News & Announcements
Affordable Care Act’s Coverage Expansions will Reduce Health Insurance Disparity by Race/Ethnicity
Posted: June 29, 2012
There are large differences in US health insurance coverage by racial and ethnic groups, yet there have been no estimates to date on how implementation of the Affordable Care Act will affect the distribution of coverage by race and ethnicity. The authors used a microsimulation model to show that racial and ethnic differentials in coverage could be greatly reduced, potentially cutting the eight-percentage-point black-white differential in uninsurance rates by more than half and the nineteen-percentage-point Hispanic-white differential by just under one-quarter. However, blacks and Hispanics are still projected to remain more likely to be uninsured than whites. Achieving low uninsurance under the Affordable Care Act will depend on effective state policies to attain high enrollment in Medicaid and the Children’s Health Insurance Program and the new insurance exchanges. Coverage gains among Hispanics will probably depend on adoption of strategies that address language and related barriers to enrollment and retention in California and Texas, where almost half of Hispanics live. If uninsurance is reduced to the extent projected in this analysis, sizable reductions in long-standing racial and ethnic differentials in access to health care and health status are likely to follow.
Special Issue on Measuring and Analyzing Racial/Ethnic Health Care Disparities
Posted: June 28, 2012
The Center for Multicultural Mental Health Research and the Harvard Catalyst Health Disparities Research Program have collaborated on a new special issue in the Journal Health Services Research, focused on Measuring and Analyzing Health Care Disparities. The special issue is now available online and will be published in June 2012 in print. Read the full text of each article by clicking on the links below:
The Center is for Multicultural Mental Health Research based at the Cambridge Health Alliance, a large public hospital system, and collaborates with outside institutions such as the Harvard University Medical School and the Recinto de Ciencias Médicas at the University of Puerto Rico. Their mission is to generate innovative mental health services research that impacts policy, practice, and service delivery for multicultural populations.
Access the special issue of Health Services Research.
HIV Diagnoses Falling Among US Hispanics: Rate Differs by Group
Posted: June 27, 2012
New HIV diagnoses among Hispanics living in the United States or Puerto Rico fell about 4% yearly from 2006 through 2009 in a study by the Centers for Disease Control and Prevention (CDC). Declines were higher for women than for men and for Puerto Ricans than for other groups. The study is titled Diagnoses of HIV Infection Among Hispanics/Latinos in 40 States and Puerto Rico, 2006–2009 and was published in the Journal of Acquired Immune Deficiency Syndromes.
Hispanics (people of Latin origin from Western Hemisphere countries outside the United States) are disproportionately affected by HIV in the United States. Because Hispanics of different national origins differ culturally, the CDC conducted this study to see if they differ in HIV diagnosis rate (incidence). The CDC team analyzed data on Hispanics diagnosed with HIV from 2006 through 2009 in 40 states and Puerto Rico. These data included place of birth and place of residence at diagnosis. The CDC researchers also estimated prevalence of AIDS diagnoses within 12 months of HIV diagnosis. Everyone studied was 13 or older and had their HIV diagnosis reported to the CDC by June 2010.
From 2006 through 2009, 33,498 Hispanics were diagnosed with HIV infection. The annual diagnosis rate dropped by an estimated 4.3% over the study period. The rate dropped more in women than in men. Puerto Ricans accounted for most of the overall decline in HIV diagnoses, with an estimated annual drop of 13.1%. A short HIV-to-AIDS interval was more common in nonurban areas than in urban areas.
“To continue to decrease the incidence of HIV infection among Hispanics,” the CDC team concludes, “prevention programs need to address cultural and regional differences.”
The Link between Domestic Violence and Mental Health, Immigrant and Refugee Communities
Posted: June 25, 2012
The United States still has a lot of work to do in regard to addressing the prevalence of domestic violence. In fact, an in-depth story from the Arizona Republic has pointed to the fact that in the last several years, the number of deaths from domestic violence has stayed fairly consistent in Arizona. While this means there hasn’t really been an increase in deaths, there certainly hasn’t been a decrease either. Fortunately, researchers are seeking more information about domestic violence and specifically about domestic violence that ends in death. Not surprisingly, much of the research has a mental health aspect. For example, the article mentioned how substance abuse, depression and estrangement are just some of many risk factors that could increase a battered woman’s chance of eventually being killed by her partner. Also, women in abusive relationships tend to suffer from mental health issues like anxiety, depression and post-traumatic stress disorder. Read more on the Fox News website.
Intimate Partner Violence in Immigrant and Refugee Communities
Many immigrant and refugee women experience domestic violence in the context of language difficulties, confusion over their legal rights, and the overall stress of adaptation to new cultural and social structures. Immigrant and refugee women are especially vulnerable because of poverty and other disparities that include -- limited language proficiency, disparities in economic and social resources, social isolation, and immigration status.
Studies of the health status of immigrant/refugee battered women indicate the general negative impact of IPV on physical health; mental health, such as depression, posttraumatic stress, and anxiety symptoms and disorders; substance abuse; and reproductive/sexual health, such as miscarriage and unwanted pregnancies.
Mental Health Care Disparities Persist for Black and Latino Children
Posted: June 25, 2012
Disparities in the use of mental health services, including outpatient care and psychotropic drug prescriptions, persist for black and Latino children, reports a new study in Health Services Research. The study is titled -- Racial/Ethnic Disparity Trends in Children's Mental Health Care Access and Expenditures from 2002 to 2007.
“Children’s mental illness is very predictive of poor outcomes later in life—socially, educationally, income-wise and employment-wise,” said lead author Benjamin Lê Cook, Ph.D., senior scientist at the Center for Multicultural Mental Health Research at the Cambridge Health Alliance and assistant professor at Harvard Medical School. “There is a real need to understand why there are these big differences in mental health care for kids.”
Cook and his colleagues looked at data from a nationally representative sample of over 30,000 youth ages 5 to 21 from the 2002-2003 and the 2006-2007 Medical Expenditure Panel Surveys (MEPS). They analyzed the data for the use of outpatient mental health care, use of psychiatric drugs and overall mental health care. “About 10 percent of white youth are using mental health care compared to about half that percentage—between 4 and 5 percent—of black and Latino youth using mental health care.” That 2-to-1, white-to-minority ratio is a giant disparity compared to other areas of health care,” Cook said.
Researchers also found that this disparity didn’t change between the two time periods studied. In addition, while money spent for mental health care increased for white children between 2002-2003 and 2006-2007, it decreased significantly for Latino children. “Even among those who are in care, it looks like the amount of dollars that the system is spending on Latino users relative to white users is shrinking,” Cook said. Marc Atkins, Ph.D., from the Institute of Juvenile Research at the University of Illinois at Chicago commented, “What’s difficult to tease out is how much of the lack of [minority children’s] access to care reflects the lack of availability of quality mental health care or lack of their family’s confidence that these services are going to be helpful. Some of that’s related to stigma about mental health care and some of that’s related to contentious relationships these families may have with social service systems.”
Atkins said research shows that when social service systems use strategies to engage these families and work to overcome barriers of stigma and trust, access to mental health care increases. Cook commented that having health insurance coverage is one of the important predictors of mental health care use. “It’s pretty clear that if we got people better insurance and insured the uninsured, that would help a lot in reducing disparities,” he said.