IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v84y2013icp102-109.html
   My bibliography  Save this article

The role of provider supply and organization in reducing racial/ethnic disparities in mental health care in the U.S

Author

Listed:
  • Cook, Benjamin Lê
  • Doksum, Teresa
  • Chen, Chih-nan
  • Carle, Adam
  • Alegría, Margarita

Abstract

Racial and ethnic disparities in mental health care access in the United States are well documented. Prior studies highlight the importance of individual and community factors such as health insurance coverage, language and cultural barriers, and socioeconomic differences, though these factors fail to explain the extent of measured disparities. A critical factor in mental health care access is a local area's organization and supply of mental health care providers. However, it is unclear how geographic differences in provider organization and supply impact racial/ethnic disparities. The present study is the first analysis of a nationally representative U.S. sample to identify contextual factors (county-level provider organization and supply, as well as socioeconomic characteristics) associated with use of mental health care services and how these factors differ across racial/ethnic groups. Hierarchical logistic models were used to examine racial/ethnic differences in the association of county-level provider organization (health maintenance organization (HMO) penetration) and supply (density of specialty mental health providers and existence of a community mental health center) with any use of mental health services and specialty mental health services. Models controlled for individual- and county-level socio-demographic and mental health characteristics. Increased county-level supply of mental health care providers was significantly associated with greater use of any mental health services and any specialty care, and these positive associations were greater for Latinos and African-Americans compared to non-Latino Whites. Expanding the mental health care workforce holds promise for reducing racial/ethnic disparities in mental health care access. Policymakers should consider that increasing the management of mental health care may not only decrease expenditures, but also provide a potential lever for reducing mental health care disparities between social groups.

Suggested Citation

  • Cook, Benjamin Lê & Doksum, Teresa & Chen, Chih-nan & Carle, Adam & Alegría, Margarita, 2013. "The role of provider supply and organization in reducing racial/ethnic disparities in mental health care in the U.S," Social Science & Medicine, Elsevier, vol. 84(C), pages 102-109.
    • Handle: RePEc:eee:socmed:v:84:y:2013:i:c:p:102-109
    DOI: 10.1016/j.socscimed.2013.02.006
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953613000798
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2013.02.006?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. FLEURBAEY, Marc & SCHOKKAERT, Erik, 2011. "Equity in health and health care," LIDAM Discussion Papers CORE 2011026, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    2. Steven Stern & Elizabeth Merwin & Ivory Hinton, 2003. "Shortages of Rural Mental Health Professionals," Virginia Economics Online Papers 395, University of Virginia, Department of Economics.
    3. Office of Health Economics, 2007. "The Economics of Health Care," For School 001490, Office of Health Economics.
    4. Padgett, D.K. & Patrick, C. & Burns, B.J. & Schlesinger, H.J., 1994. "Ethnicity and the use of outpatient mental health services in a national insured population," American Journal of Public Health, American Public Health Association, vol. 84(2), pages 222-226.
    5. Scott W. Allard & Richard M. Tolman & Daniel Rosen, 2003. "Proximity to service providers and service utilization among welfare recipients: The interaction of place and race," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 22(4), pages 599-613.
    6. Richard C. Lindrooth & Anthony T. Lo Sasso & Ithai Z. Lurie, 2006. "The effect of distance to provider on employee response to changes in mental health benefits," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1133-1141, October.
    7. repec:mpr:mprres:5678 is not listed on IDEAS
    8. Balsa, Ana I. & Cao, Zhun & McGuire, Thomas G., 2007. "Does managed health care reduce health care disparities between minorities and Whites?," Journal of Health Economics, Elsevier, vol. 26(1), pages 101-121, January.
    9. Chow, J.C.-C. & Jaffee, K. & Snowden, L., 2003. "Racial/Ethnic Disparities in the Use of Mental Health Services in Poverty Areas," American Journal of Public Health, American Public Health Association, vol. 93(5), pages 792-797.
    10. S.K. Dube & U.C. Mohanty, 2004. "Editorial," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 31(2), pages 317-317, February.
    11. Krieger, N. & Chen, J.T. & Waterman, P.D. & Rehkopf, D.H. & Subramanian, S.V., 2003. "Race/Ethnicity, Gender, and Monitoring Socioeconomic Gradients in Health: Comparison of Area-Based Socioeconomic Measures - The Public Health Disparities Geocoding Project," American Journal of Public Health, American Public Health Association, vol. 93(10), pages 1655-1671.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Alden, Alexandra M., 2023. "Operationalizing antiracism in health systems: Strategies state government administrative organizations use towards racial and ethnic mental health equity," Social Science & Medicine, Elsevier, vol. 322(C).
    2. Janczewski, Colleen E. & Nitkowski, Jenna, 2023. "Predicting mental and behavioral health service utilization among child welfare-involved caregivers: A machine learning approach," Children and Youth Services Review, Elsevier, vol. 155(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. David, Guy & Harrington, Scott E., 2010. "Population density and racial differences in the performance of emergency medical services," Journal of Health Economics, Elsevier, vol. 29(4), pages 603-615, July.
    2. David Frisvold & Ezra Golberstein, 2013. "The Effect of School Quality on Black-White Health Differences: Evidence From Segregated Southern Schools," Demography, Springer;Population Association of America (PAA), vol. 50(6), pages 1989-2012, December.
    3. Duggan, Mark & Starc, Amanda & Vabson, Boris, 2016. "Who benefits when the government pays more? Pass-through in the Medicare Advantage program," Journal of Public Economics, Elsevier, vol. 141(C), pages 50-67.
    4. Bryan Dowd & Matthew L. Maciejewski & Heidi O'Connor & Gerald Riley & Yisong Geng, 2011. "Health plan enrollment and mortality in the Medicare program," Health Economics, John Wiley & Sons, Ltd., vol. 20(6), pages 645-659, June.
    5. Linda Dynan, 2009. "The Contribution of Economists to Understanding Racial Health Disparities in the US," Atlantic Economic Journal, Springer;International Atlantic Economic Society, vol. 37(3), pages 213-223, September.
    6. Glazer, Jacob & McGuire, Thomas G., 2013. "Making Medicare advantage a middle-class program," Journal of Health Economics, Elsevier, vol. 32(2), pages 463-473.
    7. Nicholas Lauren Hersch, 2013. "Better Quality of Care or Healthier Patients? Hospital Utilization by Medicare Advantage and Fee-for-Service Enrollees," Forum for Health Economics & Policy, De Gruyter, vol. 16(1), pages 137-161, May.
    8. Eric French & Elaine Kelly & Richard Cookson & Carol Propper & Miqdad Asaria & Rosalind Raine, 2016. "Socio‐Economic Inequalities in Health Care in England," Fiscal Studies, Institute for Fiscal Studies, vol. 37, pages 371-403, September.
    9. Christian Lorenz, 2012. "Triangulating health expenditure estimates from different data sources in developing countries," Applied Health Economics and Health Policy, Springer, vol. 10(1), pages 1-13, January.
    10. James F. Burgess & Matthew L. Maciejewski & Chris L. Bryson & Michael Chapko & John C. Fortney & Mark Perkins & Nancy D. Sharp & Chuan‐Fen Liu, 2011. "Importance of health system context for evaluating utilization patterns across systems," Health Economics, John Wiley & Sons, Ltd., vol. 20(2), pages 239-251, February.
    11. McDonald, Rebecca & Powdthavee, Nattavudh, 2018. "The Shadow Prices of Voluntary Caregiving: Using Panel Data of Well-Being to Estimate the Cost of Informal Care," IZA Discussion Papers 11545, Institute of Labor Economics (IZA).
    12. Verónica Amarante & Marco Manacorda & Edward Miguel & Andrea Vigorito, 2016. "Do Cash Transfers Improve Birth Outcomes? Evidence from Matched Vital Statistics, Program, and Social Security Data," American Economic Journal: Economic Policy, American Economic Association, vol. 8(2), pages 1-43, May.
    13. Hope Corman & Dhaval Dave & Nancy E. Reichman, 2018. "Evolution of the Infant Health Production Function," Southern Economic Journal, John Wiley & Sons, vol. 85(1), pages 6-47, July.
    14. Andrew J. Mirelman & Miqdad Asaria & Bryony Dawkins & Susan Griffin & Richard Cookson & Peter Berman, 2020. "Fairer Decisions, Better Health for All: Health Equity and Cost-Effectiveness Analysis," World Scientific Book Chapters, in: Paul Revill & Marc Suhrcke & Rodrigo Moreno-Serra & Mark Sculpher (ed.), Global Health Economics Shaping Health Policy in Low- and Middle-Income Countries, chapter 4, pages 99-132, World Scientific Publishing Co. Pte. Ltd..
    15. Trottmann, Maria & Zweifel, Peter & Beck, Konstantin, 2012. "Supply-side and demand-side cost sharing in deregulated social health insurance: Which is more effective?," Journal of Health Economics, Elsevier, vol. 31(1), pages 231-242.
    16. Michael Geruso & Timothy J. Layton & Jacob Wallace, 2023. "What Difference Does a Health Plan Make? Evidence from Random Plan Assignment in Medicaid," American Economic Journal: Applied Economics, American Economic Association, vol. 15(3), pages 341-379, July.
    17. Cinzia Di Novi & Rowena Jacobs & Matteo Migheli, 2013. "The quality of life of female informal caregivers: from Scandinavia to the Mediterranean Sea," Working Papers 084cherp, Centre for Health Economics, University of York.
    18. Beshears, John Leonard & Choi, James J. & Laibson, David I. & Madrian, Brigitte & Reynolds, Gwendolyn I., 2016. "Vaccination Rates are Associated With Functional Proximity But Not Base Proximity of Vaccination Clinics," Scholarly Articles 34737827, Harvard University Department of Economics.
    19. Colombier, Carsten & Weber, Werner, 2009. "Projecting health-care expenditure for Switzerland: further evidence against the 'red-herring' hypothesis," MPRA Paper 26747, University Library of Munich, Germany, revised Nov 2009.
    20. V. Srinivasan & G. Shainesh & Anand K. Sharma, 2015. "An approach to prioritize customer-based, cost-effective service enhancements," The Service Industries Journal, Taylor & Francis Journals, vol. 35(14), pages 747-762, October.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:84:y:2013:i:c:p:102-109. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.