Dr David Herzog discusses how Ethnicity impacts Differential Access to Care for Eating Disorder Symptoms, and what the reality of the disease is vs. our public perceptions.

1. Ethnicity and Differential Access to Care for Eating Disorder
Symptoms
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A prevailing, yet unsubstantiated clinical stereotype has conventionally associated
eating disorders with privileged Caucasian girls of Anglo and European descent. The
National Eating Disorders Screening Program dataset offered an opportunity to
investigate (1) whether there are disparities in access to care between ethnic minority
women compared with non-ethnic minority women for eating disorder symptoms and
concerns and (2) whether patient-specific help-seeking factors or clinician factors have
an impact on ethnic disparities in access to care for eating disorder symptoms. Two
studies addressed these questions.
!
In the first study, 9,069 individuals from 409 college sites completed self-report
screening questionnaires which collected demographic data, including ethnicity, as well
as information on eating attitudes and behaviors.
!
Eighty-four percent of the subjects were female. The mean age of the sample was
23.57 years. The ethnicity prevalence rates were as follows: 81.6% Caucasians; 6.6%
African Americans; 3.4% Latinos; 3.0% Asians or Pacific Islanders; 0.9% Native
Americans or Alaskan Natives, and 2.5% as an ethnicity other than the choices listed.
Of the participants who completed questionnaires, 64% met with an on-site counselor to
review answers and receive a recommendation for further evaluation if needed. Among
those who met with a counselor, 76% fulfilled criteria for clinically significant symptoms
indicating the need for professional evaluation, including 1.2% (71 of 5,787) who met
criteria for urgent evaluation. Both Latino and Native American participants were
significantly less likely than Caucasians to receive a recommendation or referral for
further evaluation or care.
!
In the second study, the researchers conducted telephone interviews with 289 randomly
selected participants from the original NEDSP sample. The subjects were asked to what
extent they had volunteered information about their eating disorder symptoms to their
friends, family members, and professionals prior to the NEDSP. Among the participants
who acknowledged eating disorder-related concerns, no significant differences were
found between minority and non-minority subjects on the frequency with which they
voluntarily disclosed their symptoms. Ethnic minority subjects were less likely to seek
eating disorders treatment within 1.5-2 years following the NEDSP. Data from study #2
also revealed that mental health professionals were less likely to inquire of eating
disorders symptoms among the ethnic minority subjects than the non-minority subjects.
!
These findings suggest that clinician bias may be an important barrier to access to care
for eating disorder symptoms in ethnic minority populations.

2. LINKS
1) Link “National Eating Disorders Screening Program” to http://
mentalhealthscreening.org/events/national-eating-disorder-screening-program.aspx
2) Link “studies” (in first line of the summary) to http://www-ncbi-nlm-nih-gov.ezp-prod1.
hul.harvard.edu/pubmed/?term=Ethnicity+and+differential+access+to+care+for
+eating+disorder+symptoms.