234821 Too Sad to Care: Relationship between depressive symptoms and delays in seeking medical care

Sunday, October 30, 2011

Mandy J. Hill, DrPH, MPH , Emergency Medicine, University of Texas Health, Medical School, Houston, TX
Michael W. Ross, PhD , WHO Center for Health Promotion Research and Development, The University of Texas - Houston School of Public Health, Houston, TX
Misha Granado, MPH, MS , Emergency Medicine, University of Texas-Health Science Center, Houston, TX
Objective: 1. To determine whether five symptoms of depression are correlated to delayed medical care among an at-risk, majority African American population in Houston, TX; 2. To assess gender differences regarding the influence of symptoms of depression on delayed medical care among an at-risk predominately African American, community population.

Methods: Questionnaires administered to 215 Houston residents. Participants were recruited from clinics and club/bars locally. A chi-square analysis revealed symptoms of depression were associated with delayed medical care. Logistic regression models calculated odds ratios and 95% confidence intervals for five symptoms of depression, individually and collectively, among the study population. Obvious differences were revealed by a gender stratification of the logistic regression. Findings were stratified by 1) individual or collective entry into the regression model, 2) gender, and 3) a total analysis of cases and places, cases only, and/or places only.

Results: Women who reported feelings of worthlessness (OR=1.59, 1.18-2.14), feelings of hopelessness (OR = 1.33, 1.02-1.74), a change in appetite (OR=1.33, 1.01-1.76) and a loss of pleasure and interest in enjoyable activities (OR = 1.41, 1.06-1.87) revealed a significantly stronger correlation to delayed medical care than men. Conversely, trouble sleeping was significantly correlated with delayed medical care among men (OR=1.70, 1.02-2.82).

Conclusion: This assessment of symptoms of depression in association with delayed medical care revealed a gender difference in the relationship between symptoms of depression and willingness to sustain physical health among an at-risk, African American population. Findings such as this have not been published to date. Future research should explore this correlation among similar populations for the purpose of generalizing the findings and designing interventions purposed to improve medical care access at the onset of depression symptoms.

Learning Areas:
Provision of health care to the public
Social and behavioral sciences

Learning Objectives:
To evaluate whether symptoms of depression are significantly correlated with delayed medical care among a vulnerable population identified in Houston, TX. To assess gender differences regarding the influence of depressive symptoms on timely access to care.

Keywords: Access to Health Care, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I analyzed all of the data presented and composed the manuscript related to this abstract.
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.