Utilization of mental health services among rural elderly

Neese, Jane B.; Abraham, Ivo; Buckwalter, Kathleen C.

doi:10.1016/s0883-9417(99)80015-6

Cited by 26 publications

(26 citation statements)

References 38 publications

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“…Whereas older adults, persons in higher-income households, and adults with a college education are more likely to eat a nutritious diet, older rural adults are likely to have a lower income and less education and are more likely to be the primary caregivers of their grandchildren than are their urban counterparts (43)(44)(45)(46)(47). These data suggest that, although unhealthy diets are not limited to one race, sex, age group, or educational level, demographic factors such as age, income, and educational level do influence the overall diet quality.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the diet quality of US adults in the Lower Mississippi Delta

McCabe‐Sellers

Bowman

Stuff

et al. 2007

The American Journal of Clinical Nutrition

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Background:The Lower Mississippi Delta (LMD) is a region at high risk of nutritionally related diseases. Assessing LMD diet quality is important in policy making, monitoring service outcomes, and designing sustainable research interventions. Objective: The purpose was to assess the diet quality of LMD adults by using the Healthy Eating Index (HEI) to 1) identify potential and needed interventions, 2) determine population subgroups needing special attention, and 3) compare regional intakes with national intakes. Design: Data were obtained from a representative cross-sectional telephone survey (n ҃ 1699), Foods of our Delta Study 2000, by using the US Department of Agriculture's multiple-pass 24-h recall methodology and random-digital-assisted dialing with selection of one adult per household. The diet quality of LMD adults was compared with that of white and African American adults in the National Health and Nutrition Examination Survey (NHANES), 1999 -2000. Results: Age, race, and income of LMD adults affected overall diet quality. African Americans had lower grain, vegetable, milk, and variety scores than did whites. The consumption of grains and vegetables was associated with lower odds ratios for being overweight. The LMD adults had a lower HEI score than did the adults in NHANES 1999 -2000 (60.1 compared with 63.4), and more LMD adults ate a poor diet (24.8% compared with 18.3%). Conclusion: Low-income and young-adult households in the LMD are in need of nutrition interventions with an emphasis on increasing grain, fruit, and vegetable intakes. Because socioeconomic factors affect diet quality, a multimodal, longitudinal approach appears needed to improve nutritional health.Am J Clin Nutr 2007;86: 697-706.

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Section: Discussionmentioning

confidence: 99%

Assessment of the diet quality of US adults in the Lower Mississippi Delta

McCabe‐Sellers

Bowman

Stuff

et al. 2007

The American Journal of Clinical Nutrition

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“…Other studies of rural adult health have identified depression as a common and frequently untreated health condition (19). Rural communities have, relative to urban and suburban communities, limited access to mental health services (7,8). Even when mental health services are present, a variety of studies have shown low rates of utilization by rural elders (20).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Correlates of Depressive Symptoms Among Rural Older African Americans, Native Americans, and Whites With Diabetes

et al. 2005

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OBJECTIVE -Depression is associated with morbidity, mortality, and decreased quality of life and is a well-established complication among people with diabetes. Little is known about the prevalence and correlates of depressive symptoms among older adults living in rural communities, particularly among ethnic minority groups, who are at increased risk of developing diabetes and complications.RESEARCH DESIGN AND METHODS -Data were analyzed from the ELDER (Evaluating Long-term Diabetes Self-management Among Elder Rural Adults) diabetes study in which face-to-face interviews were conducted with 696 older (Ն65 years of age) African-American, Native American, and white men and women in two rural counties in central North Carolina.RESULTS -Using a criterion of Ն9 on a modified CES-D (Center for Epidemiologic Study of Depression) scale, 15.8% of the sample had depressive symptoms. In bivariate analyses, depressive symptomatology was more common among women and individuals who were unmarried and had less than a high school education, fewer financial resources, more chronic conditions, more prescription medications, and lower physical functioning. In multivariate analyses, sex, education, living arrangement, BMI, number of prescription medications, number of chronic conditions, and physical functioning remained significant.CONCLUSIONS -These results show that older rural adults with diabetes are at high risk for depressive symptoms, regardless of their ethnic group, and that certain demographic and health characteristics are important factors in this association. These findings add to the limited body of knowledge of comorbid depression in this population. Greater attention should be paid to diagnosing and treating this condition by those who provide care to these populations. Diabetes Care 28:823-829, 2005D epression is a common comorbidity among people with diabetes. In a recent meta-analysis, the prevalence of depression among people with diabetes was about twice as high as that among those without diabetes (1). Depression among people with diabetes reduces quality of life and is associated with morbidity, mortality, and health care costs (2-4).While there is a substantial body of research on comorbid depression among individuals with diabetes, significant gaps exist in the literature. First, little is known about this association among the rural elderly. This population constitutes Ͼ25% of the total U.S. elderly population and has limited access to health care, particularly specialty health care (5), mental health services, and other resources necessary for appropriate chronic disease management (6 -8). Second, there is limited information on comorbid depression among ethnic minorities with diabetes, particularly African Americans (9) and Native Americans. Diabetes is more common among ethnic minorities (10), so the public health impact of depression in this population may be substantial.The current study has two major aims: to assess the prevalence of depressive symptoms among a sample of older African Americans, Nati...

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“…Within the current body of literature, a predominant and re-occurring theme has emerged; that rural residents, including Aboriginals, despite their lowered perceived health status, utilize health services less frequently than their urban counterparts (Neese, Abraham, & Buckwalter, 1999;Nemet & Bailey, 2000;Yesalis, Lemke et al, 1985). Only one study has contradicted this theme.…”

mentioning

confidence: 99%

“…mental health services (Neese, Abraham & Buckwalter, 1999), even though it was believed that they would benefit from these services.…”

mentioning

confidence: 99%

“…Current literature suggests that in order for mental health services to become more accessible and available to rural residents, more innovative and creative means to deliver these services are required (Neese, Abraham & Buckwalter, 1999). This is also true for preventative services as these services also tend to be under-utilized, which may in fact be more related to a rural resident's belief of resiliency, strength and independence.…”

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confidence: 99%

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Comparison of health service utilization between Aboriginal and non-Aboriginal people living in the Bella Coola Valley.

Tatlock¹

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Utilization of mental health services among rural elderly

Cited by 26 publications

References 38 publications

Assessment of the diet quality of US adults in the Lower Mississippi Delta

Assessment of the diet quality of US adults in the Lower Mississippi Delta

Prevalence and Correlates of Depressive Symptoms Among Rural Older African Americans, Native Americans, and Whites With Diabetes

Comparison of health service utilization between Aboriginal and non-Aboriginal people living in the Bella Coola Valley.

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