Significant racial disparities in diagnosis and treatment of depression are still present, according to a new study.
African Americans were still significantly less likely to receive a depression diagnosis than were non-Hispanic whites, and African Americans diagnosed with depression were also less likely to receive treatment, said the study’s lead author Ayse Akincigil, an assistant professor in Rutgers' School of Social Work.
"Vigorous clinical and public health initiatives are needed to address this persisting disparity in care," Akincigil said.
Researchers analyzed health care use data from the 2001 to 2005 U.S. Medicare Current Beneficiary Survey involving 33,708 Medicare beneficiaries. They looked at costs, health status, as well as medical and prescription drug insurance coverage access.
According to the study
Physicians diagnosed people in various racial groups for depression at the following rates: 6.4 percent of non-Hispanic whites, 4.2 percent of African Americans, 7.2 percent of Hispanics and 3.8 percent of other races.
Akincigil noted that the heterogeneity of Hispanics made it difficult to determine reasons for lack of treatment and the group’s treatment preference. He said he was curious to learn if there were cultural differences or general differences regarding health care quality and treatment accessibility for depression.
"Whites use more antidepressants than African Americans. We presume they have better access to doctors and pharmacies, and more money to spend on drugs," Akincigil said.
Researchers also said that there may be disparities in diagnosis and treatment because help-seeking patterns, stigma, patient attitudes and knowledge may differ by race.
"African Americans might turn to their pastors or lay counselors in the absence of psychotherapists," Akincigil said. "Low-income African Americans who were engaged in psychotherapy reported that stigma, dysfunctional coping behavior, shame and denial could be reasons some African Americans do not seek professional help."
Communication with health care providers could also differ among ethnicities.
"African Americans reported greater distrust of physicians and poorer patient-physician communication than do white patients," Akincigil said.
Financial factors could also contribute to the disparity in depression treatment rates. Among Medicare beneficiaries, African Americans are significantly less likely to have private supplemental insurance compared to non-Hispanic whites.
"Differences in provider reimbursement may favor increased clinical detection of depression in white patient groups if higher payment rates result in longer visits," Akincigil said.
Around 6.6 percent of elderly Americans have experienced major depression each year.
"If untreated or undertreated, depression can significantly diminish quality of life," Akincigil said.