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To examine whether racial and ethnic differences in the distribution of individuals across types of health plans explain differences in satisfaction and trust with their physicians.Data were derived from the 1998–1999 Community Tracking Household and Followback Studies and consisted of a nationwide sample of adults (18 years and older).The data were collected by telephone survey. Surveys were administered in English and Spanish. The response rate for the Household Survey was 63 percent, and the match rate for the Followback Survey was 59 percent.Multivariate analyses used regression methods to detect independent effects of respondent race and ethnicity on satisfaction and trust with physician, while controlling for enrollment in different types of health plans.Racial and ethnic minorities are more likely than whites to have lower levels of trust and satisfaction with their physician. The most prominent differences occurred within the Latino and Native American/Asian American/Pacific Islander/Other (“Other”) populations. Plan type does not mitigate the relationship between race/ethnicity and trust and satisfaction for the overall adult population.Disparate levels of trust and satisfaction exist within ethnic and minority populations, even when controlling for the distribution of individuals across types of health plans. The results demonstrate a need to better understand the health care-related factors that drive disparate trust and satisfaction. [ABSTRACT FROM AUTHOR]

Background: Adults with co-occurring opioid use and mental health disorder (COD) recently released from incarceration have many social and health needs that place them at the most significant risk for overdose and poor reentry outcomes. Little is known about racial/ethnic differences in this population., Methods: To examine racial/ethnic differences in social and health needs, data were analyzed for 293 adults with COD within two weeks of release, a high-risk period for overdose, from six Massachusetts jails., Results: Overall, participants (62.6% non-Hispanic White, 23.1% Hispanic, 14.3% non-Hispanic Black, and 73.5% male) reported multiple health and social needs across groups. Chi-square tests and Kruskal-Wallis one-way ANOVAs were used to compare social and health needs among racial/ethnic groups. Non-Hispanic Black participants reported more problems with crack/cocaine, whereas Non-Hispanic White and Hispanic participants reported more problems with opioids (p < .001). Despite similar lifetime rates of illicit substance use, non-Hispanic Black and Hispanic participants received less treatment (p < .001). Non-Hispanic White participants reported more opioid and alcohol use (p < .006), trauma symptoms (p = .020), utilization of behavioral health treatment (p = .008), and more medical needs than Hispanic and/or non-Hispanic Black participants (p = .001). Non-Hispanic Black and Hispanic participants reported more needs related to social determinants of health (p = .008)., Conclusions: While re-entry is a vulnerable period for all adults with COD, this paper identifies specific needs by race/ethnicity and proposes strategies to advance equity and improve care for all formerly incarcerated adults with a COD., Competing Interests: Declaration of Competing Interest None. The authors report no financial relationships with relevant commercial interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Mental Health Courts (MHCs), an alternative to incarceration, aim to address behavioral health, social needs, and criminal recidivism and serve many adults with co-occurring mental health and substance use disorder (COD). Despite the growth in MHCs, little research has examined ethnic/racial differences in behavioral health and service needs of individuals with COD. This study used data from behavioral health and social assessments administered to 146 adults with COD entering a Massachusetts MHC. Multivariate linear and logistic regression controlling for key demographics tested differences between racial/ethnic groups on current and lifetime substance use, mental health symptoms, and history of criminal legal system involvement. Hispanic participants were more likely than non-Hispanic White participants to report current and lifetime serious mental illness and lifetime Emergency Department (ED) mental health treatment. Non-Hispanic White participants were more likely to report current and lifetime use of illicit substances, more recent outpatient and overall lifetime treatment attempts for substance use, and higher number of lifetime arrests compared to non-Hispanic Black participants. Lastly, non-Hispanic White participants also reported more recent outpatient and overall lifetime treatment attempts for substance use compared to Hispanic participants. Racial/ethnic differences in behavioral health and social needs of MHC enrollees with COD exist and should be considered in the planning and delivery of psychological and social services. Understanding the diverse population of new MHC enrollees is an important first step in identifying and addressing racial and ethnic disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Background: Screening rates in primary care for single behavioral health risk factors are widely documented. However, such risk factors cluster in individuals and populations. This article examines the number and types of behavioral risk factors that U.S. adults reported, and reported having been screened for in their last routine medical checkup., Methods: The sample consisted of 16,818 adults from the 1998 National Health Interview Survey who reported having a routine checkup in the past year. Respondents completed questions regarding four behavioral risk factors (physical inactivity, overweight, cigarette smoking, risky drinking), and provider screening for behaviors related to these risk factors., Results: Half of the sample (52.0%) reported having two or more of the four risk factors, and more than half (59.4%) were screened for two or more risk behaviors during their last routine checkup, although 28.6% reported being screened for none of them. Respondents reporting at least one risk factor were screened for an average of 57.7% of their own risk factors. Women, adults with lower levels of income and education, and those aged 65 and older, reported being screened for fewer of their risk factors., Conclusions: While guidelines for risk factor screening and intervention typically focus on single behavioral risk factors, most primary care patients present with, and are screened for, more than one. Behavioral risk factor screening tools and interventions must be expanded to cover multiple risks. Additionally, efforts are needed to reduce the substantial missed opportunities for screening, and to eliminate demographic disparities in screening practices and accuracy.