title: Falling through the cracks: gaps in depression treatment among older Mexican-origin and white men.
abstract: OBJECTIVE
  This study aims (i) to compare depression frequency and self-reported depression treatment in Mexican-origin and white men; (ii) to examine ethnic differences in self-reported prior depression diagnosis and types of treatment; and (iii) to determine whether Mexican-origin men (both English and Spanish language preferring) are less likely than white men to report receiving depression treatment after controlling for potential confounders.
  
  
  METHODS
  This is a cross-sectional, observational study of Mexican-origin and white men (60 years old and over) presenting for primary care visits at six outpatient clinics in California's Central Valley. Clinical depression was assessed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), module for past-year major depression and questions for chronic depression. Past year, self-reported prior depression diagnosis and treatment (i.e., medication, psychotherapy, mental health referral) were assessed through a structured questionnaire.
  
  
  RESULTS
  The frequency of past-year clinical depression was similar for both ethnic groups, yet Mexican-origin men were significantly less likely than whites to report receiving a prior diagnosis of depression or prior depression treatment. Compared with whites, the odds of untreated depression in Mexican-origin men was 4.35 (95% CI 1.35-14.08) for those interviewed in English and 10.40 (95% CI 2.11-51.25) for those interviewed in Spanish. For both ethnic groups, the majority (i.e., approximately two-thirds) of men receiving depression treatment also met criteria for past-year clinical depression.
  
  
  CONCLUSIONS
  Mexican-origin older men in primary care suffer from significant gaps in depression care (i.e., diagnosis and treatment) compared with whites. Delivering effective depression treatment (i.e., so that depression remits) remains elusive for both ethnic groups.
authors.affiliation: Psychiatry and Behavioral Sciences, University of California Davis, Sacramento, CA, USA. ladson.hinton@ucdmc.ucdavis.edu
authors.forename: Ladson
authors.initials: L
authors.lastname: Hinton
authors.forename: Ester Carolina
authors.initials: EC
authors.lastname: Apesoa-Varano
authors.forename: Hector M
authors.initials: HM
authors.lastname: González
authors.forename: Sergio
authors.initials: S
authors.lastname: Aguilar-Gaxiola
authors.forename: Megan
authors.initials: M
authors.lastname: Dwight-Johnson
authors.forename: Judith C
authors.initials: JC
authors.lastname: Barker
authors.forename: Cindy
authors.initials: C
authors.lastname: Tran
authors.forename: Ramiro
authors.initials: R
authors.lastname: Zuniga
authors.forename: Jürgen
authors.initials: J
authors.lastname: Unützer
mesh_terms: D000368:Aged; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000592:standards*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D006801:Humans; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data