Communities of color? Client-to-client racial concordance in the selection of mental health programs for Caucasians and African Americans

Health Care Manag Sci. 2011 Dec;14(4):314-23. doi: 10.1007/s10729-011-9164-9. Epub 2011 May 25.

Abstract

A discrete-choice logit model was applied to study the determinants of mental health provider choice using data from a large urban county in the Northeast US. The study subjects were 9,544 adult Medicaid recipients who received outpatient treatment from the 20 Community Mental Health Center (CMHC) programs in 2001. In addition to a conventional set of variables representing client and provider characteristics, the regression model included several interaction terms to examine whether racial concordance level among patients influences the choice of an outpatient program. The results revealed that racial concordance among the clients seems to be a factor in choosing a program. In particular, Caucasian clients are much more likely to select a program with a higher percentage of Caucasian clients, even though they have to travel further. More generally, our results suggest that program choice may be driven more by the racial composition of the clients served than by spatial proximity to the program.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulatory Care / statistics & numerical data
  • Black or African American*
  • Community Mental Health Services / statistics & numerical data*
  • Female
  • Healthcare Disparities / ethnology*
  • Humans
  • Logistic Models
  • Male
  • Medicaid / statistics & numerical data
  • Middle Aged
  • New England
  • Patient Preference / ethnology*
  • Race Relations*
  • United States
  • Urban Population
  • White People*