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Minorities And Depression: How Doctors Prescribe Antidepressants

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HOW DO DOCTORS PRESCRIBE
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A new study from the University of Michigan's School of Public Health has found that doctors are far less likely to prescribe antidepressants to African-American and Hispanic patients afflicted with major depressive disorder than Caucasian ones, who received prescriptions for the medication 1.52 times more.

But it wasn't only ethnicity that informed doctors' decisions. The paper showed that physicians who owned their own practice were 25 per cent less likely to prescribe antidepressants than those who were not owners, and doctors in metropolitan areas were 27 per cent less likely to write suggest the medication.

"This study confirmed previous findings that sociological factors, such as race and ethnicity, and patient health insurance status, influence physician prescribing behaviours," said Rajesh Balkrishnan, associate professor in U-M SPH and principal investigator. "This is true in particular for major depressive disorder treatment."

Past studies have noted a stigma surrounding mental illness in ethnic groups, creating a barrier to even discussion of the issue. Though this study utilized data from administrative databases and did not consult patients directly, the findings indicate another potential issue for these groups.

Steve Morgan, the Associate Director at the Centre for Health Services and Policy Research at the University of British Columbia in Vancouver, has studied ethnic differences in the use of prescription drugs. He notes the impact of physical location on the results.

"We do know that geography matters, that there are regional variations in drug use, across provinces and states, or even within those areas," he says. "The different forms of disparity could be related to cultural competency [the ability to interact with people from different cultures], but it could also be related to socioeconomic disparities."

Balkrishnan noted his hope that the study would change the variation in medication prescriptions across different populations to a more equal approach.

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