Significant progress has been made in reducing the prevalence of tobacco use United States.However, cessation efforts have focused on general population rather than individuals with mental illness, who demonstrate greater rates and nicotine dependence.OBJECTIVES To assess whether declines realized among illness examine association between health treatment smoking cessation.DESIGN, SETTING, AND PARTICIPANTS Use nationally representative surveys noninstitutionalized US residents to compare...

This study compared trends in racial-ethnic disparities mental health care access among whites, blacks, Hispanics, and Asians by using the Institute of Medicine definition as all differences except those due to clinical appropriateness, need, patient preferences.Racial-ethnic were examined data from a nationally representative sample 214,597 adults 2004-2012 Medical Expenditure Panel Surveys. The main outcome measures included three (use any care, outpatient psychotropic medication past...

More than one-third of the approximately two million people entering publicly funded substance abuse treatment in United States do not complete treatment. Additionally, racial and ethnic minorities with addiction disorders, who constitute 40 percent admissions programs, may be particularly at risk for poor outcomes. Using national data, we found that blacks Hispanics were 3.5–8.1 percentage points less likely whites to alcohol drugs, Native Americans 4.7 Only Asian fared better both types...

Objective To investigate disparities in mental health care episodes, aligning our analyses with decisions to start or drop treatment, and choices made during treatment. Study Design We analyzed whites, blacks, Latinos probable illness from Panels 9–13 of the Medical Expenditure Panel Survey, assessing at beginning, middle, end episodes (initiation, adequate care, having an episode only psychotropic drug fills, intensity mixture primary provider ( PCP ) specialist visits, use acute...

Importance Individuals of racial and ethnic minority groups may be less likely to use telemedicine in part due lack access technology (ie, digital divide). To date, some studies have found by individuals compared with White individuals, others the opposite. What explains these different findings is unclear. Objective quantify differences receipt total visits without accounting for demographic clinical characteristics geography. Design, Setting, Participants This cross-sectional study...

In a recent report, the Institute of Medicine (IOM) defines health service disparity between population groups to be difference in treatment or access not justified by differences status preferences groups. This paper proposes an implementation this definition, and applies it disparities outpatient mental care.Health Care for Communities (HCC) reinterviewed 9,585 respondents from Community Tracking Study 1997-1998, oversampling individuals with psychological distress, alcohol abuse, drug...

This study measured trends in disparities mental health care by use of an improved method that applies the Institute Medicine (IOM) definition racial-ethnic disparities.Data from 2000-2001 and 2003-2004 Medical Expenditure Panel Surveys were used to estimate two global measures care: having any visit total expenditure past year. Disparities between African Americans, Hispanics, white Americans examined applying a new methodology based on IOM racial disparity adjusts for status allows...

We examined potential pathways by which time in the United States may relate to differences predicted probability of past-year psychiatric disorder among Latino immigrants as compared with US-born Latinos.We estimated probabilities for and immigrant groups varying States, adjusting different combinations covariates. 6 could be associated disorders.Increased is higher risk disorders immigrants. After adjustment covariates, rates between Latinos disappear. Discrimination family cultural...

Health services and health economics research articles commonly use multivariate regression techniques to measure the relationship of service utilization outcomes (the interest) with clinical characteristics, sociodemographic factors, policy changes (usually treated as explanatory variables). Common methods differences in outcome variables between populations at mean (i.e., ordinary least squares regression), or a population average effect logistic models), after adjustment for other...

We assessed whether early implementation of Affordable Care Act (ACA) Medicaid expansion and state health insurance exchanges increased access to mental substance use treatment among those in need these changes differed by racial/ethnic group. found that rates significantly but no evidence a reduction the wide disparities preceded ACA from 2005 2013.

Natural language processing (NLP) and machine learning were used to predict suicidal ideation heightened psychiatric symptoms among adults recently discharged from inpatient or emergency room settings in Madrid, Spain. Participants responded structured mental physical health instruments at multiple follow-up points. Outcome variables of interest (GHQ-12). Predictor included items (e.g., relating sleep well-being) responses one unstructured question, “how do you feel today?” We compared...

Objective: Among persons with substance use disorders, those from racial-ethnic minority groups have been found to receive abuse treatment at rates equal or higher than of non-Latino whites. Little is known about factors underlying this apparent lack disparities. This study examines disparities in receipt and mechanisms that reduce contribute Methods: Black-white Latino-white any specialty were measured among adult respondents disorders the 2005–2009 National Survey on Drug Use Health...

Introduction. The ability to track improvement against racial/ethnic disparities in mental health care is hindered by the varying methods and disparity definitions used previous research. Data. Nationally representative sample of whites, blacks, Latinos from 2002 2006 Medical Expenditure Panel Survey. Dependent variables are total, outpatient, prescription drug expenditure. Methods. Rank‐ propensity score‐based concordant with Institute Medicine (IOM) definition were compared commonly...

Objective To estimate whether racial/ethnic behavioral health service disparities are likely to be reduced through insurance expansion coverage expected the Affordable Health Care Act. Data Sources Pooled data from nationally representative NIMH Collaborative Psychiatric Epidemiological Studies (2001–2003). Study Design We employ a novel reweighting method in presence and absence of coverage. Collection Access care was assessed by any treatment received past year. Need determined prior year...

Objective The rapid proliferation of machine learning research using electronic health records to classify healthcare outcomes offers an opportunity address the pressing public problem adolescent suicidal behavior. We describe development and evaluation a algorithm natural language processing identify behavior among psychiatrically hospitalized adolescents. Methods Adolescents on psychiatric inpatient unit in community system northeastern United States were surveyed for history suicide...

Abstract Background Immigration stress appears to augment the risk for suicide behaviors Latinos. Yet, specific factors that contribute suicidal ideation (SI) among diverse Latino immigrant populations are not well established. Methods Data were collected in Boston, Madrid and Barcelona using a screening battery assessing mental health, substance abuse risk, trauma exposure, demographics, sociocultural factors. Prevalence rates of lifetime 30-day SI compared across sites. Logistic regression...

The objective was to examine mental health treatment access disparities between Asians and whites in the United States as well role of perceived need barriers these disparities.Data are five annual cross-sections (2012-2016) responses from Asian Americans nationally representative National Survey on Drug Use Health. Multivariate logistic regression analyses adjusting for sociodemographic factors were conducted compare past-year rates across three subgroups: those with treatment, serious...

Importance Poverty is associated with greater barriers to health care and worse outcomes, but it remains unclear whether income support can improve health. Objective To examine the effect of cash benefits on utilization Design, Setting, Participants The City Chelsea, Massachusetts, a low-income community near Boston, randomly assigned individuals by lottery receive benefits. Participants’ medical records were linked across multiple systems. Outcomes assessed during intervention period from...

Importance During buprenorphine treatment for opioid use disorder (OUD), risk factors relapse or dropout include comorbid substance disorder, anxiety, residual craving. There is a need well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, address these comorbidities during treatment. Objective To compare the effects of Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving OUD....

Monitoring disparities over time is complicated by the varying disparity definitions applied in literature. This study used data from 1996-2005 Medical Expenditure Panel Survey (MEPS) to compare trends three of racial/ethnic and assess influence changes socioeconomic status (SES) among minorities on trends. prefers Institute Medicine's (IOM) definition, which adjusts for health but allows mediation through SES factors. Black—White having an office-based or outpatient visit medical...