Estimating a Model for Mental Healthcare Utilization Using Subjective Unmet Need and Psychological Distress Measures.

The objective of this study is to assess the predictive value of self-reported need and psychological distress in mental healthcare service use across racial and ethnic groups in California. Using 2014-2018 data for adults aged 18-64 in the California Health Interview Survey, both logistic and Poisson regression models are used to estimate mental healthcare utilization. Patient-reported outcome measures, such as psychological distress, are commonly used to evaluate healthcare utilization patterns. The Kessler-6 screener for psychological distress is frequently used as a tool for determining whether someone's level of distress necessitates evaluation by a mental healthcare professional. Serious psychological distress has been widely studied as a predictor of higher healthcare expenditures and use; however, moderate distress and self-reported need has been less examined in the literature. Seventy-two percent of individuals with moderate psychological distress felt like they needed to see a professional for their mental or emotional needs compared to 4% of individuals with serious psychological distress. Individuals with moderate psychological distress had 34% of all healthcare visits for mental or emotional needs during the study period, compared to 17% for those with serious psychological distress. Subjective unmet need for mental healthcare was reported by 77% of those who utilized mental healthcare during the study period. Studying subjective unmet need, in addition to moderate and serious distress, provides additional understanding of the need for mental healthcare and mental healthcare utilization.

The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups.

Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation. The opposite was true for urban ZCTAs, with high White ZCTAs being farther from most services. These patterns likely result from a combination of housing policies that restrict housing opportunities and federal health policies that are based on service provision rather than community need. The findings also illustrate the difficulty of using a single metric-distance-to investigate access to care on a national scale.

Recruitment of African American Churches to Participate in Cancer Early Detection Interventions: A Community Perspective.

This article describes the process used to engage and recruit African American churches to serve as participants in two multi-year behavioural cancer research interventions from a community perspective. Community-based organizations used purposive sampling in engaging and recruiting advisory panel members and churches to participate in these interventions. Trust, respect, open dialogue with participants, and commitment to address community health needs contributed to successful engagement and recruitment of African American churches to serve as participants in these cancer research projects. Our results may help others engage and recruit African American churches to participate in future interventions.