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Racial, Ethnic, and Nativity Differences in Mental Health Visits to Primary Care and Specialty Mental Health Providers: Analysis of the Medical Expenditures Panel Survey, 2010–2015

1
Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS 2.0), VA Salt Lake City Health Care System, Salt Lake City, UT 84148, USA
2
Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA
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Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles (UCLA), CA 90095, USA
4
Department of Statistics, University of California, Los Angeles, CA 90095, USA
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UCLA Center for Bridging Research Innovation, Training and Education for Minority Health Disparities Solutions, Los Angeles, CA 90095, USA
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UCLA Luskin School of Public Affairs, Los Angeles, CA 90095, USA
7
UCLA David Geffen School of Medicine, Los Angeles, CA 90095, USA
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UCLA Center for Health Services and Society, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA 90095, USA
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Department of Health Policy and Management, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA 90095, USA
10
UCLA Center for Health Policy Research, Los Angeles, CA 90024, USA
11
Department of Psychology, University of California, Los Angeles, CA 90095, USA
*
Author to whom correspondence should be addressed.
Healthcare 2018, 6(2), 29; https://doi.org/10.3390/healthcare6020029
Received: 25 January 2018 / Revised: 10 March 2018 / Accepted: 15 March 2018 / Published: 22 March 2018
Background. Black and Latino minorities have traditionally had poorer access to primary care than non-Latino Whites, but these patterns could change with the Affordable Care Act (ACA). To guide post-ACA efforts to address mental health service disparities, we used a nationally representative sample to characterize baseline race-, ethnicity-, and nativity-associated differences in mental health services in the context of primary care. Methods. Data were obtained from the Medical Expenditures Panel Survey (MEPS), a two-year panel study of healthcare use, satisfaction with care, and costs of services in the United States (US). We pooled data from six waves (14–19) of participants with serious psychological distress to examine racial, ethnic, and nativity disparities in medical and mental health visits to primary care (PC) and specialty mental health (SMH) providers around the time of ACA reforms, 2010–2015. Results. Of the 2747 respondents with serious psychological distress, 1316 were non-Latino White, 632 non-Latino Black, 532 identified as Latino with Mexican, Central American, or South American (MCS) origins, and 267 as Latino with Caribbean island origins; 525 were foreign/island born. All racial/ethnic groups were less likely than non-Latino Whites to have any PC visit. Of those who used PC, non-Latino Blacks were less likely than Whites to have a PC mental health visit, while foreign born MCS Latinos were less likely to visit an SMH provider. Conditional on any mental health visit, Latinos from the Caribbean were more likely than non-Latino Whites to visit SMH providers versus PC providers only, while non-Latino Blacks and US born MCS Latinos received fewer PC mental health visits than non-Latino Whites. Conclusion. Racial-, ethnic-, and nativity-associated disparities persist in PC provided mental health services. View Full-Text
Keywords: healthcare disparities; mental health services; primary health care; African Americans; Hispanic Americans healthcare disparities; mental health services; primary health care; African Americans; Hispanic Americans
MDPI and ACS Style

Jones, A.L.; Cochran, S.D.; Leibowitz, A.; Wells, K.B.; Kominski, G.; Mays, V.M. Racial, Ethnic, and Nativity Differences in Mental Health Visits to Primary Care and Specialty Mental Health Providers: Analysis of the Medical Expenditures Panel Survey, 2010–2015. Healthcare 2018, 6, 29.

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