Healthcare Disparities Within Major Depressive Disorder

Managed care experts discuss health disparities among various patient populations affected by MDD.

H. Eric Cannon, PharmD, FAMCP: When we start talking about disparities of health care, especially in MDD [major depressive disorder], there are a lot of things that play into that, including social economics. As we’ve worked with social determinants of health, we’ve identified that MDD is more prevalent in people who have a lower socioeconomic status. When you look at disparities in health care in the states where we operate—Utah, Idaho, Nevada—there are massive rural areas, so access to providers is difficult. To some degree, people are socially isolated, which makes identifying the issues and finding the people that more difficult. Understanding those disparities is critical in terms of how we put together effective programs that might address depression within the populations that we serve.

Michael Rothrock, MBA, MHA: As Dr Cannon mentioned, it’s all about access to care. That isn’t only regarding drugs. That’s also regarding treatment options, behavioral health physicians, etc. [Access can be affected] whether it’s a rural area of the country or a certain line of business, such as Medicaid, in which members may not be easily identifiable through an address. Their address may be outdated. How do we [deliver] care to patients who have a lower socioeconomic status and may be on the move or have an outdated address or no address? How do we give them not only the drug they need but the assistance they need? Let alone the opportunity to use telehealth, where they may not even have Wi-Fi, a laptop, or a smartphone that provides them the interface to have those touch points.

[Dr Cannon] is exactly right. Socioeconomic status is highly prevalent in MDD, with lower levels of patients getting the access they need in rural and Medicaid-type environments. We may not be able to [see] those patients as regularly as we should.

Transcript edited for clarity.

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