Service utilization differences for Axis I psychiatric and substance use disorders between white and black adults.
OBJECTIVE
Although studies have shown disparities between black and white populations in service utilization for mental disorders, little information exists on whether such disparities apply equally across disorders. The objective of this study was to examine racial differences in lifetime prevalence of service utilization for mood and anxiety disorders and for alcohol and drug use disorders, with controls for predisposing, enabling, and need-for-service variables unequally distributed between racial-ethnic groups.


METHODS
Data were from a face-to-face epidemiologic survey of 32,752 non-Hispanic white or black adults ages 18 and older residing in households and group quarters in the United States. Main outcome measures were treatment for mood, anxiety, and alcohol and drug use disorders.


RESULTS
White adults were consistently more likely than black adults to have had treatment for mood disorders (odds ratio [OR]=2.16, 95% confidence interval [CI]=1.80-2.59) and anxiety disorders (OR=1.77, 95% CI=1.43-2.19) after adjustment for predisposing and enabling factors and need for service (severity of disorder). In contrast no evidence of lower service utilization for treatment of alcohol use disorders emerged among black respondents (OR=.87, 95% CI=.69-1.10). Moreover, white respondents with drug use disorders were significantly less likely than black respondents to receive treatment for a drug problem (OR=.64, 95% CI=.47-.88).


CONCLUSIONS
Differences in treatment between black and white adults depended on the specific disorder and type of treatment considered. Prevention and intervention strategies should address disorder-specific disparities in services received.
Keyes
Katherine M
KM
Department of Epidemiology, Columbia University, New York, NY, USA.
Hatzenbuehler
Mark L
ML
Alberti
Philip
P
Narrow
William E
WE
Grant
Bridget F
BF
Hasin
Deborah S
DS
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000208:ethnology* / Q000523:psychology / Q000628:therapy; D014481:United States; D044465:White People