Mental Health Economics and African Americans

1
Mental Health Economics and African Americans

• Darrell J. Gaskin, PhD
• Associate Professor and Acting Chair African
  American Studies Department
• University of Maryland, College Park
• Research Associate
• Hopkins Center for Health Disparities Solutions

2
Acknowledgements

• Dr. De Lois Powell, Project Manager
• Mr. Pierre E. Wright, Director
• United Negro College Fund Special Programs
  Corporation
• National Library of Medicine

3
Are there race disparities in mental health?

• African Americans have lower rates of mental
  disorders than whites.
• ECA - 1980s sample from Baltimore, St. Louis,
  Durham-Piedmont, LA and New Haven
• NCS - nationally representative sample of 666
  African Americans, 4498 Whites

4
Lifetime Prevalence of Selected Mental Disorder
for Blacks and Whites from ECA
5
Lifetime Prevalence of Selected Mental Disorder
for Blacks and Whites from NCS
6
Race Differences in Self Reported Mental Disorders

• However, African Americans compared to White are
  more likely to report they suffer from seriously
  psychological distress.
• Based on the K6 Sadness, Nervousness, Restless,
  Hopeless, Everything an effort, Worthless over
  the past 30 days (Kessler et al 2003).

7
Percent of Adults Who Reported They Suffer from
Serious Psychological Distress, by Race 2004-2005

Source OMH website and CDC, 2007. Health United
States, 2007. Table 61
8
Percent of Adults Who Reported They Suffer from
Aspects of Serious Psychological Distress, by
Race 2004-2005
Source OMH website and CDC, 2007. Summary Health
Statistics for U.S. Adults 2006. Table 14.
9
Relationship between Race and Serious
Psychological Distress Is Related to Poverty
Status, 2004-2005
Source OMH website and CDC, 2007. Summary Health
Statistics for U.S. Adults 2006. Table 14.
10
Disparities in Mental Healthcare Use

• African Americans are less likely to use mental
  health services.
• African Americans are more likely to depend on
  primary care physician and safety net providers
  instead of mental health specialists for care.
• African Americans receive lower quality care.

11
Disparities in Treatment for Mental Health
Problems, by Race
Source OMH website and 2006 National Healthcare
Disparities Report. Table 229b 231b (2005)
Health United States, 2007. Data table for
Figure 36 (1999-2002).
12
Percent of Adults With Major Depressive Episode
Who Received Treatment for Depression, by Race
2004
Source OMH website and 2006 National Healthcare
Disparities Report. Table 93b.
13
Why are there Disparities in Mental Healthcare
Use?

• Provider/Prejudice Bias
• Diagnosis Bias
• Stigma
• Patient Preferences
• Mistrust
• Poor Communication
• Residential Segregation/Geographic Barriers
• High Rates of Poverty
• Lack of Health Insurance

14
African Americans and Hispanics Are Most Likely
to Be Uninsured
Source Table 6 CPS P60-233
15
Poverty Status by Race/Ethnicity
Source Table 6 CPS P60-233
16
Mental illness is costly

• Creates job-related problems
• Lower productivity
• Absenteeism
• Lowers quality of life
• Creates problem for children
• Academic failure
• Absenteeism
• Peer rejection

17
Contact Information

• Darrell J. Gaskin, PhD
• Associate Professor of Health Economics
• Acting Chair, African American Studies Department
• College of Behavioral and Social Sciences
• University of Maryland
• 2169 LeFrak Hall
• College Park, Maryland 20742
• 301-405-1162 (phone)
• 301-314-9932 (fax)
• dgaskin_at_aasp.umd.edu