Psychiatric Treatment Needs Among the Medically Underserved: A Study of Black and White Primary Care Patients Residing in a Racial Minority Neighborhood



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Objective: Racial disparities in psychiatric treatment are well documented. A growing body of research demonstrates that residing in a racial minority neighborhood adversely affects access to health care and may in part account for psychiatric treatment disparities. The study objective is to determine the role of race in psychiatric treatment disparities among blacks and whites residing in a racial minority neighborhood.

Method: A systematic sample of black (n = 345) and white (n = 57) patients from a primary care clinic in a racial minority neighborhood in northern Manhattan, New York, was analyzed. Logistic regression models were utilized to assess the effect of race on psychiatric treatment. The study was conducted during 1998–1999 and 2001–2003.

Results: Blacks were less likely than whites to have a lifetime psychiatric disorder (OR = 0.17; 95% CI, 0.06–0.53). Among patients with a current psychiatric disorder, there were no significant black-white differences in psychiatric treatment (OR = 0.72; 95% CI, 0.21–2.49). Yet, there were significant and substantial differences among patients without a current psychiatric disorder, with blacks less likely to receive psychiatric treatment than whites (OR = 0.09; 95% CI, 0.04–0.21).

Conclusions: The study findings suggest that neighborhood residence moderates the relationship between race and psychiatric treatment. Black and white primary care patients with a current disorder residing in this racial minority neighborhood had similar rates of psychiatric treatment. Yet, whites, who were the minority in the clinic and the neighborhood from which the clinic draws patients, appear to have more chronic psychiatric problems for which they are receiving treatment. Primary care clinics can serve as a vital tool in addressing the persistent disparities in psychiatric treatment and the psychiatric conditions among whites residing in racial minority neighborhoods.

Prim Care Companion J Clin Psychiatry 2010;12(6):e1–e7

Submitted: March 2, 2009; accepted February 10, 2010.

Published online: November 11, 2010 (doi:10.4088/PCC.09m00804whi).

Corresponding author: Azure B. Thompson, DrPH, Rutgers, The State University of New Jersey, Institute for Health, Health Care Policy and Aging Research, 30 College Ave, New Brunswick, NJ 10010 (

Prim Care Companion J Clin Psychiatry 2010;12(6):e1-e7