Ethnic disparities in accessing treatment for depression and substance use disorders in an integrated health plan.
OBJECTIVE
This study examined ethnic differences in accessing treatment for depression and substance use disorders (SUDs) among men and women in a large integrated health plan, and explored factors potentially contributing to health care disparities.


METHODS
Participants were 22,543 members ages 20 to 65 who responded to health surveys in 2002 and 2005. Survey questions were linked to provider-assigned diagnoses, electronic medication, psychiatry, and chemical dependency program records.


RESULTS
Among women diagnosed with depression, Latinas (p < .01) and Asian-Americans (p < .001) were less likely than Whites to fill an antidepressant prescription. Among men diagnosed with depression, African Americans (p < .01) were less likely than Whites to do so. Among women diagnosed with an SUD, African Americans (p < .05) were less likely than Whites to have one or more chemical dependency program visits.


CONCLUSIONS
Results demonstrated ethnic differences in accessing depression and SUD treatment among patients diagnosed with these disorders, which persisted after controlling for education, income, having a regular health care provider and length of health plan enrollment. Findings highlight potential gender differences in ethnic disparities, lower antidepressant utilization among Asian Americans, and the effects of co-occurring disorders in accessing behavioral health care.
Satre
Derek D
DD
Department of Psychiatry, University of California, San Francisco 94143, USA. dereks@lppi.ucsf.edu
Campbell
Cynthia I
CI
Gordon
Nancy S
NS
Weisner
Constance
C
D000328:Adult; D000368:Aged; D002140:California; D019033:Delivery of Health Care, Integrated; D003866:Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D019966:Substance-Related Disorders / Q000208:ethnology / Q000628:therapy*