African-American senior citizens are significantly less likely than whites to be diagnosed and treated for depression, a Rutgers University study concluded.
Researchers reviewed five years of national data from the U.S. Medicare Current Beneficiary Survey, looking at the financial, insurance and health-care use information of 33,708 beneficiaries from 2001 to 2005.
The Rutgers study, to appear in the February edition of the American Journal of Public Health, found that depression diagnosis rates were 6.4 percent for non-Hispanic whites and 4.2 percent for African-Americans.
Researchers believe that many African-Americans are depressed but aren't getting the diagnosis or help they need, said Ayse Akincigil, lead researcher and an assistant professor at Rutgers School of Social Work.
While other studies have looked at people of all ages, Rutgers researchers chose to study Medicare beneficiaries because depression is a significant and often under-treated health problem for older adults.
Economic differences were found to play a role in detection rates. African-Americans in the study sample, for example, were less likely than non-Hispanic whites to have private insurance to supplement Medicare.
“Whites use more antidepressants than African-Americans,” Akincigil said. “We presume they have better access to doctors and pharmacies and more money to spend on drugs.”
In addition to economics, it may be that African-Americans are less likely to seek help because of the perceived cultural stigma, or that some poorer neighborhoods have far fewer therapists and doctors who treat depression.
“Are there cultural differences or systemic differences regarding health-care quality and access for treatment of depression?” said Akincigil, who hopes to conduct a smaller and more detailed study that better explore those theories.
Akincigil and the researchers say doctors who treat the elderly should routinely screen all their patients for symptoms of depression.
“There needs to more awareness of the ways in which depression can aggravate other common medical problems that older people tend to have, such as diabetes and heart conditions.”
Karyne Jones, president of the National Caucus and Center on Black Aged, agreed that doctors need to be more vigilant in recognizing symptoms. But at the same time, the African-American community needs to be urged to treat depression as a medical problem, Jones said.
“There needs to be more education that it's not just that Grandma's getting older or that Grandma's in one of her moods,” Jones said. “And of course, the joke in that black community is we don't go to therapy, we go to church. There's the thinking that these kinds of things can be solved by prayer alone.”
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