Thursday, December 6, 2012

Mental Health Disparities: Is It Who You Are or Where You Live?

Racial and ethnic disparities in medical care are well-documented reasons explaining many variations in health outcomes. But are race and ethnicity the only reasons for those disparities? Researchers tracked the introduction of the long-acting injectable antipsychotic risperidone for 2.5 years after its introduction into the drug formulary of the Florida Medicaid program.

Their study covered 13,992 Medicaid beneficiaries, of whom 25 percent were black, 37 percent Latino, and 38 percent white. Adjustment for need confirmed a disparity between Latinos and whites (odds ratio=.58). However, including geographic location in the model eliminated the Latino-white disparity but confirmed the role of geographic variation in adoption of the long-acting injectable version of risperidone, wrote the RAND Corporation’s Marcela Horvitz-Lennon, M.D., M.P.H., and colleagues in the just-released December Psychiatric Services.

The authors suggest that cultural or organizational factors may play a role in these geographic differences. Culturally, the views of opinion leaders among physicians or attitudes toward pharmaceutical promotion of a new medication version might have influenced adoption of this medication. Alternatively, a key organizational factor might have been geographic variations in the availability of nurses to administer these injections.

For an abstract of this article see Psychiatric Services. To read more about issues surrounding mental health disparities, see Psychiatric News here and here.

(image: Imanol Quilez Sudupe/


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