Racial disparity in psychotropic medications prescribed for youths with medicaid insurance in Maryland

Julie Magno Zito, Daniel J. Safer, Susan DosReis, Mark A. Riddle

Research output: Contribution to journalArticlepeer-review

115 Scopus citations


Design: A retrospective analysis was conducted using state Medicaid prescription drug reimbursement claims for youths aged 5 through 14 years according to the race of the recipients of psychotropic and medical drugs. Method: A person-based data set was created from Medicaid administrative data for fiscal year 1991 from the state of Maryland to yield the following: (1) estimates of prevalence of prescription recipients per 100 eligible enrollees; (2) relative prescription use ratios according to race (African- American versus Caucasian); and (3) the interrelation of race and geographic region on prescription prevalence. Results: Five major findings were observed: (1) African-American youths with Medicaid insurance aged 5 through 14 were less than half (39% to 52%) as likely to have been prescribed psychotropic medications as Caucasian youths with Medicaid insurance; (2) the relative difference for nonpsychotropic medication classes was much less pronounced: African-American youths were prescribed nonpsychotropic medications at a rate 60% to 87% of the Caucasian youths' rate; (3) the stimulants (essentially methylphenidate) had the most disparate African- American/Caucasian ratio (1:2.5); (4) the racial disparity for psychotropics was not altered by partial (noncontinuous enrollment) eligibility status; and (5) although geographic variation reduced the racial disparity, the substantial racial difference (1:2.0) remained. Conclusion: Compared with Caucasians, African-American youths aged 5 through 14 with Medicaid insurance coverage showed a distinctly lower rate of treatment with psychopharmacological agents.

Original languageEnglish (US)
Pages (from-to)179-184
Number of pages6
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number2
StatePublished - Feb 1998
Externally publishedYes


  • Child and adolescent pharmacotherapy
  • Medicaid
  • Pharmacoepidemiology
  • Psychotropic drug utilization
  • Race

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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