189392 Do Health Preferences Vary Across Racial and Ethnic Minority Populations with Mental Health Disorders? An Exploratory Study

Monday, October 27, 2008: 1:42 PM

Norah Mulvaney-Day, PhD , Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA
Marcela Horvitz-Lennon, MD MPH , Psychiatry, University of Pittsburgh Medical School, Pittsburgh, PA
Chih-nan Chen, PhD , Center for Multicultural Mental Health Research, Cambridge Health Alliance, Somerville, MA
Mara Laderman , Cambridge Health Alliance, Center for Multicultural Mental Health Research, Somerville, MA
Margarita Alegria, PhD , Psychiatry--Center for Multicultural MH Research, Harvard Medical School, Somerville, MA
Few health preference studies have been conducted with racial and ethnic minorities or with individuals who have mental disorders. The objective of this study was to analyze variation in willingness to pay (WTP) and time trade-off (TTO) across Latinos, Asians and non-Latino whites using the combined NLAAS/NCS-R epidemiologic datasets. A secondary objective was to analyze whether a lifetime mental disorder was associated with health preferences. Bivariate analyses were conducted to explore the variability of the WTP and TTO measures across poor and good/fair health status categories by race and ethnicity. Stratified ordered logit models with WTP and TTO as dependent variables were used to test differences by race and ethnicity, with lifetime anxiety, affective and substance disorder as covariates. Health preferences for Latinos and Asians differed from non-Latino whites. Asians in good health were willing to pay more money and trade more time for health than non-Latino whites. Latinos were willing to pay more money for improvement in their health than non-Latino whites, regardless of health status; however, Latinos in poor health were less willing to trade time than non-Latino whites. Having a lifetime diagnosis of anxiety disorder was associated with WTP for those in better health, whereas both lifetime affective and anxiety disorders were positively associated with TTO regardless of health status. Results suggest that the commodity used to value health may be a critical factor for preferences across race and ethnicity. History of mental health disorder may influence the valuation process, particularly when using TTO.

Learning Objectives:
Recognize the differences between WTP and TTO as measures of health preferences, and how they vary across race and ethnicity. Assess the relationship between lifetime mental health disorders and measures of preference using WTP and TTO. Identify the clinical and policy implications of differential health valuation for Latinos depending upon the commodity used to value health.

Keywords: Mental Disorders, Minorities

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I led the analysis for this paper and am expert in mental health among minorities
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.