Geographic & Sociodemographic Patterns in Prevalence of Mental Health Conditions Among Children

In a study titled Mental Health Conditions Among School-Aged Children: Geographic and Sociodemographic Patterns in Prevalence and Treatment the authors have provided state-level estimates of the prevalence of diagnosed pediatric emotional and behavioral mental health conditions and treatment received by children and adolescents ages 6-17 with these diagnoses. "Our results show significant variation in the prevalence of diagnosed mental health conditions among children and youth by state of residence in addition to documented sociodemographic and health-related factors. In contrast, receipt of treatment was more strongly related to socioeconomic and health-related factors," write the authors of an article published in the January 2012 issue of the Journal of Developmental and Behavioral Pediatrics. The prevalence of mental health conditions and potential for both long-term and widespread negative impacts underscore the importance of early identification and treatment. Identifying variations in the prevalence of diagnosed mental health conditions and the receipt of treatment among this population may help to illustrate disparities and to highlight examples where policies and systems could better support both identification and treatment of children and adolescents with mental health problems.

Data for the study came from the 2007 National Survey of Children's Health. Mental health conditions were identified using parents' responses to three questions about whether a doctor or health professional had ever told them that their child had depression, anxiety problems, or behavioral or conduct problems. Receipt of treatment was determined by parents' report of whether their child had received any treatment or counseling from a mental health professional in the past 12 months. Although state of residence was the primary covariate of interest, seven sociodemographic and health-related variables shown to be associated with mental health conditions and access to treatment in previous research were also assessed: child's or adolescent's sex, age, race and ethnicity, poverty status, insurance type, health status, and maternal health status.

The authors found that

• Nearly 8 percent of children and adolescents ages 6-17 had ever been diagnosed with depression or anxiety, and 5.4 percent had ever been diagnosed with behavioral or conduct problems, according to parental report.
• Lifetime prevalence of parent-reported depression or anxiety varied significantly by state of residence, ranging from 4.8 percent in Georgia to 14.4 percent in Vermont.
• Lifetime prevalence of parent-reported behavioral or conduct problems ranged from 3.2 percent in California to 9.2 percent in Louisiana.
• Regardless of diagnosis, nearly 10 percent of all children and adolescents and 53.1 percent of those who had ever been diagnosed with an emotional or behavioral condition received mental health treatment or counseling within the past year, according to parental report.
• The odds of receiving past-year parent-reported treatment did not differ by state of residence with the exception of Louisiana and Nevada: children and adolescents ever diagnosed had more than two times the odds of not receiving past-year treatment in these states.

The authors conclude that "further research at both the state and national levels is needed to determine how different approaches to the provision and financing of mental health services may affect both the prevalence of diagnosis and access to treatment for these conditions."

Read the abstract of the study.

Younger Americans’ Health Disparity Gets Worse

According to a new study titled Variance Function Regression in Hierarchical Age-Period-Cohort Models - Applications to the Study of Self-Reported Health, the gap between the least and the most healthy is widening for Americans born after 1980. While the baby boom generation has consistently reported better health than any other generation, today’s young adults are expected to be less healthy as they age. According to Ohio State University researcher Hui Zheng, today’s young adults are projected to experience growing health disparities in their lifetimes. “As young people today reach middle age and preceding cohorts with a smaller health gap die off, we expect health disparities in the whole population to grow even larger,” said Zheng. The Ohio State study used data from the National Health Interview Survey from 1984-2007 to investigate how the health gap varies by age and cohort.

According to Zheng, indicators of health have been on the decline for more than decade, despite advances in medicine and technology. Future research is necessary to pinpoint factors contributing to the increased health gap among younger generations and to identify potential solutions.

Read more on the Kaiser Family Foundation website. Read the study (pdf).

Cultural Competency in Mental Health Peer-run Programs and Self-help Groups

The Cultural Competency in Mental Health: Peer-run Programs and Self-help Groups is a resource by the National Alliance on Mental Illness (NAMI) STAR Center and the University of Illinois at Chicago was created to help mental health, consumer operated programs and self-help groups assess their own cultural competency. By using it, you’ll identify the ways in which your activities are already responsive to culturally diverse peers and areas where you could use some improvement. You’ll also create specific action plans to enhance your cultural competency in five important areas. This tool is structured around five focus areas - Administration, Policies and Guidelines, Peer Providers and Group Leaders, Services and Supports, Program or Group Environment, Communication and Language Capacity. For each of the five focus areas, you will:

• Review why the area is an important part of cultural competency in peer programs and self-help groups
• Learn about where to look when conducting your assessment in that area
• Rate your program on how well it meets the given criteria
• Consider and act on ways to improve your competency in that area

Download the tool (pdf). Learn more about the NAMI STAR Center.

Addiction Discriminates? What That Means in Today’s Troubled Economy

For decades now, addiction has been branded “an equal opportunity disease.” And judging from the largely white, middle-class people who populate most AA meetings and rehabs, it is. But while no sector of society is immune from substance abuse, addiction does discriminate. Examples abound: "drug problems" among college grads is nearly a third lower than those for high school dropouts, according to the National Household Survey on Drug Abuse and Health. Unemployed people are twice as likely to be addicts as people with jobs. With America facing the greatest income gap since the Great Depression, the largely unpublicized link between financial inequality and drug addiction suggests big trouble ahead.

Of course, the causal connection between poverty and substance use runs both ways. People who are suffering from alcohol or drug problems are obviously more likely to drop out of school or lose their jobs, while those who don't have the education and skills to find a job in this fast-changing, increasingly high-tech economy not only increase face increased odds of addiction but also dramatically lower odds of recovery.

Americans earning less than $20,000 a year are half as likely to successfully quit smoking—and nearly one third less likely to end a cocaine addiction—than those making $70,000 a year or more. Addiction is disproportionately concentrated among the poor, and, consequently, among blacks and Hispanics. If we continue to ignore the special role that the lack of education and employment play in fermenting the growing drug problem, we are likely to leave them out of the solution when it comes to crafting treatment and prevention.

Read more on the AlterNet website.

Can Electronic Health Records Erase Disparities?

Switching to electronic health records might help close health gaps between black and white Americans, researchers suggest in a new study. Using government data on primary care visits from 2007 to 2008, they found a racial gap in well-controlled blood pressure among doctors who didn't use digital records, but not among those who did. That could be important, because African Americans are more likely to have high blood pressure than whites, which might in turn explain why they also have more heart attacks, strokes and kidney disease, said Dr. Lipika Samal, who worked on the new study. "If we really do find the tools help to reduce disparity," she told Reuters Health, "then as a society we should incentivize people to use these tools." But that's still a big 'if,' according to Samal, of Brigham and Women's Hospital in Boston. Her findings are just an association, she said, and can't prove that electronic health records by themselves get rid of health disparities.

The study is based on a survey of doctors across the U.S. It includes more than 17,000 primary care visits, during which doctors recorded patients' blood pressure. Fifteen percent of the doctors said they used electronic health records, with another 27 percent using special pop-up messages in addition to the digital records to help them make medical decisions. When offices used traditional records, 69 percent of blacks were estimated to have their blood pressure relatively under control (less than 140/90) after accounting for age, insurance and who owned the office, among other factors. That number was 75 percent for whites. At offices that had embraced the new technology, the numbers were similar for blacks and whites at 75 percent and 78 percent, respectively. And Hispanics had an even higher rate of good blood pressure control.

Samal said more research is needed to tease out why the gap between whites and blacks disappears at offices that use digital tools, but said it could be that the systems help doctors make better decisions -- such as suggesting cheaper medicines for poor patients.

Read more on the Medline Plus website. Read the full study (requires login).

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