This application addresses a priority area for the National Institute on Aging (NIA): to reduce or eliminate health disparities between racial/ethnic minorities and nonminorities among older adults. The focus of this application is on mental health care, where racial/ethnic minorities access mental health services at only half the rate of non- Hispanic Whites, even after controlling for mental health status. While existing literature documents individual- level characteristics associated with mental health care, area-level (i.e., geographic) characteristics of such care are poorly understood. Thus, in this proposed study, we will assess the contribution of geographic factors to racial and ethnic disparities in mental health care among older adults. The overall goal of this research is to improve our understanding of the complex, yet unexplored, relations between race/ethnicity and geographic factors. This project will be accomplished by linking nationally representative survey data on mental health care to area-level data drawn from the U.S. Census and the Area Resource File. The proposed research has two specific aims:
Aim 1. Identify geographic 'hot spots' of racial/ethnic disparities in mental health care at the regional, state, and county levels. After completing Aim 1, we will be able to identify geographic areas (at the state or county level) that need new policies to reduce racial/ethnic disparities among older adults.
Aim 2. Assess geographic characteristics associated with racial/ethnic disparities in mental health care at the regional, state, and county levels. After completing Aim 2, we will be able to identify area-level risk factors that are potentially modifiable and should be considered in development of policies to reduce disparities. Beyond the scientific aims, this career development award will provide training in advanced methodology, medical geography, and epidemiology. The skills obtained during the training period will enable the candidate to perform cutting-edge research at the intersection of aging, mental health and geography to find ways to reduce or eliminate existing disparities among older adults. The interdisciplinary mentoring team I put together and my affiliations with the UA Center for Mental Health and Aging and the Deep South RCMAR provide the infrastructure to support these endeavors.

Public Health Relevance

This project is designed to improve our understanding of the complex, yet unexplored, relations between race/ethnicity and geographic factors with respect to older adult use of mental health care services. Knowledge produced by this project would be relevant to the current efforts of the National Institutes of Health (NIH) and the National Institue on Aging (NIA) to reduce and eventually eliminate racial and ethnic disparities between racial/ethnic minorities and non-minorities among older adults.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Scientist Development Award - Research & Training (K01)
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Study Section
Neuroscience of Aging Review Committee (NIA)
Program Officer
Bhattacharyya, Partha
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University of Alabama in Tuscaloosa
Schools of Arts and Sciences
United States
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Kim, Giyeon; Parmelee, Patricia; Bryant, Ami N et al. (2017) Geographic Region Matters in the Relation Between Perceived Racial Discrimination and Psychiatric Disorders Among Black Older Adults. Gerontologist 57:1142-1147
Jimenez, Daniel E; Schmidt, Andrew C; Kim, Giyeon et al. (2017) Impact of comorbid mental health needs on racial/ethnic disparities in general medical care utilization among older adults. Int J Geriatr Psychiatry 32:909-921
Kim, Giyeon; Dautovich, Natalie; Ford, Katy-Lauren et al. (2017) Geographic variation in mental health care disparities among racially/ethnically diverse adults with psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol 52:939-948
Jung, Seung Eun; Bishop, Alex J; Kim, Minjung et al. (2017) Nutritional Status of Rural Older Adults Is Linked to Physical and Emotional Health. J Acad Nutr Diet 117:851-858
Choi, Sunha; Kim, Giyeon; Lee, Sungkyu (2016) Effects of Nativity, Length of Residence, and County-Level Foreign-Born Density on Mental Health Among Older Adults in the U.S. Psychiatr Q 87:675-688
Teresi, Jeanne A; Ocepek-Welikson, Katja; Kleinman, Marjorie et al. (2016) Measurement Equivalence of the Patient Reported Outcomes Measurement Information System® (PROMIS®) Anxiety Short Forms in Ethnically Diverse Groups. Psychol Test Assess Model 58:183-219
Kim, Giyeon; DeCoster, Jamie; Bryant, Ami N et al. (2016) Measurement Equivalence of the K6 Scale: The Effects of Race/Ethnicity and Language. Assessment 23:758-768
Cook, Benjamin L; Kim, Giyeon; Morgan, Kari Lock et al. (2016) Measuring Geographic ""Hot Spots"" of Racial/Ethnic Disparities: An Application to Mental Health Care. J Health Care Poor Underserved 27:663-84
Jimenez, Daniel E; Cook, Benjamin Lê; Kim, Giyeon et al. (2015) Relationship Between General Illness and Mental Health Service Use and Expenditures Among Racially-Ethnically Diverse Adults ?65 Years. Psychiatr Serv 66:727-33
Kim, Giyeon; Shim, Ruth; Ford, Katy L et al. (2015) The relation between diabetes self-efficacy and psychological distress among older adults: do racial and ethnic differences exist? J Aging Health 27:320-33

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