title: Residential segregation, geographic proximity and type of services used: evidence for racial/ethnic disparities in mental health.
abstract: Residential characteristics influence opportunities, life chances and access to health services in the United States but what role does residential segregation play in differential access and mental health service utilization? We explore this issue using secondary data from the 2006 Medical Expenditure Panel Survey, 2006 American Medical Association Area Research File and the 2000 Census. Our sample included 9737 whites, 3362 African Americans and 5053 Latinos living in Metropolitan Statistical Areas. Using logistic regression techniques, results show respondents high on Latino isolation and Latino centralization resided in psychiatrist shortage areas whereas respondents high on African American concentration had access to psychiatrists in their neighborhoods. Predominant race of neighborhood was associated with the type of mental health professional used where respondents in majority African American neighborhoods were treated by non-psychiatrists and general doctors whereas respondents in majority Latino neighborhoods saw general doctors. Respondents high on Latino Isolation and Latino Centralization were more likely to utilize non-psychiatrists. These findings suggest that living in segregated neighborhoods influence access and utilization of mental health services differently for race/ethnic groups which contradicts findings that suggest living in ethnic enclaves is beneficial to health.
authors: African American Studies Department, University of Maryland College Park, 1147 Taliaferro Hall, College Park, MD 20742, United States. gnieshad@umd.edu
authors: Gniesha Y
authors: GY
authors: Dinwiddie
authors: Darrell J
authors: DJ
authors: Gaskin
authors: Kitty S
authors: KS
authors: Chan
authors: Janette
authors: J
authors: Norrington
authors: Rachel
authors: R
authors: McCleary
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D000368:Aged; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D014481:United States; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult