Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, United States.
Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, United States.
Am J Epidemiol. 2024 Oct 7;193(10):1343-1351. doi: 10.1093/aje/kwae042.
US Asian adults and people with limited English proficiency (LEP) confront mental health treatment receipt disparities. At the intersection of racial and language injustice, Asian adults with LEP may face even greater disparity, but studies have not assessed this through explicitly intersectional approaches. Using 2019 and 2020 National Survey of Drug Use and Health data, we computed disparities in mental health treatment among those with mental illness comparing: non-Hispanic (NH) Asian adults with LEP to NH White adults without LEP (joint disparity), NH Asian adults without LEP to NH White adults without LEP (referent race disparity), NH Asian adults with LEP to those without LEP (referent LEP disparity), and the joint disparity versus the sum of referent disparities (excess intersectional disparity). In age- and gender-adjusted analyses, excess intersectional disparity was 26.8% (95% CI, -29.8 to 83.4) of the joint disparity in 2019 and 63.0% (95% CI, 29.1-96.8) in 2020. The 2019 joint disparity was 1.37 (95% CI, 0.31-2.42) times that if the race-related disparity did not vary by LEP, and if LEP-related disparity did not vary by race; this figure was 2.70 (95% CI, 0.23-5.17) in 2020. These findings highlight the necessity of considering the intersection of race and LEP in addressing mental health treatment disparities. This article is part of a Special Collection on Mental Health.
美国的亚裔成年人和英语水平有限的人(LEP)在获得心理健康治疗方面存在差异。在种族和语言不公正的交叉点上,英语水平有限的亚裔成年人可能面临更大的差距,但研究尚未通过明确的交叉方法对此进行评估。利用 2019 年和 2020 年全国毒品使用和健康调查数据,我们计算了患有精神疾病的人群中,英语水平有限的非西班牙裔(NH)亚裔成年人与无 LEP 的 NH 白人成年人之间(联合差异)、无 LEP 的 NH 亚裔成年人与无 LEP 的 NH 白人成年人之间(参照种族差异)、英语水平有限的 NH 亚裔成年人与无 LEP 的成年人之间(参照 LEP 差异)以及联合差异与参照差异之和之间的差异(过度交叉差异)。在年龄和性别调整分析中,2019 年过度交叉差异占联合差异的 26.8%(95%CI,-29.8 至 83.4),2020 年占 63.0%(95%CI,29.1 至 96.8)。如果种族相关差异不因 LEP 而变化,并且 LEP 相关差异不因种族而变化,2019 年的联合差异是如果不考虑 LEP,种族相关差异的 1.37 倍(95%CI,0.31-2.42);2020 年这一数字为 2.70(95%CI,0.23-5.17)。这些发现强调了在解决心理健康治疗差异时必须考虑种族和 LEP 的交叉。本文是关于心理健康的特别专辑的一部分。