1. American Psychiatric Association: Latinos

Background: It is very common for Latinos/Hispanics to rely on extended family, community, traditional healers, and religious institutions for help during a crisis. Mental illness is one such crisis. Latinos believe that mental illnesses like depression can be cured without professional medical treatment, or that the symptoms are not that serious to begin with. In addition, language barriers prevent even more Latinos from seeking treatment.

How I Intend To Use It: Cultural beliefs held by Latinos are altering their part in the racial gap between antidepressant prescriptions. Since many Latinos prefer to seek help from non-professional sources, such as family or religion, they never end up going to the psychiatrist for mental illness treatment in the first place. Latinos that can not speak English are even more discouraged from seeking help for mental illness. This is why it appears that Latinos and Hispanics are not being prescribed antidepressants at the same rate as whites and other racial/ethnic groups.

2. American Psychiatric Association: Asian Americans-Pacific Islanders

Background: Asian culture values self-reliance, a reserved personality, and family honor, which can intimidate the mentally ill from seeking treatment. The sense of shame alone in being mentally ill causes many Asians to delay seeking treatment, thus worsening their symptoms over time. Many first or second generation Asian Americans feel a strong cultural conflict between their parents and the mainstream culture. They fear the stigma of being labeled as mentally ill, for it shows a weakness that is unacceptable. Language barriers prevent many more Asians from seeking professional treatment.

How I Intend To Use It: Asian cultural beliefs are contributing to the racial gap in antidepressant prescriptions. Personal weakness and relying on others for help are looked down upon, which discourages many Asian Americans from getting the professional help that they need. The more “Americanized” generations fear that they will be stigmatized by their family for being mentally ill, and that also drives down the numbers of Asians being prescribed antidepressants. Language barriers prevent even more Asians from seeking professional mental help. All of these factors contribute to lower antidepressant prescription rates for Asians.

3. About the USPHS Syphilis Study

Background: During the Tuskegee Syphilis Study of Untreated Syphilis in the Negro Male (1932-1947), 600 participators in this experiment went untreated for the disease and infected many others, despite being told that they were being treated. The participators were told that the researchers were studying “bad blood,” a local term used to describe a variety of illnesses, including syphilis. Participants were given medical opportunities that blacks could only dream of at the time, such as free treatment and rides to and from the clinic. But the participants were never made aware of how life-threatening the “treatment” was (in this case, there was no treatment in the first place), and by the end of the study, dozens of men had died and infected those that they were close too. Even when penicillin was discovered in 1947 as a treatment for syphilis, the medication was never prescribed to save these men.

How I Intend To Use It: This is one of many unethical and inhumane studies that were conducted on blacks for the sake of so-called “research.” Distrust of medical professional resulted from these studies, and it still affects blacks today. A strong distrust of doctors will discourage many from ever seeing one, even if mental illness is involved. This contributes to the low number of blacks that receive prescriptions for antidepressants.

4. Diagnosis of Depression and Use of Antidepressant Pharmacotherapy Among Adults in the United States

Background: Published in 2012, this study on the rate of depression diagnosis and antidepressant treatment among races was conducted from 1992-2008. Although the overall rates of identifying and treating depression have increased, minority groups are still far less than whites in this category.

How I Intend To Use It: This source will be the basic foundation of my thesis. The study discusses various reasons as to why the racial gap between antidepressant diagnosis and prescription exists, and so, it will be my job to reference other sources to conclude with this notion.

5. Using Antidepressants to Treat Depression

Background: The most-updated guide to what depression is, what antidepressants are, and who needs them. All kinds of information on US available forms of antidepressants are discussed, such as generic versions, possible side-effects, the effectiveness, the average dosage level, and the average monthly cost of each antidepressant. It is important to note that brand name antidepressants tend to cost a lot more than their generic counterparts: a 20 mg capsule of Prozac costs about $260 per month, while its generic equivalent Fluoxetine costs about $31 per month for the exact same dosage. It is also important to note that generic and brand name antidepressants contain the exact same ingredients.

How I Intend To Use It: Cost factors heavily into a patient’s decision to receive treatment, especially in the case of antidepressants. Another reason that many people of all races and ethnic groups do not get prescribed antidepressants is because they simply can’t afford to pay for them. Health insurance factors into the inability to pay, but the primary culprit is the misleading notion that brand name prescriptions (which cost more) perform much better than generics. Most people see brand name as “superior” to the generics, but in reality, they have the same ingredients and do the same job.

6. Income, Poverty, and Health Insurance Coverage in the United States

Background: The US Census Bureau complied statistics of every aspect of income, poverty, and health insurance coverage in the year 2012. According to the figures, whites generally are more likely have health insurance than blacks, Hispanics, and Asians. Medical coverage based on the type of health insurance vary as well. Private plans provide a lot more coverage than Medicare or Medicaid. Whites have more private insurance than blacks, Hispanics, and Asians.

How I Intend To Use It: These statistics help conclude that because whites are more likely to be covered, and more likely to have private health insurance, they have more of an opportunity to be prescribed antidepressants. If a lack of health insurance, or other types of health insurance can’t cover the cost of prescribed antidepressants, then people will most likely not be prescribed the medication. And because more minorities lack health insurance of any type, that leads to less of them getting prescriptions, which alters the racial gap between antidepressant prescriptions.

7. What is Medicare? What is Medicaid?

Background: Medicare and Medicaid are government health insurance programs that can be more affordable for those who can’t afford private health insurance, but only apply to certain types of people. Medicaid provides medical service programs for individuals and families with low incomes. Mandatory medical services like vaccine administration, physician services, midwife services, etc., are automatically covered. But things like prescribed medications might not be covered, depending on state laws. Medicare is meant to provide for hospital and medical care for those over age 65, and certain disabled Americans. Medicare has four parts: A, B, C, and D. Part A covers hospital stays and treatment. Part B pays for necessary physician visits and home health care, but is voluntary because it requires a monthly premium that varies in cost. Part C is a customizable health plan that is partially covered by private health insurance. Part D provides a list of covered prescriptions and drugs, and covers 75% of the cost for those medications.

How I Intend To Use It: Knowing the differences between Medicare and Medicaid are crucial to my argument. Already, it can be seen that Medicare patients are less likely to have prescription drug coverage, so they are less likely to be prescribed antidepressants. Medicaid patients do get prescription drug coverage, but only for certain types of drugs, which may or may not include the type of antidepressant that they want. To prove that health insurance affects the racial gap between antidepressant prescription rates, I will tie this information in with the US Census that shows minorities are at a disadvantage because of their economic position.

8. What is Private Health Insurance?

Background: Although private health insurance generally covers most, if not all, of an individual’s medical expenses, it is the most expensive form of health insurance. All private health insurance plans require premiums, which vary in cost from year to year, and generally increase as a covered individual ages. Individuals with a pre-existing condition, such as heart disease, can be denied health coverage in most states.

How I Intend To Use It: The high cost of private health insurance deters many from getting the required health care they need, in favor of a cheaper plan. Cheaper plans might not cover prescription costs. High prescription costs prevent many mentally ill people from being prescribed antidepressants. Because white people are more likely to have private health insurance, they are in turn, more likely to be prescribed any kind of antidepressant.