Racial and Ethnic Disparities in Depression Care in Community-Dwelling Elderly in the United States

• Published in: American journal of public health (1971) Vol. 102; no. 2; pp. 319 - 328
• Main Authors: AKINCIGIL, Ayse, OLFSON, Mark, SIEGEL, Michele, ZURLO, Karen A, WALKUP, James T, CRYSTAL, Stephen
• Format: Journal Article
• Language: English
• Published: Washington, DC American Public Health Association 01.02.2012
• Subjects: Adult and adolescent clinical studies; African Americans; Age Factors; Aged; Aged, 80 and over; Antidepressants; Antidepressive Agents - therapeutic use; Beneficiaries; Biological and medical sciences; Bipolar disorder; Community; Cultural differences; Depression; Depression - ethnology; Depression - therapy; Depressive Disorder, Major - ethnology; Depressive Disorder, Major - therapy; Ethnicity; Ethnicity - statistics & numerical data; Female; General aspects; Health care access; Health care policy; Health services; Healthcare Disparities - ethnology; Hispanic Americans; Humans; Insurance coverage; Male; Medical research; Medical sciences; Medical screening; Medicare; Medicare - statistics & numerical data; Mental depression; Mental health; Miscellaneous; Mood disorders; Mortality; Older people; Patient education; Prescription drugs; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; Public health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Racial Groups - statistics & numerical data; Research and Practice; Residence Characteristics - statistics & numerical data; Sex Factors; Socioeconomic Factors; Studies; United States - epidemiology; White people; United States; North America; America; Human; Mood disorder; At home; Race; Depression; Disparity; Housing; Elderly; Ethnic group; Public health; Care
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.2011.300349

We investigated racial/ethnic disparities in the diagnosis and treatment of depression among community-dwelling elderly. We performed a secondary analysis of Medicare Current Beneficiary Survey data (n = 33,708) for 2001 through 2005. We estimated logistic regression models to assess the association of race/ethnicity with the probability of being diagnosed and treated for depression with either antidepressant medication or psychotherapy. Depression diagnosis rates were 6.4% for non-Hispanic Whites, 4.2% for African Americans, 7.2% for Hispanics, and 3.8% for others. After we adjusted for a range of covariates including a 2-item depression screener, we found that African Americans were significantly less likely to receive a depression diagnosis from a health care provider (adjusted odds ratio [AOR] = 0.53; 95% confidence interval [CI] = 0.41, 0.69) than were non-Hispanic Whites; those diagnosed were less likely to be treated for depression (AOR = 0.45; 95% CI = 0.30, 0.66). Among elderly Medicare beneficiaries, significant racial/ethnic differences exist in the diagnosis and treatment of depression. Vigorous clinical and public health initiatives are needed to address this persisting disparity in care.