Regional Variation of Racial Disparities in Mental Health Service Use Among Older Adults

Kim, Giyeon; Parton, Jason; DeCoster, Jamie; Bryant, Ami N.; Ford, Katy L.; Parmelee, Patricia A.

doi:10.1093/geront/gns107

Cited by 25 publications

(23 citation statements)

References 29 publications

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“…Also, women were more likely to have an unmet need for mental health treatment or counselling in comparison to men 15. Women might be more susceptible to a lack of mental health services within high-income inequality states 16 17…”

Section: Introductionmentioning

confidence: 99%

Income inequality among American states and the incidence of major depression

Pabayo

Kawachi

Gilman

2013

J Epidemiol Community Health

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Background Although cross-sectional and ecological studies have shown that higher area-level income inequality is related to increased risk for depression, few longitudinal studies have been conducted. This investigation examines the relationship between state-level income inequality and major depression among adults participating in a population-based, representative longitudinal study. Methods We used data from the National Epidemiologic Survey on Alcohol and Related Conditions (n=34,653). Respondents completed structured diagnostic interviews at baseline (2001–2002) and follow-up (2004–2005). Weighted multi-level modeling was used to determine if US State-level income inequality (measured by the Gini coefficient) was a significant predictor of depression at baseline and at follow-up, while controlling for individual and state-level covariates. We also repeated the longitudinal analyses excluding those who had a history of depression or at baseline, in order to test whether income inequality was related to incident depression. Results State-level inequality was associated with increased incidence of depression among women but not men. In comparison to women residing in states belonging to the lowest quintile of income inequality, there was increased risks for depression among women in the second [Odds Ratio (OR)=1.18, 95% Confidence Interval (CI)=0.86,1.62], third (OR=1.22, 95% CI=0.91,1.62), fourth (OR=1.37, 95% CI=1.03,1.82), and fifth (OR=1.50, 95% CI=1.14,1.96) quintiles at follow-up (p<0.05 for the linear trend). Conclusion Living in a state with higher income inequality increases the risk for the development of depression among women.

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Section: Introductionmentioning

confidence: 99%

Income inequality among American states and the incidence of major depression

Pabayo

Kawachi

Gilman

2013

J Epidemiol Community Health

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“…[26][27][28][29][30] In fact, models of health care utilization have included geographic factors since the 1960s. 31,32 A patient's geographic location is not only associated with access to and utilization of services, 30,33,34 but also with outcomes of care. 35 However, despite the multitude of documented health disparities associated with unmet need for behavioral health services [1][2][3][4][5][6][7] and the growing body of evidence supporting integrated primary care, [19][20][21][22][23] little is known about disparities in access to integrated care.…”

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confidence: 99%

Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care

Wielen¹,

Gilchrist²,

Nowels³

et al. 2015

hpu

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“…Disparities in mental health care between racial-ethnic minority and non-minority groups in the United States have been well documented. Previous research consistently suggests that people in racial-ethnic minority groups tend to underutilize mental health services compared with non-Hispanic whites (1–7). However, racial-ethnic differences in regard to mental health problems do not always indicate greater need for such services among racial-ethnic minority groups (8–13).…”

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confidence: 99%

“…According to Andersen’s (18,19) behavioral model of health service utilization, which is the conceptual framework of this study, individuals’ health care access is influenced not only by person-level factors (predisposing, enabling, and health need factors), but also by community-level factors, including geographic location and geographic characteristics. Research suggests the important role of geography in mental health care (20–22), as well as in mental health service use (7,23–25). In a study of adults in 13 states, Ayers and colleagues (25) identified geographic variations in need for mental health services, mental health service use, unmet need for mental health services, overuse of mental health services, and intensity of mental health services.…”

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confidence: 99%

“…The authors emphasized geographic influences on mental health care, concluding that despite the importance of individual-level characteristics, geographic-level characteristics, such as state population characteristics and state mental health laws, function as strong predictors of variation in mental health service use (25). A recent study of older adults in the United States found that black-white disparities in mental health service use existed in the South, whereas no racial disparities were observed in other regions (7). This suggests that improving access to mental health care in certain geographic regions (the South in this study) may be crucial to reduce racial disparities at the national level.…”

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confidence: 99%

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Geographic and Racial-Ethnic Differences in Satisfaction With and Perceived Benefits of Mental Health Services

Kim¹,

Parton²,

Ford³

et al. 2014

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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.

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Regional Variation of Racial Disparities in Mental Health Service Use Among Older Adults

Abstract: The findings suggest that improving the access to mental health care in certain regions, the South in particular, may be essential to reduce racial disparities at the national level. Policy implications are discussed.

Cited by 25 publications

References 29 publications

Income inequality among American states and the incidence of major depression

Income inequality among American states and the incidence of major depression

Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care

Geographic and Racial-Ethnic Differences in Satisfaction With and Perceived Benefits of Mental Health Services

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