According to a new study, elderly white Americans receive more diagnoses of depression than their minority counterparts. The study, which was a follow-up to a previous longitudinal study, was led by Ayse Akincigil of the Institute for Health, Health Care Policy and Aging Research at Rutgers University. Akincigil used data gathered from the Medicare Current Beneficiary Survey that included over 33,000 elderly individuals. Several studies conducted in the decade prior to this longitudinal study provided evidence that there were differences in depression diagnoses and treatments for older Americans. The results of these studies led to an increase of both depression diagnosis and medication among African-American and Latino elderly adults for several years. However, recent research has suggested that the ethnic differences still exist among this vulnerable segment of the population.
To shed some light on whether or not there are racial, cultural, or ethnic differences in the treatment and diagnosis of depression, Akincigil looked at the original data and found that among older Americans, the rates of depression were highest among Hispanics and Whites. Specifically, 6.4% of the cases of depression were White Americans, 7.2% were Hispanic Americans, and only 4.2% were African Americans. These results suggest that elderly African Americans are still being underserved in the clinical population with respect to this debilitating mood disorder.
Akincigil believes that there are many factors that could be influencing these findings. First, minority attitudes toward mental health care differ, and some ethnic groups think that psychological problems do not always need medical intervention. Stigma is another barrier to seeking help among minorities, and many people are ashamed to ask for help because of how they will be judged. Financial challenges also prevent many elderly minority individuals from receiving the care they need. Akingcigil said that communities have become proactive in addressing these needs and added, “Promising approaches include providing universal depression screening and ensuring access to care in low-income and minority neighborhoods.” Akincigil also noted that despite efforts on the part of mental health clinicians, African Americans are less likely to trust their doctors than White clients. This lack of trust significantly limits disclosure, which is a key element to accurate diagnosis and treatment. Overall, these results imply that depression does not discriminate. However, the current cultural perceptions and conditions perpetuate the prejudice surrounding depression, and, like any discrimination, limit the mental health care opportunities for minority adults.
Akincigil, A., Olfson, M., Siegel, M., Zurlo, K. A., Walkup, J. T. (2012). Racial and ethnic disparities in depression care in community-dwelling elderly in the United States. American Journal of Public Health, 102.2, 319-328.
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