title: Social determinants of mental health treatment among Haitian, African American, and White youth in community health centers.
abstract: We examine adequate mental health treatment, emergency room (ER) use, and early treatment dropout for Haitian, African American and White youth with a psychiatric diagnosis treated in community health centers in the United States. We present associations with possible socioeconomic determinants of care. Adequate treatment was less likely among Haitian youth from areas with greater poverty and among all youth from areas with more female-headed households. Medicaid-insured youth had more ER visits, especially African Americans. The relative impact of poverty on adequate care was higher for Haitians than Whites, and the relative impact of Medicaid coverage on ER use was higher for African Americans than for Whites. Early dropout was more likely among youth who were uninsured or from areas with more female-headed households. Socioeconomic factors and insurance status were significant determinants of care. Haitians living in poverty in the U.S. may face barriers to mental health services relative to other racial/ethnic groups.
authors.affiliation: Department of Psychiatry at the Harvard Medical School/Cambridge HealthAlliance, Somerville, MA 02143, USA. ncarson@charesearch.org
authors.forename: Nicholas
authors.initials: N
authors.lastname: Carson
authors.forename: Ben
authors.initials: B
authors.lastname: Lê Cook
authors.forename: Margarita
authors.initials: M
authors.lastname: Alegria
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003156:Community Mental Health Services; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005191:Family Characteristics / Q000208:ethnology; D005260:Female; D006205:Haiti / Q000208:ethnology; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured; D008605:Mental Health Services / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
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