Cited by 201Mental Health Treatment and AccessHealth disparities and outcomesMigration, Health and Trauma

Disparities in mental health service use of racial and ethnic minority elderly adults

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Jimenez, Daniel E., Cook, Ben, Bartels, Stephen J., Alegría, Margarita·2013·Journal of the American Geriatrics Society

Abstract

Objectives: To apply the I nstitute of M edicine definition of healthcare disparities, to measure disparities in different aspects of episodes of mental health care and to identify disparities in types of mental health services used. Design: Four 2‐year longitudinal datasets from Panels 9 to 13 (2004–2009) of the Medical Expenditure Panel Surveys were combined. Setting: Large‐scale surveys of families and individuals and their medical providers across the United States. Participants: One thousand six hundred fifty‐eight participants (981 white, 303 black, and 374 Latino) aged 60 and older with probable mental healthcare needs. Measurements: Mental healthcare need was defined as a Kessler‐6 Scale score >12 and a Patient Health Questionnaire‐2 score >2. Five aspects of mental healthcare episodes were analyzed: treatment initiation, adequacy of care, duration of care, number of visits, and expenditures. Whether episodes of care included only prescription drug fills, only outpatient visits, or both was assessed. Results: Treatment initiation and adequacy were lower for blacks and Latinos than whites. Latinos experienced episodes of longer duration, more visits, and higher expenditures. Blacks and Latinos had significantly lower rates of episodes that consisted of only medication refills. Blacks had significantly greater rates of episodes with only outpatient care visits. Latinos had significantly higher rates of medication plus outpatient visits. Conclusion: Low mental health treatment initiation and poor adequacy suggest the need for culturally appropriate interventions to engage older blacks and Latinos in mental health care. The surprising findings in blacks (higher rates of outpatient care visits) and Latinos (higher rates of medication plus outpatient visits) highlight the complexities of the older adult population and suggest new avenues for disparities research.

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  • Traditional clinical or primary care approaches to disability have not reduced disparities in treatment access and quality of care.

    “Traditional approaches that address disability in clinical or primary care contexts have failed to reduce disparities in treatment access (14) and quality of care (16).”

    From Effectiveness of a Disability Preventive Intervention for Minority and Immigrant Elders: The Positive Minds-Strong Bodies Randomized Clinical Trial (2019) · cites this paper as [14]

    The Results and Discussion report lower mental health treatment initiation among older Black and Latino adults than among White adults, supporting the treatment-access disparity. The paper does not evaluate traditional clinical or primary-care approaches to disability or show that those approaches failed to reduce disparities. In the citing sentence, the separate quality-of-care claim is attached to citation (16), not this source. (LLM, conf=0.85)

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Research works printed but not linked: 1

  1. [42]Cook BL McGuire T Lock K comparing methods of racial and ethnic disparities measurement across different settings of mental health care Health Serv Res 2010 45 825 847 20337739 PMC2875762

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Authors
Jimenez, D. E., Cook, B., Bartels, S. J., & Alegría, M.
Affiliations
  • Dartmouth College (US)
  • Cambridge Health Alliance (US)
  • Center for Multicultural Mental Health Research Cambridge Health Alliance Somerville Massachusetts USA
Corresponding author
Jimenez, Daniel E.
Venue
Journal of the American Geriatrics Society
Publisher
Wiley
Published
2012-12-18
Volume
61
Issue
1
Pages
18-25
ISSN
  • 0002-8614 (ISSN-L)
  • 1532-5415
OpenAlex
W2073417746
Cited by
201
References
53
Citations by year
2026: 5 · 2025: 9 · 2024: 11 · 2023: 12 · 2022: 10 · 2021: 11 · 2020: 16 · 2019: 21 · 2018: 13 · 2017: 57 · 2016: 8 · 2015: 10 · 2014: 11 · 2013: 4 · 2012: 2
FWCI
12.99
Type
journal article
Language
en
Open access
Locations
  • Journal of the American Geriatrics Society (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Mental Health
  • Centers for Disease Control and Prevention
Topics
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
Keywords
mental health care disparities, racial and ethnic minorities, older adults, Black older adults, Latino older adults, treatment initiation, duration of care, mental health care costs, outpatient visits, psychotropic drugs, culturally sensitive interventions, mental health service utilization
MeSH terms
Aged, Aged, 80 and over, Ethnicity, Female, Follow-Up Studies, Health Services Accessibility, Humans, Male, Mental Health Services, Middle Aged, Minority Groups, Retrospective Studies, Socioeconomic Factors, United States, Health Care Surveys, Racial Groups, Healthcare Disparities

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