Assessing mental health treatment receipt among Asian adults with limited English proficiency using an intersectional approach

Author:

Nguyễn Charlie H1ORCID,Dean Lorraine T123ORCID,Jackson John W14567ORCID

Affiliation:

1. Johns Hopkins University Bloomberg School of Public Health Department of Epidemiology, , Baltimore, MD 21205 , United States

2. Johns Hopkins University Bloomberg School of Public Health Department of Health Policy and Management, , Baltimore, MD 21205 , United States

3. Johns Hopkins University School of Medicine Sidney Kimmel Cancer Center, , Baltimore, MD 21205 , United States

4. Johns Hopkins University Bloomberg School of Public Health Department of Biostatistics, , Baltimore, MD 21205 , United States

5. Johns Hopkins University Bloomberg School of Public Health Department of Mental Health, , Baltimore, MD 21205 , United States

6. Johns Hopkins University Bloomberg School of Public Health Center for Health Disparities Solutions, , Baltimore, MD 21205 , United States

7. Johns Hopkins University Johns Hopkins Center for Health Equity, , Baltimore, MD 21205 , United States

Abstract

Abstract US Asian adults and people with limited English proficiency (LEP) confront mental health treatment receipt disparities. At the intersection of racial and language injustice, Asian adults with LEP may face even greater disparity, but studies have not assessed this through explicitly intersectional approaches. Using 2019 and 2020 National Survey of Drug Use and Health data, we computed disparities in mental health treatment among those with mental illness comparing: non-Hispanic (NH) Asian adults with LEP to NH White adults without LEP (joint disparity), NH Asian adults without LEP to NH White adults without LEP (referent race disparity), NH Asian adults with LEP to those without LEP (referent LEP disparity), and the joint disparity versus the sum of referent disparities (excess intersectional disparity). In age- and gender-adjusted analyses, excess intersectional disparity was 26.8% (95% CI, −29.8 to 83.4) of the joint disparity in 2019 and 63.0% (95% CI, 29.1-96.8) in 2020. The 2019 joint disparity was 1.37 (95% CI, 0.31-2.42) times that if the race-related disparity did not vary by LEP, and if LEP-related disparity did not vary by race; this figure was 2.70 (95% CI, 0.23-5.17) in 2020. These findings highlight the necessity of considering the intersection of race and LEP in addressing mental health treatment disparities. This article is part of a Special Collection on Mental Health.

Funder

National Heart, Lung, and Blood Institute

National Institute on Minority Health and Health Disparities of the National Institutes of Health

Publisher

Oxford University Press (OUP)

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