Behavioral health equity: scale of impact
Behavioral health conditions are on the rise,1 and stark disparities exist that are disproportionately affecting marginalized groups—especially people of color. The first step in providing support for your workforce is grasping the extent of behavioral health disparities.
Mental health conditions are projected to contribute to $16 trillion in lost productivity by 2030.2
Estimates show that those of the lowest socioeconomic status are up to 3X more likely to have a mental health condition.3
63% of Black adults believe that a mental health condition is a sign of personal weakness, which could lead those with a mental health challenge to worry about discrimination.4
- Only 1 in 3 Black adults who need mental healthcare receive it.5
- Only about 34% of Hispanic/Latino adults with mental health conditions receive treatment each year, compared to the U.S. average of 45%.6
staying in treatment
- Due to stigma, people of color are 20%-50% less likely to seek out mental healthcare, and 40%-80% more likely to end treatment prematurely.7
- Rates of prescription treatment for diagnosed major depression are 33% lower for Hispanic communities and 13% lower for Black communities than for white communities. Rates of counseling for diagnosed major depression are also 21% lower for Hispanic communities than white communities.8
- Likely due to underdiagnosis, majority Black and Hispanic communities have a 30%-40% lower diagnosis rate of major depression than white communities.9
- Early and consistent screening combined with the context of known risk factors has been found to help detect and treat postpartum depression.10 But according to a recent survey from Blue Cross Blue Shield Association, 34% of Black women and 38% of Hispanic women said they were not screened for postpartum depression or did not know if they were screened.11 Learn more about maternal health disparities in Volume #2 of our Health Equity mini-eMagazine series.
- 80% of all rural counties are lacking even a single psychiatrist.12 This is especially relevant given the change in moving patterns over the last two years—six of the top ten states with the highest inbound moving percentages of 2021 are among the 20 least densely populated states in America.13
- Socioeconomic status also reflects sizable disparities that have been amplified by COVID-19. 35% of adults with less than $40K a year in household income reported a major negative impact to their mental health due to the pandemic, versus 21% with $40K-$89K and 17% with $90K or more.14
- Adults who are uninsured or low-income are more likely to experience serious mental health conditions than individuals with insurance or higher incomes.15
- Those diagnosed with a chronic illness are twice as likely to have a behavioral health condition, and those with a behavioral health condition are more likely to have a chronic illness.16 Comorbidities such as this are associated with worse health outcomes, more complex clinical management and increased healthcare costs.17
- People of color are up to two times more likely to have major long-term conditions when compared to white people.18
Impact on employers
With people of color projected to make up over half of the U.S. population by 2050,19 persistence of behavioral health disparities among diverse segments of the workforce could have significant impacts on businesses. Depression is one condition in particular that has massive cost implications both to the well-being of the workforce and to organizations.
Addressing behavioral health is good business.Learn More
Advancing behavioral health equity takes all of us.
There’s much more to learn about the different groups affected by behavioral health disparities, key contributing factors and strategies for employers to change the tide for their workforce. Download our latest Health Equity mini-eMagazine and join the journey to make healthcare more equitable at smarterbetterhealthcare.com.Learn More
1 Ages 18-64, Blue Cross Blue Shield Health Index, 2018.
2 Kelly McCain and Philip Campbell, “Declines in Mental Health Workforce Need to Be Met by More Rigorous Employer Support,” Scientific American, Sept. 14, 2021.
3 Young-Mee Kim, PhD, and Sung il-Cho, PhD, MD, “Socioeconomic Status, Work-Life Conflict, and Mental Health,” American Journal of Industrial Medicine, May 17, 2020.
4, 5 “Identity and Cultural Dimensions: Black/African American,” Your Journey, National Alliance on Mental Illness (NAMI).
6 National Alliance on Mental Illness (NAMI), “Hispanic/Latinx,“ 2021.
7 Neil Krishan Aggarwal, et al., “Clinician Descriptions of Communication Strategies to Improve Treatment Engagement by Racial/Minorities in Mental Health Services: A Systematic Review,” Patient Education and Counseling, Feb. 2016, 198–209, cited in National Center for Biotechnology Information/US National Library of Medicine, National Institutes of Health.
8, 9 Blue Cross Blue Shield Association, Analysis on Racial Disparities in Diagnosis & Treatment of Major Depression, 2022.
10 Zoleykha Asgarlou, Mohammad Arzanlou, and Mohammad Mohseni, “The Importance of Screening in Prevention of Postpartum Depression,” Iranian Journal of Public Health, May 2021, 1072–1073, cited in National Center for Biotechnology Information/US National Library of Medicine, National Institutes of Health.
11 Blue Cross Blue Shield Association, Maternal Health Survey. 2020.
12 New American Economy, “New Study Shows 60 Percent of U.S. Counties Without a Single Psychiatrist, One-Third of All Psychiatrists Nationwide Trained Abroad,” Oct. 23, 2017.
13 Annual 2021 United Van Lines National Movers Study, United Van Lines, Jan. 3, 2022.
14 Nirmita Panchal, Rabah Kamal, and Cynthia Cox, “The Implications of COVID-19 for Mental Health and Substance Use,” KFF (Kaiser Family Foundation), Feb. 10, 2021.
15 The Costs and Consequences of Disparities in Behavioral Health Care, National Conference of State Legislatures, Feb. 2018.
16, 25 Steven Ross Johnson and Harris Meyer, “Behavioral Health: Fixing a System in Crisis,” Modern Healthcare, Jun. 12, 2017.
17 Jose M. Valderas, MD, et al., “Defining Comorbidity: Implications for Understanding Health and Health Services,” Annals of Family Medicine, July 2009, 7(4): 357–363.
18 Rachel Reiff Ellis, “Minorities and Chronic Disease: Obstacles to Care,” WebMD, Oct. 7, 2020.
19 Nambi Ndugga and Samantha Artiga, “Disparities in Health and Health Care: 5 Key Questions and Answers,” KFF (Kaiser Family Foundation), May 11, 2021.
20 Center for Workplace Mental Health, American Psychiatric Association Foundation, “Investing in a Mentally Healthy Workforce Is Good for Business,” 2020.
21 Don Mordecai, MD, ”Mental Health at Work - Why Stigma Is a Workforce Health Issue,” Kaiser Permanente Business, March 18, 2019.
22 “The High Cost of Mental Disorders: Facts for Employers,” One Mind At Work.
23 Mental Health in the Workplace, World Health Organization.
24 Milliman Research Report, “Potential Economic Impact of Integrated Medical-Behavioral Healthcare, Implications for Psychiatry,” 2014.