TY - JOUR
KW - Adult
KW - African Continental Ancestry Group
KW - Antidepressants
KW - Antidepressive Agents/therapeutic use
KW - Datasets as Topic
KW - Depression
KW - Depressive Disorder/drug therapy/ethnology
KW - Drug Prescriptions/statistics & numerical data
KW - Ethnic Groups/statistics & numerical data
KW - ethnicity
KW - European Continental Ancestry Group
KW - Female
KW - Humans
KW - London/ethnology
KW - Male
KW - Middle Aged
KW - Primary Health Care
KW - Regression Analysis
KW - Residence Characteristics
KW - Young Adult
AU - P. Schofield
AU - J. Das-Munshi
AU - R. Mathur
AU - P. Congdon
AU - S. Hull
A1 - 
AB - BACKGROUND: Studies have linked ethnic differences in depression rates with neighbourhood ethnic density although results have not been conclusive. We looked at this using a novel approach analysing whole population data covering just over one million GP patients in four London boroughs. METHOD: Using a dataset of GP records for all patients registered in Lambeth, Hackney, Tower Hamlets and Newham in 2013 we investigated new diagnoses of depression and antidepressant use for: Indian, Pakistani, Bangladeshi, black Caribbean and black African patients. Neighbourhood effects were assessed independently of GP practice using a cross-classified multilevel model. RESULTS: Black and minority ethnic groups are up to four times less likely to be newly diagnosed with depression or prescribed antidepressants compared to white British patients. We found an inverse relationship between neighbourhood ethnic density and new depression diagnosis for some groups, where an increase of 10% own-ethnic density was associated with a statistically significant (p < 0.05) reduced odds of depression for Pakistani [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.70-0.93], Indian (OR 0.88, CI 0.81-0.95), African (OR 0.88, CI 0.78-0.99) and Bangladeshi (OR 0.94, CI 0.90-0.99) patients. Black Caribbean patients, however, showed the opposite effect (OR 1.26, CI 1.09-1.46). The results for antidepressant use were very similar although the corresponding effect for black Caribbeans was no longer statistically significant (p = 0.07). CONCLUSION: New depression diagnosis and antidepressant use was shown to be less likely in areas of higher own-ethnic density for some, but not all, ethnic groups.
BT - Psychological medicine
C5 - Healthcare Disparities
CP - 6
CY - England
DO - 10.1017/S0033291715002913
IS - 6
JF - Psychological medicine
N2 - BACKGROUND: Studies have linked ethnic differences in depression rates with neighbourhood ethnic density although results have not been conclusive. We looked at this using a novel approach analysing whole population data covering just over one million GP patients in four London boroughs. METHOD: Using a dataset of GP records for all patients registered in Lambeth, Hackney, Tower Hamlets and Newham in 2013 we investigated new diagnoses of depression and antidepressant use for: Indian, Pakistani, Bangladeshi, black Caribbean and black African patients. Neighbourhood effects were assessed independently of GP practice using a cross-classified multilevel model. RESULTS: Black and minority ethnic groups are up to four times less likely to be newly diagnosed with depression or prescribed antidepressants compared to white British patients. We found an inverse relationship between neighbourhood ethnic density and new depression diagnosis for some groups, where an increase of 10% own-ethnic density was associated with a statistically significant (p < 0.05) reduced odds of depression for Pakistani [odds ratio (OR) 0.81, 95% confidence interval (CI) 0.70-0.93], Indian (OR 0.88, CI 0.81-0.95), African (OR 0.88, CI 0.78-0.99) and Bangladeshi (OR 0.94, CI 0.90-0.99) patients. Black Caribbean patients, however, showed the opposite effect (OR 1.26, CI 1.09-1.46). The results for antidepressant use were very similar although the corresponding effect for black Caribbeans was no longer statistically significant (p = 0.07). CONCLUSION: New depression diagnosis and antidepressant use was shown to be less likely in areas of higher own-ethnic density for some, but not all, ethnic groups.
PP - England
PY - 2016
SN - 1469-8978; 0033-2917
SP - 1321
EP - 1329
EP - 
T1 - Does depression diagnosis and antidepressant prescribing vary by location? Analysis of ethnic density associations using a large primary-care dataset
T2 - Psychological medicine
TI - Does depression diagnosis and antidepressant prescribing vary by location? Analysis of ethnic density associations using a large primary-care dataset
U1 - Healthcare Disparities
U2 - 26879871
U3 - 10.1017/S0033291715002913
VL - 46
VO - 1469-8978; 0033-2917
Y1 - 2016
ER -