Ethnicity and differential access to care for eating disorder symptoms

Int J Eat Disord. 2003 Mar;33(2):205-12. doi: 10.1002/eat.10129.


Objective: The impact of ethnicity on access to health care for eating disorder symptoms among participants in the 1996 National Eating Disorders Screening Program (NEDSP) was examined in two studies.

Method: Self-report and clinician-assessed data were analyzed from 9,069 participants in an educational and two-stage screening program for eating disorders in Study I. In Study II, both cross-sectional and prospective data from a randomly selected sample of 289 participants from the same program were analyzed to investigate the impact of ethnic minority status on both help-seeking patterns and clinician referral patterns for eating disorder symptoms.

Results: Even after controlling for severity of self-reported eating disorder symptoms, both Latino and Native American participants in the NEDSP were significantly less likely than Whites to receive a recommendation or referral for further evaluation or care. Ethnic minority subjects with self-acknowledged eating and weight concerns were also significantly less likely than non-minority participants to have been asked by a doctor about eating disorder symptoms. Only one marginally significant difference was found between ethnic minority and non-minority respondents with respect to their help-seeking behaviors, namely, ethnic minority subjects were less likely (at the level of a trend) to seek eating disorders treatment within 1(1/2)-2 years following the NEDSP.

Discussion: These data suggest that clinician bias may be an important barrier to access to care for eating disorder symptoms in ethnic minority populations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Ethnic Groups / statistics & numerical data*
  • Feeding and Eating Disorders / diagnosis
  • Feeding and Eating Disorders / epidemiology*
  • Feeding and Eating Disorders / therapy*
  • Female
  • Health Services Accessibility*
  • Humans
  • Male
  • Mass Screening
  • Middle Aged
  • Patient Acceptance of Health Care
  • Prospective Studies
  • Severity of Illness Index