RACIAL DISPARITY: Minorities Get Fewer Anti-Depressants
Whites are more than twice as likely as African Americans and Hispanics to be prescribed anti-depressant medication after being diagnosed with depression, according to a new study that appears in the May/June issue of the Harvard Review of Psychiatry. The Washington State University study found that 6.5% of whites diagnosed with depression were prescribed antidepressant drugs in 1992-93 and 7.7% in 1994-95. Blacks' prescription rates increased from 2.6% to 3.4% over the same period, and Hispanics' rates increased from 3% to 3.2%. The study utilized data from 80 million office visit by people aged 20-79.
Is There Bias?
The study did not control for socio-economic or other non-racial factors -- unlike a February published in the New England Journal of Medicine -- leading researchers at Washington State University to conclude that varying prescription drug coverage was largely to blame for the difference in care. Lead researcher David Sclar said he doubts "the ethnic disparity in prescription rates stems from bias on the part of doctors ... Doctors must write prescriptions based on what a patients's insurance coverage allows, and often must prescribe the least expensive medication or no medication at all."
He noted that programs such as Medicaid provide far less prescription drug coverage than some private insurance plans, forcing beneficiaries to resort to cheaper, less effective alternatives or to forego drug treatment altogether. Sclar added that differences "among ethnic groups' attitudes about mental illness could also contribute to the disparity," with some minority groups possibly "less likely than whites to inform a doctor they are suffering symptoms of depression." He concluded, "We have to change delivery systems somehow so everyone gets equitable access to mental-health services" (Jewell, AP/Seattle Times, 6/2).