The present study examines the effect of race/ethnicity on measurement equivalence of the Everyday Discrimination Scale (EDS). Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES), adults aged 18 and older from four racial/ethnic groups were selected for analyses: 884 non-Hispanic Whites, 4,950 Blacks, 2,733 Hispanics/Latinos, and 2,089 Asians. Multiple-group confirmatory factor analyses were conducted. After adjusting for age and gender, the underlying construct of the EDS was invariant across four racial/ethnic groups, with Item 7 (“People act as if they’re better than you are”) associated with lower intercepts for the Hispanic/Latino and Asian groups relative to the non-Hispanic White and Black groups. In terms of latent factor differences, Blacks tended to score higher on the latent construct compared to other racial/ethnic groups, whereas Asians tended to score lower on the latent construct compared to Whites and Hispanics/Latinos. Findings suggest that although the EDS in general assesses the underlying construct of perceived discrimination equivalently across diverse racial/ethnic groups, caution is needed when Item 7 is used among Hispanics/Latinos or Asians. Implications are discussed in cultural and methodological contexts.

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Objective This study examined whether racial-ethnic differences in satisfaction with and perceived benefits from mental health services vary by geographic region among U.S. adults. Methods Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES), selected samples consisted of 2,160 adults age 18 and older from diverse racial-ethnic groups (Asian, black, Hispanic/Latino, and white) who had used mental health services in the past 12 months. Generalized linear model analysis was conducted for the United States as a whole and separately by geographic region (Northeast, South, Midwest, and West) after adjustment for covariates. Results In the national sample, no significant main effects of race-ethnicity and geographic region were found in either satisfaction with or perceived benefits from mental health services. In the stratified analyses for geographic regions, however, significant racial-ethnic differences were observed in the West; blacks in the West were significantly more likely to report higher satisfaction and perceived benefits, whereas Hispanics/Latinos in the West were significantly less likely to do so. Conclusions The findings suggest that there are regional variations of racial-ethnic differences in satisfaction with and perceived benefits from mental health services among U.S. adults and that addressing needs of Hispanics/Latinos in the West may help reduce racial-ethnic disparities in mental health care. Clinical and policy implications are discussed.

This study examines whether English proficiency and geographic context explain health insurance status among older Latino and Asian immigrants in the U.S. Drawn from the 2010–2012 ACS PUMS, 57,936 Latino and 47,742 Asian immigrants aged 65 and older were selected. Logistic regression analysis was conducted for the U.S. as a whole and separately by geographic region. In the entire U.S., having limited English proficiency (LEP) and being proficient in English (EP) increased odds of being uninsured among Latino immigrants, whereas LEP and EP decreased odds of being uninsured among Asian immigrants. In the stratified analyses for geographic regions, there were significant ethnic differences in the directionality of the relation between English proficiency and uninsured status. Regional institutions should take care to expand access to information on health care and insurance coverage to racial/ethnic minorities, taking into account the characteristics of these groups at the local level.

Objectives: Though several national-level mental health policies have been enacted and implemented over the past decade, older adults’ rates of mental health service (MHS) utilization remain low. We aimed to examine individual- and community-level factors that have fostered the most successful implementations of national mental health policies in recent years. Methods: We conducted a multilevel growth curve analysis to examine older adults’ MHS use using the Medical Expenditure Panel Survey – Household Component, or MEPS-HC. We considered MHS use in the MEPS-HC for the period of 2002-2012, during which members of MEPS Panels 6-17 provided responses. We identified 8,416 respondents aged 65+ with mental health need, and examined the rates of actual MHS utilization among this sample as it varied by insurance status, rural/urban location, and race/ethnicity. Results: Analyses revealed that rates of older adults’ MHS use did not increase significantly over our examination period, regardless of race/ethnicity or rurality of location. Only insurance status was a significant predictor of change in MHS use rates over the years 2002-2012; t=3.93 (19), p<0.001. Conclusions: Findings suggest that rates of MHS use remained stagnant over the decade examined, revealing problems with implementation of relevant policies for older adults. Additionally, our analyses highlighted that although there were no disparities in rates of MHS use by geographic location or race/ethnicity, there may be significant disparities in identified need for services among older adults. We make suggestions for ensuring greater efficiency and efficacy of efforts to improve older adults’ MHS use in the coming decade.