Patient Ethnicity and the Identification and Active Management of Depression in Late Life

Previous research shows that black Americans more often receive mental health services from a primary care physician than from a mental health specialist. This study assessed whether ethnicity was related to the diagnosis and treatment of depression among older patients. Researchers used a cross-sectional survey of 355 older adults from primary care settings in Baltimore, Md. Physicians completed a short assessment of each participant's condition for current level of depression and reported on the existence of active management of depression over the past six months. Three hundred and forty-one participants completed follow-up interviews.

Key Findings:

  • Black patients were more likely than white patients to report poorer physical and social functioning.
  • The proportion of black patients identified by physicians as depressed was smaller than the proportion of white patients identified as depressed. Black patients were also less likely to report existence of active management of depression during the six months prior to the interview. These differences remained after controlling for a number of other characteristics.
  • Among patients who reported active management of depression, black patients had statistically significantly higher depression scores than white patients and reported more visits to a primary care office.