title: Race, education, and the treatment of depression in nursing homes.
abstract: OBJECTIVE
  We investigate, among older adult nursing home residents diagnosed with depression, whether depression treatment differs by race and schooling, and whether differences by schooling differ by race. We examine whether Blacks and less educated residents are placed in facilities providing less treatment, and whether differences reflect disparities in care.
  
  
  METHODS
  Data from the 2006 Nursing Home Minimum Data Set for 8 states (n = 124,431), are merged with facility information from the Online Survey Certification and Reporting system. Logistic regressions examine whether resident and/or facility characteristics explain treatment differences; treatment includes antidepressants and/or psychotherapy.
  
  
  RESULTS
  Blacks receive less treatment (adj. OR = .79); differences by education are small. Facilities with more Medicaid enrollees, fewer high school graduates, or more Blacks provide less treatment.
  
  
  CONCLUSIONS
  We found disparities at the resident and facility level. Facilities serving a low-SES (socioeconomic status), minority clientele tend to provide less depression care, but Blacks also receive less depression treatment than Whites within nursing homes (NHs).
authors.affiliation: Medical Center, Traumatic Stress Studies Division, Department of Psychiatry, Mount Sinai School of Medicine, Bronx, NY 10029-6574, USA. michele.siegel@mssm.edu
authors.forename: Michele J
authors.initials: MJ
authors.lastname: Siegel
authors.forename: Judith A
authors.initials: JA
authors.lastname: Lucas
authors.forename: Ayse
authors.initials: A
authors.lastname: Akincigil
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gaboda
authors.forename: Donald R
authors.initials: DR
authors.lastname: Hoover
authors.forename: Ece
authors.initials: E
authors.lastname: Kalay
authors.forename: Stephen
authors.initials: S
authors.lastname: Crystal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D044383:Black People / Q000523:psychology* / Q000706:statistics & numerical data; D003863:Depression / Q000208:ethnology* / Q000628:therapy; D004522:Educational Status; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid; D009735:Nursing Homes; D011613:Psychotherapy / Q000706:statistics & numerical data; D014481:United States; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data; D001741:Black or African American
chemical_list: D000928:Antidepressive Agents