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Disparities in Mental Health Service Use of Racial and Ethnic Minority Elderly Adults
Open accessAbstract
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 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]
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Self-citationAssessing the Individual, Neighborhood, and Policy Predictors of Disparities in Mental Health Care
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Self-citation
Metadata
- 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
- PMC
- PMC3545089
- 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
- green
- www.ncbi.nlm.nih.gov
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › 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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