Ethnic/Racial Differences in Depression among U.S. Primary Care Patients: Cultural Considerations in Screening and Detection

Abstract

Screening and detection are essential building blocks for prevention and early treatment of depression. Despite their critical role in early identification and treatment, primary care physicians fail to recognize depression in about half of their patients. Because depressed patients of color tend to seek treatment in primary care settings, the need for greater attention to, and understanding of, ethnic and racial disparities in general practitioners' ability to detect cases of depression is compelling. The purpose of this article is to discuss the screening and detection of depression among patients from different U.S. ethnic/racial and cultural groups. Specifically, the objective is to identify within- and between-culture factors that may impact on symptom presentation for African-Americans, Asians, Hispanic/Latinos, and Native Americans, and subsequently on the diagnosis of depression in primary care settings. Implications for the role of allied health professionals, especially social workers, in enhancing the cultural competence of primary care doctors are discussed.

Keywords:

• cultural bias
• depression
• ethnicity/race
• primary care
• screening and detection

Acknowledgments

This project was supported by a predoctoral fellowship from the Hogg Foundation for Mental Health to the first author. We express our appreciation to Dr. King Davis, whose tenure as the executive director of the Hogg Foundation made this project possible.