The impact of insurance coverage in diminishing racial and ethnic disparities in behavioral health services

Health Serv Res. 2012 Jun;47(3 Pt 2):1322-44. doi: 10.1111/j.1475-6773.2012.01403.x. Epub 2012 Mar 30.


Objective: To estimate whether racial/ethnic behavioral health service disparities are likely to be reduced through insurance expansion coverage expected through the Affordable Health Care Act.

Data sources: Pooled data from the nationally representative NIMH Collaborative Psychiatric Epidemiological Studies (2001-2003).

Study design: We employ a novel reweighting method to estimate service disparities in the presence and absence of insurance coverage.

Data collection: Access to care was assessed by whether any behavioral health treatment was received in the past year. Need was determined by presence of prior year psychiatric disorder, psychiatric diagnoses, physical comorbidities, gender, and age.

Principal findings: Improving patient education and availability of community clinics, combined with insurance coverage reduces service disparities across racial/ethnic groups.However, even with expanded insurance coverage, approximately 10 percent fewer African Americans with need for behavioral health services are likely to receive services compared to non-Latino whites while Latinos show no measurable disparity.

Conclusions: Expansion of insurance coverage might have different effects for racial/ethnic groups, requiring additional interventions to reduce disparities for all groups.

Publication types

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

MeSH terms

  • Adult
  • Community Mental Health Services / organization & administration
  • Community Mental Health Services / statistics & numerical data
  • Continental Population Groups*
  • Ethnic Groups*
  • Female
  • Health Services Accessibility / organization & administration
  • Health Services Accessibility / statistics & numerical data
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Insurance, Health / statistics & numerical data*
  • Male
  • Mental Health Services / organization & administration
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Socioeconomic Factors