Pharmaceutical Side Effects and Mental Health Paradoxes among Racial-Ethnic Minorities

Abstract

Sociologists have long struggled to explain the minority mental health paradox: that racial-ethnic minorities often report better mental health than non-Hispanic whites despite social environments that seem less conducive to well-being. Using data from the 2008–2013 Medical Expenditure Panel Survey (MEPS), this study provides a partial explanation for the paradox rooted in a very different disparity. Evidence from MEPS indicates that non-Hispanic whites consume more pharmaceuticals than racial-ethnic minorities for a wide variety of medical conditions. Moreover, non-Hispanic whites consume more pharmaceuticals that although effective in treating their focal indication, include depression or suicide as a side effect. In models that adjust for the use of such medications, the minority advantage in significant distress is reduced, in some instances to statistical nonsignificance. Although a significant black and Hispanic advantage in a continuous measure of distress remains, the magnitude of the difference is reduced considerably. The relationship between the use of medications with suicide as a side effect and significant distress is especially large, exceeding, for instance, the relationship between poverty and significant distress. For some minority groups, the less frequent use of such medications is driven by better health (as in the case of Asians), whereas for others, it reflects a treatment disparity (as in the case of blacks), although the consequences for the mental health paradox are the same. The implications of the results are discussed, especially with respect to the neglect of psychological side effects in the treatment of physical disease as well as the problem of multiple morbidities.

Status Variation in Anticipatory Stressors and Their Associations with Depressive Symptoms

“…Research on the minority mental health paradox indicates that blacks and Latinos report mental health outcomes that are equivalent to or more optimal than whites despite greater stress exposure (Louie and Wheaton 2019; Schnittker and Do 2020). However, evidence of this phenomenon is inconclusive in samples of adolescents and young adults, with several studies demonstrating higher levels of depressive symptoms among racial-ethnic minority groups (Adkins, Wang, and Elder 2009; Boardman and Alexander 2011).…”

Declining Life Expectancy in the United States: Missing the Trees for the Forest

“…Recent work suggests that the increase in overdose mortality is explained largely by the availability and relatively low cost of opioids rather than by economic conditions (123). Earlier increases in opioid deaths among non-Hispanic whites are also plausibly explained by a combination of greater access to prescription opioids, as well as racial bias in pain management (63,111,129).…”

Trends in the use of medications with insomnia side effects and the implications for insomnia among US adults

“…Previous studies have independently established the accuracy and reliability of Micromedex's coverage of the FDA’s black box warnings and drug–drug interactions (Barrons, 2004; Cheng, Guglielmo, Maselli, & Auerbach, 2010). In addition, a growing number of studies have used Micromedex to identify medication side effects and to assess the association between medication side effects and the health of the population (Do & Schnittker, 2020; Qato et al., 2018; Schnittker & Do 2020). This study identified 239 medications with insomnia side effects.…”

“…Multivariate ordinary least squared and logistic models were used to assess the association between insomnia‐related outcomes and the use of medications with insomnia side effects. To address the issue of unobserved heterogeneity in health and other factors, all analyses controlled for the use of medications without insomnia side effects (Do & Schnittker, 2020; Qato et al., 2018; Schnittker & Do, 2020). If the relationship between medications with insomnia side effects and insomnia was driven by unobserved heterogeneity in health and other factors, the relationship between medications without known insomnia side effects and insomnia should be equally significant as that between medications with insomnia side effects and insomnia.…”