School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
8087Montclair State University, Public Health Department, Montclair, NJ, USA.
Hisp Health Care Int. 2022 Sep;20(3):184-194. doi: 10.1177/15404153211057563. Epub 2021 Dec 13.
In the United States, Hispanics are more likely to experience financial barriers to mental health care than non-Hispanics. We used a unique survey to study the effect of these financial barriers on the severity of depressive symptoms among Hispanics who had previously been diagnosed as having depression. This cross-sectional study used data from the 2015 Washington Heights Community Survey, administered to 2,489 households in Manhattan, New York City. Multiple regression models and propensity score matching were used to estimate the association between financial barriers to mental health care and depressive symptoms and the likelihood of being clinically depressed. Among those diagnosed with depression, those with financial barriers to mental health services or counseling had significantly higher (β = 0.36, 95% CI = 0.03, 0.70) depressive symptoms. When propensity score matching was utilized, those with financial barriers to mental health services had significantly greater depressive symptoms (β = 0.63, 95% CI = 0.37, 0.89) and were significantly more likely to be currently depressed (OR = 2.38, 95% CI = 1.46, 3.89), in comparison to those who had access. Making mental health care more affordable and therefore more accessible to Hispanics is one step toward mitigating the burden on mental illness and decreasing health disparities.
在美国,西班牙裔比非西班牙裔更有可能面临心理健康护理的经济障碍。我们使用一项独特的调查研究了这些经济障碍对先前被诊断患有抑郁症的西班牙裔人群中抑郁症状严重程度的影响。这项横断面研究使用了 2015 年华盛顿高地社区调查的数据,该调查对纽约市曼哈顿的 2489 户家庭进行了调查。多元回归模型和倾向评分匹配用于估计心理健康护理经济障碍与抑郁症状以及临床抑郁可能性之间的关联。在那些被诊断患有抑郁症的人中,那些在心理健康服务或咨询方面存在经济障碍的人抑郁症状明显更严重(β=0.36,95%置信区间=0.03,0.70)。当使用倾向评分匹配时,那些在心理健康服务方面存在经济障碍的人抑郁症状明显更严重(β=0.63,95%置信区间=0.37,0.89),并且目前更有可能患有抑郁症(OR=2.38,95%置信区间=1.46,3.89),与那些有机会接受治疗的人相比。使心理健康护理更负担得起,从而使西班牙裔更容易获得心理健康护理,是减轻精神疾病负担和减少健康差距的一步。