Racial Disparities in Diagnosis and Treatment of Major Depression
People worldwide are suffering with mental health challenges now more than ever. Social distancing and remote work and school have translated into emotional distancing for many. The pandemic has magnified the challenges at home and abroad, and some racial and ethnic groups suffer disproportionately.1,2 Quantifying the extent of racial and ethnic inequities in mental health can help us better understand how to address them.
This study investigates disparities in the prevalence of diagnosis and treatment of major depressive disorder, or major depression3, between majority white, Black and Hispanic communities. Our analysis spans 2016 to 2020 and is based on the medical claims of 3.1 million Blue Cross and Blue Shield (BCBS) commercially insured individuals with major depression between the ages of 12 and 64. For additional insights, we surveyed more than 2,700 adults, aged 18 to 75, about their attitudes and perspectives around mental health and how they access care.
This is the second in a series of reports supporting the Blue Cross and Blue Shield national strategy to address racial disparities in health. The first report in our series examined maternal health; future reports will explore disparities in diabetes and heart health.
Key Findings
Major depression goes undiagnosed and untreated at disproportionally greater rates in majority Black and Hispanic communities, leading to unnecessary suffering.
Key Findings
The presence of more mental and behavioral health providers in Black and Hispanic communities is associated with higher diagnosis rates for major depression. This suggests that increased access to these providers could mitigate the underdiagnosis of major depression in these communities.
Key Findings
Rates of treatment for major depression are lowest in Hispanic communities and lower in Black communities than in white communities. When treated for major depression, Black and Hispanic communities have a lower frequency of both prescription drug treatment and counseling.
Key Findings
Survey findings show that Black and Hispanic respondents are more likely to seek information on mental health outside of the health care system, to prefer providers with similar life experiences and perceive greater stigma about mental illness in their communities.
ENDNOTES
- World Health Organization (2022). Mental Health and COVID-19: Early evidence of the pandemic’s impact: Scientific brief, 02 March 2022.
- National Center for Health Statistics, U.S. Census Bureau (2022). Household Pulse Survey, Indicators of Anxiety or Depression based on Reported Frequency of Symptoms.
- ICD-10 codes in the F32 and F33 groupings.
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