Macroeconomic Antecedents of Racial Disparities in Psychiatric Emergency Department Visits

Parvati Singh

Psychiatric Emergency Department (ED) usage among African Americans exceeds that of all other race/ethnicities in the US. Economic downturns can exacerbate this racial disparity by increasing help-seeking for newly developed or pre-existing disorders, combined with cost-shifting from private care to public safety nets. I use repeated cross-sectional time series data for 3.2 million psychiatric outpatient ED visits for five states over six years (2006-2011) to test whether monthly aggregate employment decline precedes a rise in African American psychiatric ED visits relative to whites. Logistic regression results show that the odds of psychiatric ED visits for African Americans increase two and three months after ambient employment decline, relative to whites (OR:1.012, p value <0.01). This increase is concentrated among those who do not have private insurance (OR:1.013, p value <0.05). Findings from this study can inform measures for anticipating and delivering mental health services to vulnerable populations during macroeconomic downturns.

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 Presented in Session 11. Health & Mortality 2