Show simple item record

dc.contributor.authorPennap, D.
dc.contributor.authorBurcu, M.
dc.contributor.authorSafer, D.J.
dc.date.accessioned2019-07-15T16:12:09Z
dc.date.available2019-07-15T16:12:09Z
dc.date.issued2017
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85018888667&doi=10.18865%2fed.27.2.85&partnerID=40&md5=a6b582bbd206fb7f4ac5b73ce0c63b78
dc.identifier.urihttp://hdl.handle.net/10713/9913
dc.description.abstractObjective: This study aimed to evaluate a conceptual framework that assessed the effect of Hispanic residential isolation on Attention Deficit Hyperactivity Disorder (ADHD) health service utilization among 2.2 million publicly insured youth. Design: Cross-sectional. Setting: Medicaid administrative claims data for ambulatory care services from a US Pacific state linked with US census data. Participants: Youth, aged 2-17 years, continuously enrolled in 2009. Main Outcome Measures: The percent annual prevalence and odds of ADHD diagnosis and stimulant use according to two measures of racial/ethnic residential isolation: 1) the county-level Hispanic isolation index (HI) defined as the population density of Hispanic residents in relation to other racial/ethnic groups in a county (<.5; .5-.64; ?.65); and 2) the proportion of Hispanic residents in a ZIP code tabulation area (<25%; 25%-50%; >50%). Results: Among the 47,364 youth with a clinician-reported ADHD diagnosis, 60% received a stimulant treatment (N = 28,334). As the county level HI increased, Hispanic residents of ethnically isolated locales were significantly less likely to receive an ADHD diagnosis (adjusted odds ratio [AOR]=.92 [95% CI=.88-.96]) and stimulant use (AOR=.61 [95% CI=.59-.64]) compared with Hispanic youth in less isolated areas. At the ZIP code level, a similar pattern of reduced ADHD diagnosis (AOR=.81 [95% CI=.77-.86]) and reduced stimulant use (AOR=.65 [95% CI=.61-.69]) was observed as Hispanic residential isolation increased from the least isolated to the most isolated ZIP code areas. Conclusions: These findings highlight the opportunity for Big Data to advance mental health research on strategies to reduce racial/ethnic health disparities, particularly for poor and vulnerable youth. Further exploration of racial/ethnic residential isolation in other large data sources is needed to guide future policy development and to target culturally sensitive interventions. Copyright 2017, ISHIB. All rights reserved.en_US
dc.description.sponsorshipThis project was funded by the Food and Drug Administration, Centers of Excellence in Regulatory Science and Innovation, Minority Health Award (1U01FD004320).en_US
dc.description.urihttps://www.doi.org/10.18865/ed.27.2.85en_US
dc.language.isoen_USen_US
dc.publisherISHIBen_US
dc.relation.ispartofEthnicity and Disease
dc.subjectADHDen_US
dc.subjectHispanic youthen_US
dc.subjectMedicaiden_US
dc.subjectRacial/ethnic disparitiesen_US
dc.subjectResidential segregationen_US
dc.subjectStimulantsen_US
dc.titleHispanic residential isolation, ADHD diagnosis and stimulant treatment among Medicaid-insured youthen_US
dc.typeArticleen_US
dc.identifier.doi10.18865/ed.27.2.85


This item appears in the following Collection(s)

Show simple item record