Carson Nicholas, Lê Cook Ben, Alegria Margarita
Department of Psychiatry at the Harvard Medical School/Cambridge HealthAlliance, Somerville, MA 02143, USA.
J Health Care Poor Underserved. 2010 May;21(2 Suppl):32-48. doi: 10.1353/hpu.0.0297.
We examine adequate mental health treatment, emergency room (ER) use, and early treatment dropout for Haitian, African American and White youth with a psychiatric diagnosis treated in community health centers in the United States. We present associations with possible socioeconomic determinants of care. Adequate treatment was less likely among Haitian youth from areas with greater poverty and among all youth from areas with more female-headed households. Medicaid-insured youth had more ER visits, especially African Americans. The relative impact of poverty on adequate care was higher for Haitians than Whites, and the relative impact of Medicaid coverage on ER use was higher for African Americans than for Whites. Early dropout was more likely among youth who were uninsured or from areas with more female-headed households. Socioeconomic factors and insurance status were significant determinants of care. Haitians living in poverty in the U.S. may face barriers to mental health services relative to other racial/ethnic groups.
我们对在美国社区健康中心接受治疗的患有精神疾病诊断的海地、非裔美国和白人青年的心理健康充分治疗情况、急诊室使用情况以及早期治疗退出情况进行了研究。我们呈现了与护理可能的社会经济决定因素的关联。来自贫困程度更高地区的海地青年以及来自女性为户主家庭较多地区的所有青年获得充分治疗的可能性较低。参加医疗补助保险的青年急诊就诊次数更多，尤其是非裔美国人。贫困对海地人充分护理的相对影响高于白人，医疗补助覆盖对急诊室使用的相对影响对非裔美国人高于白人。未参保或来自女性为户主家庭较多地区的青年更有可能早期退出治疗。社会经济因素和保险状况是护理的重要决定因素。在美国生活在贫困中的海地人相对于其他种族/族裔群体可能面临心理健康服务障碍。
