Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women
Objective:The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients. Methods:In a retrospective cohort study, administrative claims data from New Jersey's Medicaid p...
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| Veröffentlicht in: | Psychiatric services (Washington, D.C.) D.C.), 2011-06, Vol.62 (6), p.619-625 |
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| creator | Kozhimannil, Katy Backes Trinacty, Connie Mah Busch, Alisa B Huskamp, Haiden A Adams, Alyce S |
| description | Objective:The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients.
Methods:In a retrospective cohort study, administrative claims data from New Jersey's Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-ethnic differences were estimated with logistic regression for initiation of antidepressant medication or outpatient mental health visits within six months of delivery, follow-up (a prescription refill or second visit), and continued mental health care (at least three visits or three filled antidepressant prescriptions within 120 days).
Results:Nine percent (N=1,120) of white women initiated postpartum mental health care, compared with 4% (N=568) of black women and 5% (N=162) of Latinas. With analyses controlling for clinical factors, the odds of initiating treatment after delivery were significantly (p |
| doi_str_mv | 10.1176/ps.62.6.pss6206_0619 |
| format | Article |
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Methods:In a retrospective cohort study, administrative claims data from New Jersey's Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-ethnic differences were estimated with logistic regression for initiation of antidepressant medication or outpatient mental health visits within six months of delivery, follow-up (a prescription refill or second visit), and continued mental health care (at least three visits or three filled antidepressant prescriptions within 120 days).
Results:Nine percent (N=1,120) of white women initiated postpartum mental health care, compared with 4% (N=568) of black women and 5% (N=162) of Latinas. With analyses controlling for clinical factors, the odds of initiating treatment after delivery were significantly (p<.001) lower for blacks (adjusted odds ratio [AOR]=.43) and Latinas (AOR=.59) compared with whites. Among those who initiated treatment, blacks and Latinas were less likely than whites to receive follow-up treatment (blacks, AOR=.66, p<.001; Latinas, AOR=.67, p<.05) or continued care (blacks, AOR=.81, p=.069; Latinas, AOR=.67, p<.05). Among those who initiated antidepressant treatment, black women and Latinas were less likely than whites to refill a prescription.
Conclusions:There were significant racial-ethnic differences in depression-related mental health care after delivery. Suboptimal treatment was prevalent among all low-income women in the study. However, racial and ethnic disparities in the initiation and continuation of postpartum depression care were particularly troubling and warrant clinical and policy attention. (Psychiatric Services 62:619–625, 2011)</description><identifier>ISSN: 1075-2730</identifier><identifier>ISSN: 1557-9700</identifier><identifier>EISSN: 1557-9700</identifier><identifier>DOI: 10.1176/ps.62.6.pss6206_0619</identifier><identifier>PMID: 21632730</identifier><language>eng</language><publisher>Arlington, VA: American Psychiatric Association</publisher><subject><![CDATA[Adolescent ; Adult ; Aftercare - psychology ; Aftercare - statistics & numerical data ; Antidepressive Agents - therapeutic use ; Biological and medical sciences ; Black or African American ; Black People - psychology ; Black People - statistics & numerical data ; Cohort Studies ; Community Mental Health Services - statistics & numerical data ; Depression, Postpartum - epidemiology ; Depression, Postpartum - ethnology ; Drug Utilization - statistics & numerical data ; Ethnicity ; Female ; Health services utilization ; Healthcare Disparities - statistics & numerical data ; Hispanic or Latino - psychology ; Hispanic or Latino - statistics & numerical data ; Humans ; Low income groups ; Medicaid - statistics & numerical data ; Medical sciences ; Medication Adherence - ethnology ; Medication Adherence - psychology ; Medication Adherence - statistics & numerical data ; Miscellaneous ; New Jersey ; Odds Ratio ; Postpartum depression ; Probability ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Race ; Regression Analysis ; Retrospective Studies ; Social psychiatry. Ethnopsychiatry ; United States ; Utilization Review - statistics & numerical data ; White People - psychology ; White People - statistics & numerical data ; Young Adult]]></subject><ispartof>Psychiatric services (Washington, D.C.), 2011-06, Vol.62 (6), p.619-625</ispartof><rights>Copyright © 2011 by the American Psychiatric Association. 2011</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 by the American Psychiatric Association.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a3679-1a5ef7102f47336c24cfd5674373744c8f6d18db44384900d7f98c278c38defe3</citedby><cites>FETCH-LOGICAL-a3679-1a5ef7102f47336c24cfd5674373744c8f6d18db44384900d7f98c278c38defe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/ps.62.6.pss6206_0619$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/ps.62.6.pss6206_0619$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>314,777,781,2842,21607,21608,21609,27905,27906,77543,77548</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24218573$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21632730$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kozhimannil, Katy Backes</creatorcontrib><creatorcontrib>Trinacty, Connie Mah</creatorcontrib><creatorcontrib>Busch, Alisa B</creatorcontrib><creatorcontrib>Huskamp, Haiden A</creatorcontrib><creatorcontrib>Adams, Alyce S</creatorcontrib><title>Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women</title><title>Psychiatric services (Washington, D.C.)</title><addtitle>Psychiatr Serv</addtitle><description>Objective:The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients.
Methods:In a retrospective cohort study, administrative claims data from New Jersey's Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-ethnic differences were estimated with logistic regression for initiation of antidepressant medication or outpatient mental health visits within six months of delivery, follow-up (a prescription refill or second visit), and continued mental health care (at least three visits or three filled antidepressant prescriptions within 120 days).
Results:Nine percent (N=1,120) of white women initiated postpartum mental health care, compared with 4% (N=568) of black women and 5% (N=162) of Latinas. With analyses controlling for clinical factors, the odds of initiating treatment after delivery were significantly (p<.001) lower for blacks (adjusted odds ratio [AOR]=.43) and Latinas (AOR=.59) compared with whites. Among those who initiated treatment, blacks and Latinas were less likely than whites to receive follow-up treatment (blacks, AOR=.66, p<.001; Latinas, AOR=.67, p<.05) or continued care (blacks, AOR=.81, p=.069; Latinas, AOR=.67, p<.05). Among those who initiated antidepressant treatment, black women and Latinas were less likely than whites to refill a prescription.
Conclusions:There were significant racial-ethnic differences in depression-related mental health care after delivery. Suboptimal treatment was prevalent among all low-income women in the study. However, racial and ethnic disparities in the initiation and continuation of postpartum depression care were particularly troubling and warrant clinical and policy attention. (Psychiatric Services 62:619–625, 2011)</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aftercare - psychology</subject><subject>Aftercare - statistics & numerical data</subject><subject>Antidepressive Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Black or African American</subject><subject>Black People - psychology</subject><subject>Black People - statistics & numerical data</subject><subject>Cohort Studies</subject><subject>Community Mental Health Services - statistics & numerical data</subject><subject>Depression, Postpartum - epidemiology</subject><subject>Depression, Postpartum - ethnology</subject><subject>Drug Utilization - statistics & numerical data</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Health services utilization</subject><subject>Healthcare Disparities - statistics & numerical data</subject><subject>Hispanic or Latino - psychology</subject><subject>Hispanic or Latino - statistics & numerical data</subject><subject>Humans</subject><subject>Low income groups</subject><subject>Medicaid - statistics & numerical data</subject><subject>Medical sciences</subject><subject>Medication Adherence - ethnology</subject><subject>Medication Adherence - psychology</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Miscellaneous</subject><subject>New Jersey</subject><subject>Odds Ratio</subject><subject>Postpartum depression</subject><subject>Probability</subject><subject>Psychiatry</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Race</subject><subject>Regression Analysis</subject><subject>Retrospective Studies</subject><subject>Social psychiatry. Ethnopsychiatry</subject><subject>United States</subject><subject>Utilization Review - statistics & numerical data</subject><subject>White People - psychology</subject><subject>White People - statistics & numerical data</subject><subject>Young Adult</subject><issn>1075-2730</issn><issn>1557-9700</issn><issn>1557-9700</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kNuKFDEQhoMo7jr6BiIBEa96zKlzuFxmV10YUBbFy5BNJ5qlO2lT3Yhvb4YZXfHCmzrx1V_Fj9BzSraUKvlmhq1kW7mdASQj0hJJzQN0TvtedUYR8rDVRPUdU5ycoScAd4QQqqh8jM4YlfwwP0c3N84nN2KXB3y1fMvJ48sEs6tpSQFwyvhjgaX1yzrhyzDXAJBKxjtXA76YSv6K9-VHd519mQL-0kJ-ih5FN0J4dsob9Pnt1afd-27_4d317mLfOS6V6ajrQ1SUsCgU59Iz4ePQSyW44koIr6McqB5uheBaGEIGFY32TGnP9RBi4Bv0-qg71_J9DbDYKYEP4-hyKCtYrQjTxnDTyJf_kHdlrbk9ZykxveZUGdEocaR8LQA1RDvXNLn6s0H2YLmdwUpmD_ne8rb24iS-3k5h-LP02-MGvDoBDrwbY3XZJ7jnBKO6bxZsED1ybp7T3x_-5_gvawiZEQ</recordid><startdate>201106</startdate><enddate>201106</enddate><creator>Kozhimannil, Katy Backes</creator><creator>Trinacty, Connie Mah</creator><creator>Busch, Alisa B</creator><creator>Huskamp, Haiden A</creator><creator>Adams, Alyce S</creator><general>American Psychiatric Association</general><general>American Psychiatric Publishing, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201106</creationdate><title>Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women</title><author>Kozhimannil, Katy Backes ; Trinacty, Connie Mah ; Busch, Alisa B ; Huskamp, Haiden A ; Adams, Alyce S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a3679-1a5ef7102f47336c24cfd5674373744c8f6d18db44384900d7f98c278c38defe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aftercare - psychology</topic><topic>Aftercare - statistics & numerical data</topic><topic>Antidepressive Agents - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>Black or African American</topic><topic>Black People - psychology</topic><topic>Black People - statistics & numerical data</topic><topic>Cohort Studies</topic><topic>Community Mental Health Services - statistics & numerical data</topic><topic>Depression, Postpartum - epidemiology</topic><topic>Depression, Postpartum - ethnology</topic><topic>Drug Utilization - statistics & numerical data</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Health services utilization</topic><topic>Healthcare Disparities - statistics & numerical data</topic><topic>Hispanic or Latino - psychology</topic><topic>Hispanic or Latino - statistics & numerical data</topic><topic>Humans</topic><topic>Low income groups</topic><topic>Medicaid - statistics & numerical data</topic><topic>Medical sciences</topic><topic>Medication Adherence - ethnology</topic><topic>Medication Adherence - psychology</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Miscellaneous</topic><topic>New Jersey</topic><topic>Odds Ratio</topic><topic>Postpartum depression</topic><topic>Probability</topic><topic>Psychiatry</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Race</topic><topic>Regression Analysis</topic><topic>Retrospective Studies</topic><topic>Social psychiatry. Ethnopsychiatry</topic><topic>United States</topic><topic>Utilization Review - statistics & numerical data</topic><topic>White People - psychology</topic><topic>White People - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kozhimannil, Katy Backes</creatorcontrib><creatorcontrib>Trinacty, Connie Mah</creatorcontrib><creatorcontrib>Busch, Alisa B</creatorcontrib><creatorcontrib>Huskamp, Haiden A</creatorcontrib><creatorcontrib>Adams, Alyce S</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Psychiatric services (Washington, D.C.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kozhimannil, Katy Backes</au><au>Trinacty, Connie Mah</au><au>Busch, Alisa B</au><au>Huskamp, Haiden A</au><au>Adams, Alyce S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women</atitle><jtitle>Psychiatric services (Washington, D.C.)</jtitle><addtitle>Psychiatr Serv</addtitle><date>2011-06</date><risdate>2011</risdate><volume>62</volume><issue>6</issue><spage>619</spage><epage>625</epage><pages>619-625</pages><issn>1075-2730</issn><issn>1557-9700</issn><eissn>1557-9700</eissn><abstract>Objective:The goal of this study was to characterize racial-ethnic differences in mental health care utilization associated with postpartum depression in a multiethnic cohort of Medicaid recipients.
Methods:In a retrospective cohort study, administrative claims data from New Jersey's Medicaid program were obtained for 29,601 women (13,001 whites, 13,416 blacks, and 3,184 Latinas) who delivered babies between July 2004 and October 2007. Racial-ethnic differences were estimated with logistic regression for initiation of antidepressant medication or outpatient mental health visits within six months of delivery, follow-up (a prescription refill or second visit), and continued mental health care (at least three visits or three filled antidepressant prescriptions within 120 days).
Results:Nine percent (N=1,120) of white women initiated postpartum mental health care, compared with 4% (N=568) of black women and 5% (N=162) of Latinas. With analyses controlling for clinical factors, the odds of initiating treatment after delivery were significantly (p<.001) lower for blacks (adjusted odds ratio [AOR]=.43) and Latinas (AOR=.59) compared with whites. Among those who initiated treatment, blacks and Latinas were less likely than whites to receive follow-up treatment (blacks, AOR=.66, p<.001; Latinas, AOR=.67, p<.05) or continued care (blacks, AOR=.81, p=.069; Latinas, AOR=.67, p<.05). Among those who initiated antidepressant treatment, black women and Latinas were less likely than whites to refill a prescription.
Conclusions:There were significant racial-ethnic differences in depression-related mental health care after delivery. Suboptimal treatment was prevalent among all low-income women in the study. However, racial and ethnic disparities in the initiation and continuation of postpartum depression care were particularly troubling and warrant clinical and policy attention. (Psychiatric Services 62:619–625, 2011)</abstract><cop>Arlington, VA</cop><pub>American Psychiatric Association</pub><pmid>21632730</pmid><doi>10.1176/ps.62.6.pss6206_0619</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aftercare - psychology Aftercare - statistics & numerical data Antidepressive Agents - therapeutic use Biological and medical sciences Black or African American Black People - psychology Black People - statistics & numerical data Cohort Studies Community Mental Health Services - statistics & numerical data Depression, Postpartum - epidemiology Depression, Postpartum - ethnology Drug Utilization - statistics & numerical data Ethnicity Female Health services utilization Healthcare Disparities - statistics & numerical data Hispanic or Latino - psychology Hispanic or Latino - statistics & numerical data Humans Low income groups Medicaid - statistics & numerical data Medical sciences Medication Adherence - ethnology Medication Adherence - psychology Medication Adherence - statistics & numerical data Miscellaneous New Jersey Odds Ratio Postpartum depression Probability Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Race Regression Analysis Retrospective Studies Social psychiatry. Ethnopsychiatry United States Utilization Review - statistics & numerical data White People - psychology White People - statistics & numerical data Young Adult |
| title | Racial and Ethnic Disparities in Postpartum Depression Care Among Low-Income Women |
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