Racial and ethnic disparities in depression care in community-dwelling elderly in the United States

Objectives. We investigated racial/ethnic disparities in the diagnosis and treatment of depression among community-dwelling elderly. Methods. We performed a secondary analysis of Medicare Current Beneficiary Survey data (n=33708) for 2001 through 2005. We estimated logistic regression models to assess the association of race/ethnicity with the probability of being diagnosed and treated for depression with either antidepressant medication or psychotherapy. Results. Depression diagnosis rates were 6.4% for non-Hispanic Whites, 4.2% for African Americans, 7.2% for Hispanics, and 3.8% for others. After we adjusted for a range of covariates including a 2-item depression screener, we found that African Americans were significantly less likely to receive a depression diagnosis from a health care provider (adjusted odds ratio [AOR]=0.53; 95% confidence interval [CI]=0.41, 0.69) than were non-Hispanic Whites; those diagnosed were less likely to be treated for depression (AOR=0.45; 95% CI=0.30, 0.66). Conclusions. Among elderly Medicare beneficiaries, significant racial/ethnic differences exist in the diagnosis and treatment of depression. Vigorous clinical and public health initiatives are needed to address this persisting disparity in care.