Racial and ethnic disparities in depression care in community-dwelling elderly in the United States

Am J Public Health. 2012 Feb;102(2):319-28. doi: 10.2105/AJPH.2011.300349. Epub 2011 Dec 15.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use*
  • Continental Population Groups / statistics & numerical data*
  • Depression / ethnology
  • Depression / therapy*
  • Depressive Disorder, Major / ethnology
  • Depressive Disorder, Major / therapy*
  • Ethnic Groups / statistics & numerical data*
  • Female
  • Healthcare Disparities / ethnology
  • Humans
  • Male
  • Medicare / statistics & numerical data
  • Psychotherapy*
  • Residence Characteristics / statistics & numerical data
  • Sex Factors
  • Socioeconomic Factors
  • United States / epidemiology

Substances

  • Antidepressive Agents