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Racial and Ethnic Differences in Psychotropic Prescription Receipt Among Pediatric Patients Enrolled in North

Alexis French1, Kelley A Jones1, Christopher Bush1

  • 1Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).

Psychiatric Services (Washington, D.C.)
|August 30, 2022
PubMed

Insights

Black and Hispanic children with Medicaid were less likely to receive psychotropic prescriptions compared to White children. Further research is needed to understand these racial and ethnic disparities in pediatric mental health treatment.

Area of Science:

  • Pediatric Health
  • Health Disparities
  • Psychopharmacology

Background:

  • Racial and ethnic minorities often experience disparities in healthcare access and outcomes.
  • Psychotropic medication is a key component of mental health treatment for pediatric populations.

Purpose of the Study:

  • To investigate racial-ethnic differences in filled psychotropic prescriptions among children covered by Medicaid.
  • To identify potential disparities in psychotropic medication use within a large pediatric population.

Main Methods:

  • Retrospective cohort study of North Carolina Medicaid claims from 2017-2018.
  • Included nearly one million patients aged 0-21 years.
  • Used multivariable modified Poisson regression to analyze filled psychotropic prescriptions, adjusting for demographics.

Main Results:

  • Black and Hispanic children were significantly less likely to receive any filled psychotropic prescription compared to White children.
  • This trend persisted across four major psychotropic drug classes.
  • Adjusted risk ratios indicated substantial underrepresentation in Black (ARR=0.61) and Hispanic (ARR=0.29) pediatric patients.

Conclusions:

  • Significant racial and ethnic disparities exist in psychotropic prescription rates among pediatric Medicaid recipients.
  • Understanding the underlying factors contributing to these disparities is crucial for equitable mental healthcare.
  • Future research should explore the drivers of these observed differences to inform targeted interventions.
Abstract

Keywords:
Child psychiatry/generalCommunity psychiatryPrimary careResearch/service delivery

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