Abstract
Often considered to fare better than White Americans in terms of mental health, African-Americans are nevertheless more vulnerable to chronic, persistent conditions should they become mentally ill, the literature suggests. The present study used data from the 2009 National Health Interview Survey to examine race differences in the prevalence rates of serious mental illness and race’s role in relationships among such illness and variables of (a) social status and (b) health services. Results showed that non-Hispanic Blacks’ level of reported chronic mental illness (in the past 30 days) exceeded that of non-Hispanic Whites. The results indicate that variables describing respondents’ mental health care, along with their age and alcohol consumption, affect serious mental illness differently among African-Americans compared to Whites. Implications concerning racial disparities in mental health are discussed.
References
Aneshensel, C. S. (1992). Social stress theory and research. Annual Review of Sociology, 18, 15–38.
Aneshensel, C. S. (2009). Toward explaining mental health disparities. Journal of Health and Social Behavior, 50(4), 377–394.
Baker, T. A., Buchanan, N. T., & Spencer, T. R. (2010). Commentary: Disparities and social inequities: Is the health of African American women still in peril? Ethnicity and Disease, 20(3), 304–309.
Botman, S. L., Moore, T. F., Moriarity, C. L., & Parsons, V. L. (2000). Design and estimation for the National Health Interview Survey, 1995–2004. National Center for Health Statistics. Vital Health Statistics, 2(130), 1–31.
Breslau, J., Aguilar-Gaxiola, S., Kendler, K. S., Su, M., Williams, D., & Kessler, R. C. (2006). Specifying race-ethnic differences in risk for psychiatric disorder in a USA national sample. Psychological Medicine, 36(1), 57–68.
Breslau, J., Javaras, K. N., Blacker, D., Murphy, J. M., & Normand, S. L. T. (2008). Differential item functioning between ethnic groups in the epidemiological assessment of depression. Journal of Nervous and Mental Disease, 196(4), 297–306.
Breslau, J., Kendler, K. S., Su, M., Gaxiola-Aguilar, S., & Kessler, R. C. (2005). Lifetime risk and persistence of psychiatric disorders across ethnic groups in the United States. Psychological Medicine, 35(3), 317–327.
Brown, T. N. (2003). Critical race theory speaks to the sociology of mental health: Mental health problems produced by racial stratification. Journal of Health and Social Behavior, 44(3), 292–301.
Cook, E. L., & Harman, J. S. (2008). A comparison of health-related quality of life for individuals with mental health disorders and common chronic medical conditions. Public Health Reports, 123(1), 45–51.
Dailey, A. B., Kasl, S. V., Holford, T. R., Lewis, T. T., & Jones, B. A. (2010). Neighborhood- and individual-level socioeconomic variation in perceptions of racial discrimination. Ethnicity & Health, 15(2), 145–163.
Donabedian, A. (1990). The 7 pillars of quality. Archives of Pathology and Laboratory Medicine, 114, 1115–1118.
Gibbs, J. T., & Fuery, D. (1994). Mental-health and well-being of Black women: Toward strategies of empowerment. American Journal of Community Psychology, 22(4), 559–582.
Griffith, D. M., Johnson, J., Ellis, K. R., & Schulz, A. J. (2010). Cultural context and a critial approach to eliminating health disparities. Ethnicity and Disease, 20(1), 71–76.
Institute of Medicine. (2006). Improving the quality of health care for mental health and substance-use conditions: A report in the quality chasm series. Washington, DC: Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. Board on Health Care Services.
Jackson, J. S., Knight, K. M., & Rafferty, J. A. (2010). Race and unhealthy behaviors: Chronic stress, the HPA axis, and physical and mental health disparities over the life course. American Journal of Public Health, 100(5), 933–939.
Kessler, R. C., Demler, O., Frank, R. G., Olfson, M., Pincus, H. A., Walters, E. E., et al. (2005). Prevalence and treatment of mental disorders, 1990 to 2003. New England Journal of Medicine, 352(24), 2515–2523.
Keyes, C. L. M. (2009). The black-white paradox in health: Flourishing in the face of social inequality and discrimination. Journal of Personality, 77(6), 1677–1706.
Keyes, K. M., Barnes, D. M., & Bates, L. M. (2011). Stress, coping, and depression: Testing a new hypothesis in a prospectively studied general population sample of U.S.-born Whites and Blacks. Social Science and Medicine, 72(5), 650–659.
Kip, K. E., Peters, R. H., & Morrison-Rodriguez, B. (2002). Commentary on why national epidemiological estimates of substance abuse by race should not be used to estimate prevalence and need for substance abuse services at community and local levels. American Journal of Drug and Alcohol Abuse, 28(3), 545–556.
Lincoln, K. D., Chatters, L. M., Taylor, R. J., & Jackson, J. S. (2007). Profiles of depressive symptoms among African Americans and Caribbean Blacks. Social Science and Medicine, 65(2), 200–213.
Lo, C. C., & Cheng, T. C. (2011). Racial/Ethnic differences in access to substance abuse treatment. Journal of Health Care for the Poor and Underserved, 22(2), 621–637.
Lo, C. C., & Cheng, T. C. (2012). Discrimination’s role in minority groups’ rates of substance-use disorder. American Journal on Addictions, 21(2), 150–156.
McMillan, K. A., Enns, M. W., Asmundson, G. J. G., & Sareen, J. (2010). The association between income and distress, mental disorders, and suicidal ideation and attempts: Findings from the collaborative psychiatric epidemiology surveys. Journal of Clinical Psychiatry, 71(9), 1168–1175.
Merikangas, K. R., He, J. P., Burstein, M., Swendsen, J., Avenevoli, S., Case, B., et al. (2011). Service utilization for lifetime mental disorders in U.S. adolescents: Results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 50(1), 32–45.
Miranda, J., McGuire, T. G., Williams, D. R., & Wang, P. (2008). Mental health in the context of health disparities. American Journal of Psychiatry, 165(9), 1102–1108.
Muennig, P., & Murphy, M. (2011). Does Racism affect health? Evidence from the United States and the United Kingdom. Journal of Health Politics, Policy and Law, 36(1), 187–214.
Ray, W. A., Hall, K., & Meador, K. G. (2007). Racial differences in antidepressant treatment preceding suicide in a medicaid population. Psychiatric Services, 58(10), 1317–1323.
Sriwattanakomen, R., McPherron, J., Chatman, J., Morse, J. Q., Martire, L. M., Karp, J. F., et al. (2010). A comparison of the frequencies of risk factors for depression in older black and white participants in a study of indicated prevention. Internation Psychogeriatrics, 22(8), 1240–1247.
Stoskopf, C. H., Kim, Y. K., & Glover, S. H. (2001). Dual diagnosis: HIV and mental illness, a population-based study. Community Mental Health Journal, 37(6), 469–479.
Suthers, K. (2008). Evaluating the economic causes and consequences of racial and ethnic health disparities. Washington, DC: American Public Health Association.
Tenorio, K. A., & Lo, C. C. (2011). Social location, social integration, and the co-occurrence of substance abuse and psychological distress. American Journal of Drug and Alcohol Abuse, 37(4), 218–223.
Turner, R. J., & Lloyd, D. A. (1999). The stress process and the social distribution of depression. Journal of Health and Social Behavior, 40(4), 374–404.
U. S. Department of Health & Human Services. (2000). Addressing racial and ethnic disparities in health care. Fact Sheet (February). Retrieved from http://www.ahrq.gov/research/disparit.htm.
U. S. Department of Health and Human Services. (2000). Updating estimates of the economic costs of alcohol abuse in the United States: Estimates, update methods, and data. Rockville, MD: National Institutes of Health.
Wells, K., Klap, R., Koike, A., & Sherbourne, C. (2001). Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. American Journal of Psychiatry, 158(12), 2027–2032.
Williams, D. R. (1995). African African mental health: Persisting questions and paradoxical findings. African American Research Perspectives, 2(1), 8–16.
Williams, D. R., & Earl, T. R. (2007). Commentary: Race and mental health—More questions than answers. International Journal of Epidemiology, 37, 758–760.
Williams, D. R., Gonzalez, H. M., Neighbors, H., Nesse, R., Abelson, J. M., Sweetman, J., et al. (2007). Prevalence and distribution of major depressive disorder in African Americans, Caribbean blacks, and non-Hispanic whites—Results from the National Survey of American Life. Archives of General Psychiatry, 64(3), 305–315.
Zemore, S. E., Mulia, N., Ye, Y., Borges, G., & Greenfield, T. K. (2009). Gender, acculturation, and other barriers to alcohol treatment utilization among Latinos in three National Alcohol Surveys. Journal of Substance Abuse Treatment, 36(4), 446–456.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lo, C.C., Cheng, T.C. & Howell, R.J. Access to and Utilization of Health Services as Pathway to Racial Disparities in Serious Mental Illness. Community Ment Health J 50, 251–257 (2014). https://doi.org/10.1007/s10597-013-9593-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-013-9593-7