Disparities in access to eating disorders treatment for publicly-insured youth and youth of color: a retrospective cohort study

Journal of Eating Disorders

Research

Ruby Moreno¹  Erin C. Accurso²  Sara M. Buckelew³  Marissa Raymond-Flesch⁴ 

[1] Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA;Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA;Division of Adolescent & Young Adult Medicine, University of California, San Francisco, San Francisco, CA, USA;Division of Adolescent & Young Adult Medicine, University of California, San Francisco, San Francisco, CA, USA;Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, USA;

关键词: Family-based treatment (FBT);    Cognitive behavioral therapy (CBT);    Anorexia nervosa (AN);    Atypical anorexia nervosa (AAN);    Bulimia nervosa (BN);    Binge eating disorder (BED);    Public insurance;    County rurality;    Structural racism;    Hospitalization;   

DOI  :  10.1186/s40337-022-00730-7

 received in 2022-06-12, accepted in 2022-12-28,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundEating disorders are associated with substantial morbidity and mortality that can be minimized by timely access to evidence-based treatment. However, disparate access to eating disorders treatment may contribute to significant health disparities amongst marginalized groups. This study examined the association between insurance type (public vs. private) and receipt of recommended mental health treatment in a sample of racially/ethnically diverse youth who presented to an adolescent medicine clinic with malnutrition secondary to disordered eating.MethodsA retrospective chart review was conducted for youth ages 11–25 years (N = 1060) who presented to an urban adolescent medicine specialty program between June 1, 2012 and December 31, 2019 for malnutrition secondary to disordered eating. Bivariate and logistic regression analyses examined the association between insurance type (public vs. private) and other demographic/clinical factors on receipt of recommended treatment within six months of the initial evaluation.ResultsPatients with public insurance were one third as likely to receive recommended treatment as patients with private insurance (AOR = 3.23; 95% CI = 1.99, 4.52), after adjusting for demographic and clinical factors. Latinx (AOR = 0.49; 95% CI = 0.31, 0.77) and Asian (AOR = 0.55; 95% CI = 0.32, 0.94) patients were half as likely to receive recommended treatment as White patients.ConclusionsAccess to evidence-based mental health treatment is a necessary first step towards health equity for individuals with eating disorders. Additional work is needed to dismantle systemic inequities that contribute to disparities in care for youth of color and those with public insurance.

【 授权许可】

CC BY   
© The Author(s) 2023