Differences in Diffusion of FDA Antidepressant Risk Warnings Across Racial-Ethnic Groups
Abstract
Objective
Methods
Results
Conclusions
The diffusion of health care safety information
Black-box antidepressant warnings
The IOM definition of racial-ethnic health care disparities
Methods
Data
Estimation
Measuring disparities
Variance estimation
Results
Characteristic | Whites (N=18,932) | Blacks (N=8,887) | Latinos (N=16,603) |
---|---|---|---|
Antidepressant use in past year | 2.6 | .8 | 1.0 |
Period | |||
2002–2003 | 29.4 | 28.7 | 26.3 |
2004–2005 | 28.8 | 29.5 | 28.4 |
2006–2008 | 41.9 | 41.8 | 45.3 |
Psychological impairment score ≥16b | 10.7 | 10.5 | 6.1 |
Parent-reported mental health of child | |||
Excellent or very good | 83.8 | 78.3 | 77.6 |
Good, fair, or poor | 16.3 | 21.8 | 22.5 |
Gender | |||
Female | 48.8 | 50.1 | 48.7 |
Male | 51.2 | 49.9 | 51.3 |
Age | |||
5–11 | 52.0 | 51.3 | 56.6 |
12–17 | 48.0 | 48.7 | 43.4 |
Household income | |||
Under federal poverty level (FPL) | 8.9 | 30.7 | 27.0 |
Near poverty (100%–199% FPL) | 15.9 | 26.3 | 33.4 |
Middle income (200%–399% FPL) | 37.6 | 28.5 | 27.5 |
High income (≥400% FPL) | 37.7 | 14.6 | 12.1 |
Parent education high school or more | 94.4 | 85.2 | 62.2 |
Parent offered health insurance via employer | 66.7 | 54.3 | 45.6 |
Region | |||
Northeast | 19.5 | 16.7 | 12.6 |
Midwest | 27.6 | 19.5 | 8.7 |
South | 33.5 | 54.9 | 33.6 |
West | 19.4 | 8.9 | 45.1 |
Urbanicity | |||
Population >250,000 | 21.4 | 11.8 | 7.5 |
Population ≤250,000 or nonmetropolitan | 78.6 | 88.2 | 92.5 |
Insurance | |||
Private | 74.5 | 42.6 | 35.2 |
Medicaid | 19.5 | 51.8 | 49.9 |
Other public | .4 | .6 | .6 |
Uninsured | 5.7 | 5.0 | 14.5 |
Health maintenance organization participation | 36.4 | 52.6 | 45.7 |
Characteristic | Coefficient | SE | p |
---|---|---|---|
Race (reference: white) | |||
Black | −1.76 | .27 | <.001 |
Latino | −1.18 | .23 | <.001 |
Period (reference: 2002–2003) | |||
2004–2005 | –.30 | .13 | .02 |
2006–2008 | –.60 | .14 | <.001 |
Race × time interaction | |||
Black × 2004–2005 | .10 | .43 | |
Black × 2006–2008 | .89 | .37 | .02 |
Latino × 2004–2005 | .50 | .32 | |
Latino × 2006–2008 | .58 | .32 | |
Need-related variables | |||
Psychological impairment score ≥16 (reference: CIS score <16)b | 1.48 | .11 | <.001 |
Parent reported mental health of child as good, fair, or poor (reference: excellent or very good) | 1.83 | .11 | <.001 |
Female (reference: male) | <.01 | .11 | |
Age 12–17 (reference: age 5–11) | 1.08 | .11 | <.001 |
Other variables | |||
Income (reference: below poverty line) | |||
Near poverty | –.09 | .12 | |
Middle income | .47 | .15 | .002 |
High income | .50 | .19 | .01 |
Region (reference: Northeast) | |||
Midwest | –.16 | .19 | |
South | .03 | .15 | |
West | –.24 | .18 | |
Population >250,000 (reference: ≤250,000) | .23 | .14 | |
Insurance (reference: private) | |||
Public | –.24 | .20 | |
Medicaid | .66 | .20 | .001 |
Uninsured | −1.07 | .27 | <.001 |
Health maintenance organization participation (reference: none) | –.07 | .11 | |
Parent with at least high school education (reference: high school not completed) | –.04 | .14 | <.001 |
Parent offered health insurance via employer | –.09 | .14 | |
Constant | −5.43 | .34 | <.001 |
Group and period | Predicted probability (%) | SE (%) | Disparity (%) | SE (%) | p | Change since previous period (%) | SE (%) | p |
---|---|---|---|---|---|---|---|---|
Whites | ||||||||
2002–2003 | 3.3 | .2 | ||||||
2004–2005 | 2.7 | .2 | ||||||
2006–2008 | 2.1 | .2 | ||||||
Blacks | ||||||||
2002–2003 | .5 | <.1 | 2.8 | .2 | <.001 | |||
2004–2005 | .6 | .1 | 2.1 | .2 | <.001 | –.7 | .3 | <.001 |
2006–2008 | 1.0 | .1 | 1.1 | .2 | <.001 | –1.0 | .3 | <.001 |
Latinos | ||||||||
2002–2003 | 1.2 | .1 | 2.1 | .2 | <.001 | |||
2004–2005 | 1.5 | .1 | 1.2 | .2 | <.001 | –.9 | .2 | <.001 |
2006–2008 | 1.2 | .1 | .9 | .2 | <.001 | –.3 | .2 |
Discussion
Conclusions
Acknowledgments and disclosures
Supplementary Material
- View/Download
- 170.45 KB
References
Information & Authors
Information
Published In
History
Authors
Metrics & Citations
Metrics
Citations
Export Citations
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
View Options
View options
PDF/EPUB
View PDF/EPUBGet Access
Login options
Already a subscriber? Access your subscription through your login credentials or your institution for full access to this article.
Personal login Institutional Login Open Athens loginNot a subscriber?
PsychiatryOnline subscription options offer access to the DSM-5-TR® library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development.
Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.).