Regional variation of racial disparities in mental health service use among older adults

Gerontologist. 2013 Aug;53(4):618-26. doi: 10.1093/geront/gns107. Epub 2012 Aug 2.


Purpose: Given the paucity of research on the role of geography in mental health care, this study examined whether racial differences in mental health service use varied across geographic regions among older adults.

Design and methods: Drawn from the Collaborative Psychiatric Epidemiology Surveys (CPES), blacks (n = 1,008) and whites (n = 1,870) aged 60 and older were selected for analysis. Logistic regression analyses were conducted.

Results: Results showed significant racial disparities in mental health service use in the overall sample, as well as significant variation by region. Although no racial differences were observed in the Northeast, West, or Midwest regions, black elders in the South were significantly less likely than whites to use mental health services (odds ratios [OR], 2.08; 95% confidence interval [CI], 1.34-3.23).

Implications: The findings suggest that improving the access to mental health care in certain regions, the South in particular, may be essential to reduce racial disparities at the national level. Policy implications are discussed.

Keywords: Geography; Mental health; Racial disparities; Regional variation; Service use.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude to Health*
  • Ethnicity / statistics & numerical data*
  • Female
  • Geography
  • Health Care Surveys
  • Health Services Accessibility / statistics & numerical data
  • Health Services for the Aged / statistics & numerical data*
  • Healthcare Disparities / ethnology*
  • Humans
  • Logistic Models
  • Male
  • Mental Disorders / ethnology
  • Mental Disorders / psychology*
  • Mental Disorders / therapy
  • Mental Health Services / statistics & numerical data*
  • Middle Aged
  • Severity of Illness Index
  • Socioeconomic Factors
  • United States / epidemiology