Racial differences in antidepressant use among older home health care patients

The objective of this study was to determine the association of race (black and white) with depression diagnosis and antidepressant use among older home health care patients.

Cross-sectional data were obtained from the 2007 National Home and Hospice Care Survey of patients 65 years and older (N=3,157). Data were analyzed by race, antidepressant use, and charted depression diagnosis.

Whites had greater odds than blacks of receiving a depression diagnosis (adjusted odds ratio [AOR]=4.46, 95% confidence interval [CI]=1.52-13.09). Whites with no depression diagnosis were also more likely to receive an antidepressant (AOR=2.62, CI=1.58-4.36); however, the difference in receipt of an antidepressant between whites and blacks with a depression diagnosis was not significant.

Older blacks were less likely than older whites to receive antidepressants, independent of a depression diagnosis. This finding suggests that older blacks with depression in home health care may face two disparities relative to whites: underdiagnosis and undertreatment of depression.