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Disparities in Health Care: Race, Ethnicity and Gender

     

It is well-established that adults with mental health disorders spend more on medical care than adults without mental illness, and members of racial and ethnic minority groups have in the past often had less access to care. Researchers led by Judith Weissman, Ph.D., J.D. with the Icahn School of Medicine at Mt. Sinai, New York, wanted to evaluate the impact the Affordable Care Act has had on ethnic, racial and gender disparities in access to health care among adults with mental health conditions.

They looked at national survey data for nearly 9,000 adults 18 to 64 with serious psychological distress in 2006 to 2015. Serious psychological distress, while not a diagnosis of a specific disorder, is a measure of mental health within a community. The research was published online Feb. 1 in Psychiatric Services in Advance.

Researchers found that a greater proportion of whites had private health insurance. Hispanics were more likely than other groups to report no health coverage. Whites and those with private health insurance reported less access and use of health care compared with people of other racial-ethnic groups and people with Medicaid. The study found that whites were significantly more likely than blacks to experience barriers to using health care, such as not having money for needed medications and mental health care and having delays in care.

The researchers note their findings are “surprising in light of numerous studies demonstrating disparities in health care utilization among adults in racial-ethnic minority groups.” Previously, black and Hispanic adults have historically fared worse than white adults. The researchers suggest that with “implementation of the ACA, these historical black-white disparities appear to have improved.”

women-group

Disparities in Care for Women

Unlike the changes in ethnic and racial disparities, the researchers found ongoing disparities by gender—women continued to be more likely than men to experience delays in care, to lack money for medications or mental health care and to have changes in their usual place of care. Other studies have identified particular challenges faced by women seeking mental health care.

For example, a study in Canada found that women were more likely than men to report problems with access and availability, including issues such as lack of transportation and childcare. A study looking at women veterans’ perceptions and use of mental health services identified challenges, such as feeling stigmatized by providers and other military personnel and lack of interest from those providing care in hearing their stories. All of the women veterans interviewed for the study noted that that they would not have sought services without the help of a supportive peer who encouraged them to seek care.

By APA Staff

References

  • Indelse K, and Messecar D. Rural Women Veterans’ Use and perception of Mental Health Services. Arch Psychiatr Nurs. 2016, 30(2):244-8.
  • Weissman J, Russell D, Jay M, Malaspina D. Racial, Ethnic and Gender Disparities in Health Care Access and Use Among U.S. Adults with Serious Psychological Distress. Psychiatric Services in Advance. Feb. 1, 2018.
  • Slaunwhite AK. The Role of Gender and income in Predicting Barriers to Mental Health Care in Canada. Community Mental Health Journal. 2015, 51(5):621-7.

     

AnxietyBipolar DisordersDepressionSchizophreniaPTSD

 

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