Disparities in care for depression among primary care patients

J Gen Intern Med. 2004 Feb;19(2):120-6. doi: 10.1111/j.1525-1497.2004.30272.x.

Abstract

Context: Ethnic minorities traditionally receive less care for depression than do white populations; we examine ethnic minority care for depression in a large cross-national primary care sample.

Design: This is a cross-sectional study of identification and treatment of depression among diverse primary care patients, using self-report of symptoms and care.

Subjects: One thousand four hundred and ninety-eight depressed primary care patients participating in four large studies of quality improvement for depression care are examined at baseline.

Results: Primary care providers recommend depression treatments for Latino and African-American patients as frequently as they do for white patients. However, Latino and African-American patients are less likely to take antidepressant medications (adjusted odds ratio [OR], 0.30; 95% confidence interval [CI], 0.21 to 0.42 and adjusted OR, 0.56; 95% CI, 0.36 to 0.87, respectively) and Latinos are less likely to obtain specialty mental health care (adjusted OR, 0.50; 95% CI, 0.36 to 0.75).

Conclusions: Primary care providers are now able to recognize depression and recommend treatment for Latino and African-American patients, with this care recommended at equal rates to that of white patients. However, Latino and African-American patients remain less likely to obtain appropriate care, such as antidepressant medications or specialty care. New approaches to improving access to appropriate care for Latino and African-American primary care patients are needed.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / psychology*
  • Aged
  • Antidepressive Agents / therapeutic use
  • Counseling
  • Cross-Sectional Studies
  • Depression / ethnology*
  • Depression / therapy*
  • Female
  • Health Care Surveys
  • Hispanic Americans / psychology*
  • Humans
  • Male
  • Middle Aged
  • Minority Groups / psychology*
  • Physician-Patient Relations*
  • Primary Health Care*
  • Quality of Health Care*
  • Social Support
  • United States

Substances

  • Antidepressive Agents