Disparities in care for depression among primary care patients.
BACKGROUND
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.


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


METHODS
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.
UCLA-Neuropsychiatric Institute and Department of Biobhavioral Services, Los Angeles, Calif 90024, USA. Mirandaj@ucla.edu
Jeanne
J
Miranda
Lisa A
LA
Cooper
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D003376:Counseling; D003430:Cross-Sectional Studies; D003863:Depression / Q000208:ethnology* / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000523:psychology*; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011787:Quality of Health Care; D012944:Social Support; D014481:United States
D000928:Antidepressive Agents