Racial/Ethnic Disparities in Depression and Its Theoretical Perspectives

Kim, Minjeong

doi:10.1007/s11126-013-9265-3

Cited by 39 publications

(31 citation statements)

References 30 publications

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“…In sum, the people most vulnerable to work disability are characterized by diabetes and mental or musculoskeletal disorders and might also live alone, be single parents, or immigrants. Possible overarching factors for these people are economic hardship and weak or no social ties and support from other people (26,27). Our study is in line with previous research that shows an association between living alone, single parenthood, and mood disorders (26,28,29).…”

Section: Discussionsupporting

confidence: 91%

“…The higher prevalence of depression among ethnic minority groups and immigrants is well documented, and it has been suggested that depression among these groups is more persistent and disabling (27). We found a higher prevalence of diabetes among foreign-born people than among those born in Sweden and demonstrated that people with diabetes who were born outside Sweden had high levels of work disability owing to mental disorders.…”

Section: Discussionmentioning

confidence: 50%

“…We found a higher prevalence of diabetes among foreign-born people than among those born in Sweden and demonstrated that people with diabetes who were born outside Sweden had high levels of work disability owing to mental disorders. Mental disorders among immigrants may reflect, for example, economic and social stressors of resettlement and exposure to racism, which may be compounded by poor health and problems with cultural competence, i.e., accessing health care and communicating with health care professionals (27,30).…”

Section: Discussionmentioning

confidence: 99%

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Trends of Diagnosis-Specific Work Disability After Newly Diagnosed Diabetes: A 4-Year Nationwide Prospective Cohort Study

et al. 2015

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OBJECTIVEWe examined trends of diagnosis-specific work disability after newly diagnosed diabetes, comparing individuals with diabetes with those without diabetes, and identified the subgroups with the highest levels of work disability. RESEARCH DESIGN AND METHODSThe register data of diabetes medication and in-and outpatient hospital visits were used to identify all recorded new diabetes cases among the population aged 25-59 years in Sweden in 2006 (n = 14,098). Data for a 4-year follow-up of ICD-10 physician-certified sickness absence and disability pension days (2007)(2008)(2009)(2010) were obtained from the Swedish Social Insurance Agency. Comparisons were made using a random sample of the population without recorded diabetes (n = 39,056). RESULTSThe most common causes of work disability were mental and musculoskeletal disorders; diabetes as a reason for disability was rare. Most of the excess work disability among people with diabetes compared with those without diabetes was owing to mental disorders (mean difference adjusted for confounding factors 18.8-19.8 compensated days/year), musculoskeletal diseases (12.1-12.8 days/year), circulatory diseases (5.9-6.5 days/year), diseases of the nervous system (1.8-2.0 days/year), and injuries (1.0-1.2 days/year). The disparity in mental disorders first widened and then narrowed, while the difference in other major diagnostic categories was stable over 4 years. The highest rate (45.3 days/year) was found among people who had diabetes, lived alone, and were disabled from work owing to mental disorders. CONCLUSIONS

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 50%

Section: Discussionmentioning

confidence: 99%

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Trends of Diagnosis-Specific Work Disability After Newly Diagnosed Diabetes: A 4-Year Nationwide Prospective Cohort Study

et al. 2015

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“…Widespread use of a depression screener, shown not to possess measurement invariance, would likely result in under‐detection or over‐detection of depression in certain groups. Under‐detection would lead to under‐treatment of depression, which could increase sociodemographic disparities in depression care and outcomes (Kim, ; Simpson, Krishnan, Kunik, & Ruiz, ), whereas over‐detection would lead to the wasting of limited treatment resources.…”

Section: Introductionmentioning

confidence: 99%

Measurement invariance of the patient health questionnaire‐9 (PHQ‐9) depression screener in U.S. adults across sex, race/ethnicity, and education level: NHANES 2005–2016

et al. 2019

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Background Despite its popularity, little is known about the measurement invariance of the Patient Health Questionnaire‐9 (PHQ‐9) across U.S. sociodemographic groups. Use of a screener shown not to possess measurement invariance could result in under/over‐detection of depression, potentially exacerbating sociodemographic disparities in depression. Therefore, we assessed the factor structure and measurement invariance of the PHQ‐9 across major U.S. sociodemographic groups. Methods U.S. population representative data came from the 2005–2016 National Health and Nutrition Examination Survey (NHANES) cohorts. We conducted a measurement invariance analysis of 31,366 respondents across sociodemographic factors of sex, race/ethnicity, and education level. Results Considering results of single‐group confirmatory factor analyses (CFAs), depression theory, and research utility, we justify a two‐factor structure for the PHQ‐9 consisting of a cognitive/affective factor and a somatic factor (RMSEA = 0.034, TLI = 0.985, CFI = 0.989). On the basis of multiple‐group CFAs testing configural, scalar, and strict factorial invariance, we determined that invariance held for sex, race/ethnicity, and education level groups, as all models demonstrated close model fit (RMSEA = 0.025–0.025, TLI = 0.985–0.992, CFI = 0.986–0.991). Finally, for all steps ΔCFI was <−0.004, and ΔRMSEA was <0.01. Conclusions We demonstrate that the PHQ‐9 is acceptable to use in major U.S. sociodemographic groups and allows for meaningful comparisons in total, cognitive/affective, and somatic depressive symptoms across these groups, extending its use to the community. This knowledge is timely as medicine moves towards alternative payment models emphasizing high‐quality and cost‐efficient care, which will likely incentivize behavioral and population health efforts. We also provide a consistent, evidence‐based approach for calculating PHQ‐9 subscale scores.

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“…Behavioral health conditions are the leading cause of disability in the United States and are estimated to cost the United States more than 190 billion dollars per year, in unearned income . Higher rates of chronic mental illness and mental illness‐associated morbidity have been documented for some racial and ethnic groups, relative to whites . Differences in behavioral health treatment may underlie these disparate outcomes in mental illness‐associated morbidity.…”

Section: Introductionmentioning

confidence: 99%

Racial/ethnic disparities in specialty behavioral health care treatment patterns and expenditures among commercially insured patients in managed behavioral health care plans

Narain

Azocar

et al. 2019

Health Services Research

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Objective To document differences among racial/ethnic/gender groups in specialty behavioral health care (BH) utilization/expenditures; examine whether these differences are driven by probability vs intensity of treatment; and identify whether differences are explained by socioeconomic status (SES). Data Source The cohort consists of adults continuously enrolled in Optum plans with BH benefits during 2013. Study Design We modeled each outcome using linear regressions among the entire sample stratified by race/ethnicity, language and gender. Then, we estimated logistic regressions of the probability that an enrollee had any spending/use in a given service category (service penetration) and linear regressions of spending/use among the user subpopulation (treatment intensity). Lastly, all analyses were rerun with SES controls. Data Collection This study links administrative data from a managed BH organization to a commercial marketing database. Principal Findings We found that in many cases, racial/ethnic minorities had lower specialty BH expenditures/utilization, relative to whites, primarily driven by differences in service penetration. Among women, relative to whites, Asian non‐English speakers, Asian English speakers, Hispanic non‐English speakers, Hispanic English speakers, and blacks had $106, $95, $90, $48, and $61 less in total expenditures. SES explained racial/ethnic differences in treatment intensity but not service penetration. Conclusions In this population, SES was not a major driver of racial/ethnic differences in specialty BH utilization. Future studies should explore the role of other factors not studied here, such as stigma, cultural competence, and geography.

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Racial/Ethnic Disparities in Depression and Its Theoretical Perspectives

Cited by 39 publications

References 30 publications

Trends of Diagnosis-Specific Work Disability After Newly Diagnosed Diabetes: A 4-Year Nationwide Prospective Cohort Study

Trends of Diagnosis-Specific Work Disability After Newly Diagnosed Diabetes: A 4-Year Nationwide Prospective Cohort Study

Measurement invariance of the patient health questionnaire‐9 (PHQ‐9) depression screener in U.S. adults across sex, race/ethnicity, and education level: NHANES 2005–2016

Racial/ethnic disparities in specialty behavioral health care treatment patterns and expenditures among commercially insured patients in managed behavioral health care plans

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