Exploring racial disparity in posttraumatic stress disorder diagnosis: Implications for care of African American Women

Julia S. Seng, Laura Kohn-Wood, Lilian A. Odera

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: To explore factors contributing to disparities in posttraumatic stress disorder (PTSD) diagnosis between African Americans and White Americans, while controlling for gender and class by using a data set limited to poor women. Design: A cross-sectional epidemiologic al secondary analysis. Setting: Michigan Medicaid fee-for-service claims data from 1994 through 1997. Sample: A total of 20,298 African American and White American adolescents and adult women, including 2,996 with PTSD diagnosis. Main out come measures: Victimization, PTSD diagnosis, psychiatric and somatic comorbidities, and PTSD treatment. Results: African American wo men were under-represented in the group diagnosed with PTSD (12% versus 31% in the comparison group), despite having equal rates of hospitalization for rape and battering. They were less likely to be diagnosed with comorbidities associated with complex PTSD, such as dissociative disorder (OR = 0.259, p <.001) or borderline personality disorder (OR = 0. 178, p <.001), but were equally likely to be diagnosed with conduct disorder, schizophrenia, or substance abuse. African American women were 40% less likely to have continuous insurance coverage. Conclusions: Patient, provider, and system factors appear to interact to create disparities in PTSD diagnosis and treatment. Attention to case finding and provider or system bias may help reduce disparities.

Original languageEnglish
Pages (from-to)521-530
Number of pages10
JournalJOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing
Volume34
Issue number4
DOIs
StatePublished - Jul 1 2005
Externally publishedYes

Fingerprint

Post-Traumatic Stress Disorders
African Americans
Comorbidity
Dissociative Disorders
Fee-for-Service Plans
Conduct Disorder
Borderline Personality Disorder
Insurance Coverage
Crime Victims
Rape
Medicaid
Mental Disorders
Substance-Related Disorders
Schizophrenia
Hospitalization
Therapeutics

Keywords

  • African American women
  • Health disparities
  • Mental health
  • Posttraumatic stress disorder (PTSD)

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

Cite this

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title = "Exploring racial disparity in posttraumatic stress disorder diagnosis: Implications for care of African American Women",
abstract = "Objective: To explore factors contributing to disparities in posttraumatic stress disorder (PTSD) diagnosis between African Americans and White Americans, while controlling for gender and class by using a data set limited to poor women. Design: A cross-sectional epidemiologic al secondary analysis. Setting: Michigan Medicaid fee-for-service claims data from 1994 through 1997. Sample: A total of 20,298 African American and White American adolescents and adult women, including 2,996 with PTSD diagnosis. Main out come measures: Victimization, PTSD diagnosis, psychiatric and somatic comorbidities, and PTSD treatment. Results: African American wo men were under-represented in the group diagnosed with PTSD (12{\%} versus 31{\%} in the comparison group), despite having equal rates of hospitalization for rape and battering. They were less likely to be diagnosed with comorbidities associated with complex PTSD, such as dissociative disorder (OR = 0.259, p <.001) or borderline personality disorder (OR = 0. 178, p <.001), but were equally likely to be diagnosed with conduct disorder, schizophrenia, or substance abuse. African American women were 40{\%} less likely to have continuous insurance coverage. Conclusions: Patient, provider, and system factors appear to interact to create disparities in PTSD diagnosis and treatment. Attention to case finding and provider or system bias may help reduce disparities.",
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