Racial-ethnic disparities in use of antidepressants in private coverage: implications for the Affordable Care Act

Psychiatr Serv. 2014 Sep 1;65(9):1140-6. doi: 10.1176/appi.ps.201300182.

Abstract

Objective: The objective of this study was to examine racial-ethnic disparities in the use of antidepressants among people with private coverage and people with public insurance or no coverage.

Methods: Data were from Medical Expenditure Panel Surveys (2006-2010), and logistic regression was used for the analysis.

Results: Among persons with depression and private coverage, racial-ethnic minority groups were significantly less likely than non-Hispanic whites to use antidepressants (N=4,468; adjusted odds ratio [AOR]=.50, 95% confidence interval [CI]=.33-.66 for non-Hispanic blacks; AOR=.70, CI=.55-.89 for Hispanics). No significant racial-ethnic disparity in the use of antidepressants was found in Medicare (N=1,944), Medicaid (N=2,125), and uninsured populations (N=1,679). For all racial-ethnic groups, persons with no insurance coverage had much lower rates of antidepressant use than their insured counterparts.

Conclusions: A wide racial-ethnic gap in the use of antidepressants existed in private coverage. As the nation continues to implement the Affordable Care Act, which will increase the number of enrollees from racial-ethnic minority groups in private plans, continuing efforts will be needed to reduce racial-ethnic disparities in the use of antidepressants.

MeSH terms

  • Adult
  • Aged
  • Antidepressive Agents / therapeutic use*
  • Black People / statistics & numerical data*
  • Depression / drug therapy*
  • Female
  • Healthcare Disparities / statistics & numerical data*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Insurance, Health / statistics & numerical data*
  • Male
  • Medicaid / statistics & numerical data
  • Medically Uninsured / statistics & numerical data
  • Medicare / statistics & numerical data
  • Middle Aged
  • Patient Protection and Affordable Care Act / statistics & numerical data
  • United States
  • White People / statistics & numerical data*

Substances

  • Antidepressive Agents