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

Ayse Akincigil, Mark Olfson, Michele Siegel, Karen A. Zurlo, James T. Walkup, and Stephen Crystal

American Journal of Public Health
2012
Objectives. We investigated racial/ethnic disparities in the diagnosis and treatment of depression among community-dwelling elderly.

Methods. 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.

Results. 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 ).

Conclusions. 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.

Ayse Akincigil, Mark Olfson, Michele Siegel, Karen A. Zurlo, James T. Walkup, and Stephen Crystal. 2012. "Racial and Ethnic Disparities in Depression Care in Community-Dwelling Elderly in the United States," American Journal of Public Health, 102 (2): 319-328.



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