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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Public Mental Health
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1287791

Macroeconomic antecedents of racial disparities in psychiatric-related Emergency Department visits

Provisionally accepted
Parvati Singh Parvati Singh *
  • The Ohio State University, Columbus, United States

The final, formatted version of the article will be published soon.

    Objective: To test whether monthly declines in aggregate employment precede a rise in African American psychiatric-related ED visits (PREDVs) relative to white visits among low-income, working-age populations. Design: This study used repeated cross-sectional time series data for 6.7 million PREDVs among African Americans and white individuals from the State Emergency Department Database in 48 Metropolitan Statistical Areas (MSAs) across 4 states (Arizona, California, New York, New Jersey) from 2006 to 2011. MSA-level monthly employment data were obtained from the US Bureau of Labor Statistics. The outcome was specified as the race of a PREDV (African American = 1, white = 0). The exposure was operationalized as monthly percent change in MSA-level aggregate employment lagged by 0 to 3 months. Analysis included logistic regressions with county, month and year fixed effects, and clustered standard errors to examine the relation between odds of an African American PREDV (relative to white) following 0 to 3 months lag of MSA-level aggregate employment change. Findings: Logistic regression results indicate that the odds of PREDVs for publicly insured, working-age African Americans (relative to white individuals) increase three months after ambient employment decline (OR: 0.994, 95% CI: [0.990 0.998]). Conclusion: Economic downturns may marginally increase psychiatric help-seeking in EDs among publicly insured (low-income), working-age African Americans relative to white individuals. Findings from this study may contribute to the theoretical understanding of dynamic drivers of racial disparities in psychiatric ED visits.

    Keywords: Economic downturns, psychiatric-related ED visits (PREDVs), Help-seeking, emergency department, Racial Disparities

    Received: 02 Sep 2023; Accepted: 07 May 2024.

    Copyright: © 2024 Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Parvati Singh, The Ohio State University, Columbus, United States

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