title: Racial and ethnic disparities in depression care in community-dwelling elderly in the United States.
abstract: OBJECTIVE
  We investigated racial/ethnic disparities in the diagnosis and treatment of depression among community-dwelling elderly.
  
  
  METHODS
  We performed a secondary analysis of Medicare Current Beneficiary Survey data (n = 33,708) for 2001 through 2005. We estimated logistic regression models to assess the association of race/ethnicity with the probability of being diagnosed and treated for depression with either antidepressant medication or psychotherapy.
  
  
  RESULTS
  Depression diagnosis rates were 6.4% for non-Hispanic Whites, 4.2% for African Americans, 7.2% for Hispanics, and 3.8% for others. After we adjusted for a range of covariates including a 2-item depression screener, we found that African Americans were significantly less likely to receive a depression diagnosis from a health care provider (adjusted odds ratio [AOR] = 0.53; 95% confidence interval [CI] = 0.41, 0.69) than were non-Hispanic Whites; those diagnosed were less likely to be treated for depression (AOR = 0.45; 95% CI = 0.30, 0.66).
  
  
  CONCLUSIONS
  Among elderly Medicare beneficiaries, significant racial/ethnic differences exist in the diagnosis and treatment of depression. Vigorous clinical and public health initiatives are needed to address this persisting disparity in care.
authors.affiliation: School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA. aakinci@rci.rutgers.edu
authors.forename: Ayse
authors.initials: A
authors.lastname: Akincigil
authors.forename: Mark
authors.initials: M
authors.lastname: Olfson
authors.forename: Michele
authors.initials: M
authors.lastname: Siegel
authors.forename: Karen A
authors.initials: KA
authors.lastname: Zurlo
authors.forename: James T
authors.initials: JT
authors.lastname: Walkup
authors.forename: Stephen
authors.initials: S
authors.lastname: Crystal
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression / Q000208:ethnology / Q000628:therapy*; D003865:Major Depressive Disorder / Q000208:ethnology / Q000628:therapy*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006801:Humans; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D011613:Psychotherapy; D044469:Racial Groups / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000928:Antidepressive Agents