黑人和白人以及亚裔和拉丁裔亚群体在心理健康症状方面的差异以及心理健康服务使用中的不平等现象。
Differences in Mental Health Symptoms and Inequities in Mental Health Service Use Among Black and White Populations and Asian and Latine Subpopulations.
作者信息
Park Sungchul, Alegria Margarita, Bustamante Arturo Vargas, Chen Jie, Fung Vicki, Ortega Alexander N
机构信息
Department of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea.
L-HOPE Program for Community-Based Total Learning Health Systems, Korea University, 145 Anam-Ro, Seongbuk-Gu, Seoul, 02841, South Korea.
出版信息
J Gen Intern Med. 2025 Feb;40(3):569-578. doi: 10.1007/s11606-024-09273-w. Epub 2024 Dec 13.
BACKGROUND
While studies have observed mental health inequities across aggregated Asian and Latine populations, a critical gap exists in our understanding of inequities within and across Asian and Latine subpopulations.
OBJECTIVE
We examined the prevalence of mental health symptoms and variations in mental health service use across Black and White populations and Asian and Latine subpopulations at a more granular level.
METHODS
We conducted a cross-sectional study using data from the 2016-2021 Medical Expenditure Panel Survey. Outcomes included mental health symptoms (mild and serious) and mental health service use (outpatient mental health visits and psychotropic medication fills). The primary independent variable was the category of 13 racial/ethnic groups: Black and non-Latine White individuals and Asian (Asian Indian, Chinese, Filipino, and Other Asian) and Latine (Central/South American, Cuban, Dominican, Mexican, Other Latine, and Puerto Rican) subpopulation individuals.
RESULTS
We found modest differences in mental health symptoms by race/ethnicity. However, significant differences were observed in mental health service use among individuals with mental health symptoms. These differences were pronounced across Asian subpopulations with serious mental health symptoms. The likelihood of having any outpatient mental health visit was lower among Asian Indian (- 12.2 percentage points [95% CI - 18.2, - 6.2], Chinese (- 11.7 [- 21.6, - 1.7]), and Filipino individuals (- 16.1 [- 22.5, - 9.8]) than White individuals. The likelihood of having psychotropic medication fill was lower among Asian Indian (- 23.3 [- 34, - 12.7]), Chinese (- 19.8 [- 30.7, - 8.9]), Filipino (- 27.6 [- 40.2, - 14.9]), and other Asian individuals (- 22.5 [- 29.4, - 15.6]) than White individuals. On the other hand, some of these differences were observed in certain Latine subpopulations but not in others.
CONCLUSIONS
There is a heterogeneity in inequities in mental health service use among Asian and Latine subpopulation groups. These findings underscore the importance of studying granular categories of race/ethnicity for targeting mental health inequities.
背景
虽然研究已经观察到亚洲和拉丁裔总体人群中的心理健康不平等现象，但我们对亚洲和拉丁裔亚人群内部以及之间不平等现象的理解存在重大差距。
目的
我们在更细化的层面上研究了黑人和白人以及亚洲和拉丁裔亚人群中心理健康症状的患病率以及心理健康服务使用情况的差异。
方法
我们使用2016 - 2021年医疗支出面板调查的数据进行了一项横断面研究。结果包括心理健康症状（轻度和重度）以及心理健康服务使用情况（门诊心理健康就诊和精神药物配药）。主要自变量是13个种族/族裔群体的类别：黑人和非拉丁裔白人个体以及亚洲（印度裔、华裔、菲律宾裔和其他亚洲裔）和拉丁裔（中南美裔、古巴裔、多米尼加裔、墨西哥裔、其他拉丁裔和波多黎各裔）亚人群个体。
结果
我们发现不同种族/族裔在心理健康症状方面存在适度差异。然而，在有心理健康症状的个体中，心理健康服务使用情况存在显著差异。这些差异在有严重心理健康症状的亚洲亚人群中尤为明显。印度裔（-12.2个百分点[95%置信区间-18.2，-6.2]）、华裔（-11.7[-21.6，-1.7]）和菲律宾裔个体（-16.1[-22.5，-9.8]）进行门诊心理健康就诊的可能性低于白人个体。印度裔（-23.3[-34，-12.7]）、华裔（-19.8[-30.7，-8.9]）、菲律宾裔（-27.6[-40.2，-14.9]）和其他亚洲裔个体（-22.5[-29.4，-15.6]）配药精神药物的可能性低于白人个体。另一方面，在某些拉丁裔亚人群中观察到了其中一些差异，但在其他拉丁裔亚人群中未观察到。
结论
亚洲和拉丁裔亚人群体在心理健康服务使用不平等方面存在异质性。这些发现强调了研究细化的种族/族裔类别以解决心理健康不平等问题的重要性。
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