220) was randomly selected from a Computer-Assisted Web Interviewing panel, ensuring racial diversity (45.45% White, 13.53% Black, 13.25% Indigenous, 11.30% Arab, 7.32% Asian). Multiple linear and logistic regression analyses examined the associations between racial discrimination, resilience, and depression, controlling for sociodemographic factors. FINDINGS: The prevalence of depressive and severe depressive symptoms varied significantly across racial groups: Indigenous (49.37% and 21.11%), Arab (44.23% and 17.19%), Asian (41.42% and 13.92%), Black (32.92% and 12.78%), and White (32.69% and 10.53%), χ(2) (6) = 88.41, p < 0.0001 and χ(2) (6) = 65.16, p < 0.0001. For depressive symptoms, gender differences were significant only among White (28.96% men, 35.37% women, χ(2) (1) = 8.92, p = 0.0028) and Indigenous (41.40% men, 54.14% women) participants, χ(2) (1) = 8.54, p = 0.0035 and only for Indigenous participants for severe depressive symptoms. Younger participants consistently reported higher depressive and severe depressive symptoms rates across all racial groups. Everyday racial discrimination was significantly associated with depressive symptoms among all racialized and Indigenous groups (β = 0.28-0.43, p < 0.0001). Those reporting very high levels of discrimination were 4.79-18.61 times more likely to exhibit clinically significant depressive symptoms compared to those with low discrimination (Adjusted Odds Ratio = 4.79-18.61, p < 0.0001) with similar patterns for severe depressive symptoms. Resilience was negatively associated with depressive symptoms across all groups. INTERPRETATION: This study highlights the ongoing mental health crisis in Canada, particularly among racialized and Indigenous communities, which has been exacerbated by the complex racial trauma related to the experience of racial discrimination. There is a critical need for a national mental health plan that incorporates anti-racist and culturally sensitive prevention and care to ensure equitable access to mental health services. FUNDING: This study was funded by a grant from the Public Health Agency of Canada (PHAC - grant # 2324-HQ-000162).