L R Snowden
Biographic Data
| ID | 7765 |
|---|---|
| NAME | L R Snowden |
| GIVEN NAMES | L R |
| FAMILY NAME | Snowden |
| SIGNATURE | SNOWDEN L R |
| AFFILIATIONS | University of California, Berkeley |
| ORCID | 0000-0003-1722-699X |
| VERIFIED | Yes |
| TOTAL WORKS | 78 |
| TOTAL CITATIONS | 582 |
| AUTHOR COUNT | 78 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1985 |
| LATEST PUBLICATION YEAR | 2023 |
| H-INDEX | 14 |
Racial Bias Correlates with States Having Fewer Health Professional Shortage Areas and Fewer Federally Qualified Community Health Center Sites
Federally Qualified Community Health Centers (FQHCs), serving Health Professional Shortage Areas (HPSAs), are fixtures of the healthcare safety net and are central to healthcare delivery for African Americans and other marginalized Americans. Anti-African American bias, tied to anti- “welfare” sentiment and to a belief in African Americans’ supposed safety net dependency, can suppress states’ willingness to identify HPSAs and to apply for and ope…
US states' racial bias correlates with less SNAP participation by “undeserving poor” adults and lower unemployment benefit maximums
The present study assessed whether Whites' anti‐African American bias correlates with states placing greater emphasis on work incentives in two government assistance programs. The study regressed the representation of “able‐bodied adults without dependents” in Supplemental Nutrition Assistance Programs (SNAP, also known as food stamps) and maximum unemployment benefits on White residents' implicit and explicit bias, while controlling for key econ…
(C) Medicaid Waivers for Children With Severe Emotional Disturbance
Several states have invested in 1915(c) Home and Community Based Service (HCBS) Medicaid policies to improve outcomes and reduce costs for children and youth with significant behavioral health needs, or Severe Emotional Disturbance (SED). However, little is known about these programs and the children they serve. Through a retrospective cross-sectional analysis, this study aimed to understand if the program was successfully reaching its target pop…
Subsidized Marketplace Purchases Reduced Racial Disparities in Private Coverage Under the Affordable Care Act
Racial and Ethnic Disparities in Health Status and Community Functioning Among Persons with Untreated Mental Illness
Using 6 years of data from the National Survey of Drug Use and Health, the present study investigated ethnic minority-White disparities in self-rated health and community functioning for persons with untreated mental illness. Comparing minority and White persons with untreated severe mental illness (SMI) and mild and moderate mental illness (MMMI), the study sought evidence of 'double jeopardy': that minority persons with mental illness suffer an…
Covid-19, Social Determinants Past, Present, and Future, and African Americans’ Health
Medicaid Waivers for Youth with Severe Emotional Disturbance
Medicaid Waiver Adoption for Youth With Complex Behavioral Health Care Needs
Many states have enacted Home- and Community-Based Services (HCBS) Medicaid waivers, which waive or expand Medicaid means tests to increase access to community-based public mental health services for youth with Serious Emotional Disturbance (SED). This study sought to understand key factors in State Mental Health Authorities and Medicaid Agency decision-making in adopting Medicaid waivers for youth with SED. Using purposive sampling to collect da…
African Americans and Caribbean Blacks
The purpose of this study was to advance a theoretical understanding of the effects of impoverished neighborhoods on mental health and to inform policy measures encouraging residents to leave such neighborhoods. To do this, we investigated whether individuals’ perceived neighborhood disadvantage served as a risk factor for clinical depression in a nationally representative sample of African Americans and Caribbean Blacks. We performed logistic re…
The “Undeserving Poor,” Racial Bias, and Medicaid Coverage of African Americans
The Affordable Care Act’s Medicaid expansion increased coverage especially for the “undeserving poor”—nondisabled, nonelderly adults, who disproportionately are African American. However, African Americans benefited comparably less than other groups from Medicaid expansion because they disproportionately reside in states that rejected Medicaid expansion. Psychological and other social science research establishes that disapproval of providing “we…
Mental health treatment and work among African American and Caribbean Black welfare recipients
Results indicated that mental health treatment was likely among Black TANF participants if depression was identified. TANF participants working less than full-time did not receive as much treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Medicaid waivers and public sector mental health service penetration rates for youth
To assist families of youth with serious emotional disturbance in financing youth's comprehensive care, some states have sought and received Medicaid waivers. Medicaid waivers waive or relax the Medicaid means test for eligibility to provide insurance coverage to nonpoor families for expensive, otherwise out-of-reach treatment for youth with Serious Emotional Disturbance (SED). Waivers promote treatment access for the most troubled youth, and the…
States higher in racial bias spend less on disabled medicaid enrollees
The role of Medicaid home and community-based service policies in organizing and financing care for children with severe emotional disturbance
Reducing Mental Health Emergency Services for Children Served Through California’s Full Service Partnerships
BACKGROUND: Children's Full Service Partnerships (FSP), created through California's Mental Health Services Act of 2004 are comprehensive treatment and support programs incorporating a wraparound model designed to serve undertreated families with children who have a serious emotional disturbance and are at risk for suicide, violence, residential instability, criminal justice involvement, or involuntary hospitalization. OBJECTIVE: This study inves…
Population targeting amid complex mental health programming
California's Mental Health Services Act (MHSA) created Full Service Partnership programs (FSPs) targeting socially and economically vulnerable children with mental illness who are underserved by counties' public mental health treatment system. To determine whether FSPs reach a distinctive group of children, this study compares indicators of FSP-targeted underservice for FSP entrants (n = 15,598) versus everyone treated in the counties' public men…
Patterns and priorities of service need identified through the Child and Adolescent Needs and Strengths (Cans) assessment
Blacks’ Death Rate Due to Circulatory Diseases Is Positively Related to Whites’ Explicit Racial Bias
Perceptions of racial bias have been linked to poorer circulatory health among Blacks compared with Whites. However, little is known about whether Whites' actual racial bias contributes to this racial disparity in health. We compiled racial-bias data from 1,391,632 Whites and examined whether racial bias in a given county predicted Black-White disparities in circulatory-disease risk (access to health care, diagnosis of a circulatory disease; Stud…
Racial bias is associated with ingroup death rate for Blacks and Whites
Poverty, safety net programs, and African Americans’ mental health
African Americans' poverty and deep-poverty rates are higher than those of Whites, and African Americans' poverty spells last longer. Furthermore, nonpoor African Americans are especially likely to slip into poverty, and over the course of a lifetime, very many African Americans will experience poverty. Accordingly, African Americans are disproportionately likely to be assisted by safety net programs providing income support and health and social…
Looking beneath and in-between the hidden surfaces
Poverty, social disadvantage, and the black/white placement gap
Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients
Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied…
Relationship between placement change during foster care and utilization of emergency mental health services
The Impact of Threshold Language Assistance Programming on the Accessibility of Mental Health Services for Persons With Limited English Proficiency in the Medi-Cal Setting
BACKGROUND: Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-En…
Use of inpatient mental health services by members of ethnic minority groups
Community mental health and ethnic minority populations
Racial/Ethnic Disparities in the Use of Mental Health Services in Poverty Areas
Objectives. This study examined racial/ethnic disparities in mental health service access and use at different poverty levels. Methods. We compared demographic and clinical characteristics and service use patterns of Whites, Blacks, Hispanics, and Asians living in low-poverty and high-poverty areas. Logistic regression models were used to assess service use patterns of minority racial/ethnic groups compared with Whites in different poverty areas.…
Blacks’ Death Rate Due to Circulatory Diseases Is Positively Related to Whites’ Explicit Racial Bias
Perceptions of racial bias have been linked to poorer circulatory health among Blacks compared with Whites. However, little is known about whether Whites' actual racial bias contributes to this racial disparity in health. We compiled racial-bias data from 1,391,632 Whites and examined whether racial bias in a given county predicted Black-White disparities in circulatory-disease risk (access to health care, diagnosis of a circulatory disease; Stud…
Ethnic populations in public mental health
BACKGROUND. Barriers to access and use of mental health care by Asians, Blacks, and Hispanic Americans have been a source of concern for many years. Limitations in our knowledge base persist regarding patterns of use in public sector programs of certain services. Using a sample of almost 27,000 persons, this study examined access and level of use by ethnic minority groups of emergency services, inpatient care, individual outpatient visit, and cas…
Bias in Mental Health Assessment and Intervention
A recent surgeon general’s report and various studies document racial and ethnic disparities in mental health care, including gaps in access, questionable diagnostic practices, and limited provision of optimum treatments. Bias is a little studied but viable explanation for these disparities. It is important to isolate bias from other barriers to high-quality mental health care and to understand bias at several levels (practitioner, practice netwo…
Racial bias is associated with ingroup death rate for Blacks and Whites
Emergency care avoidance
Symptoms of depression among blacks and whites
OBJECTIVES. We sought to examine relationships between sociodemographic indicators of risk and depression symptoms within the Black and White populations. METHODS. In a national probability sample, differences in sex, age, marital status, religion, social class, employment status, urbanicity, and region were evaluated against a Center for Epidemiological Studies Depression Scale score of 16 or greater. Risk factors were identified within the two …
A Scale to Assess African American Acculturation
This study examined an acculturation scale designed for use in the African American population. Consisting of 10 items presented in Likert-scale format, the scale asked about: race-related cultural and media preferences (music, radio, television); racial balance in contexts of social interaction (friends, church congregation, parties, neighborhoods); race-related attitudes (relying on relatives for help, desirability of interracial marriage); and…
States higher in racial bias spend less on disabled medicaid enrollees
Ethnic characteristics of mental disorders in five U.S. communities
The study examined the ethnic ratio of 16 DSM-III mental disorders among White, Black, Hispanic, and Asian Americans. A total of 18,126 residents from 5 sites and 2,939 residents from the Epidemiological Catchment Area's Los Angeles site were studied separately. Logistic regression analysis was performed. Results showed that Blacks were significantly less likely than Whites to have major depressive episode, major depression, dysthymia, obsessive-…
Poverty, social disadvantage, and the black/white placement gap
Psychoeducation to Address Stigma in Black Adults Referred for Mental Health Treatment
The peculiar successes of community psychology
The 20-year history of community psychology is considered with respect to activities on behalf of ethnic minority participation in psychotherapy, increasing cultural diversity, and to a considerably lesser extent, enhancing community systems. A discrepancy was found between community psychology in principle and community psychology in practice. For the future, community psychologists are advised to identify and seek to strengthen (a) indigenous r…
Ethnic differences in emergency psychiatric care and hospitalization in a program for the severely mentally ill
Racial, Cultural and Ethnic Disparities in Health and Mental Health
We need to further develop theoretically informed, empirically grounded bodies of knowledge on how community structures, norms, and processes operate in local communities and how they affect human well-being, especially in culturally diverse and ethnic minority communities. Scholars pursuing this agenda will benefit from "population thinking" which focuses attention on human aggregates and on equilibrium processes and social and community mechani…
The “Undeserving Poor,” Racial Bias, and Medicaid Coverage of African Americans
The Affordable Care Act’s Medicaid expansion increased coverage especially for the “undeserving poor”—nondisabled, nonelderly adults, who disproportionately are African American. However, African Americans benefited comparably less than other groups from Medicaid expansion because they disproportionately reside in states that rejected Medicaid expansion. Psychological and other social science research establishes that disapproval of providing “we…
Social Embeddedness and Psychological Well‐Being Among African Americans and Whites
Using data from the National Medical Expenditure Survey, a household survey of more than 18,000 respondents, this study examined racial and gender differences in social embeddedness, an indicator of community well‐being and social support. The study hypothesized that higher levels of social embeddedness would be found among African Americans than among Whites and that the association between social embeddedness and psychological well‐being would …
African Americans and Caribbean Blacks
The purpose of this study was to advance a theoretical understanding of the effects of impoverished neighborhoods on mental health and to inform policy measures encouraging residents to leave such neighborhoods. To do this, we investigated whether individuals’ perceived neighborhood disadvantage served as a risk factor for clinical depression in a nationally representative sample of African Americans and Caribbean Blacks. We performed logistic re…
Limited English proficient Asian Americans
Effects on Outpatient and Emergency Mental Health Care of Strict Medicaid Early Periodic Screening, Diagnosis, and Treatment Enforcement
We investigated enforcement of mental health benefits provided by California Medicaid’s Early Periodic Screening, Diagnosis, and Treatment (EPSDT) program. Enforcement, compelled by a consumer-driven lawsuit, resulted in an almost 4-fold funding increase over a 5-year period. We evaluated the impact of enforcement on outpatient treatment intensity (number of visits per child) and rates of emergency care treatment. Using fixed-effects regression, …
Patterns and priorities of service need identified through the Child and Adolescent Needs and Strengths (Cans) assessment
Racial/Ethnic Minority Children’s Use of Psychiatric Emergency Care in California’s Public Mental Health System
Objectives. We examined rates and intensity of crisis services use by race/ethnicity for 351174 children younger than 18 years who received specialty mental health care from California’s 57 county public mental health systems between July 1998 and June 2001. Methods. We used fixed-effects regression for a controlled assessment of racial/ethnic disparities in children’s use of hospital-based services for the most serious mental health crises (cris…
Strategies to improve minority access to public mental health services in California
The present study documented and evaluated steps taken by public mental health administrators to recruit members of underrepresented ethnic minority populations into treatment. By surveying county‐level ethnic program specialists in the decentralized California state system, the study identified strategies considered effective for reaching African American, Asian American, Latino, and Native Americans communities and overcoming barriers to treatm…
The long struggle
Agency characteristics and client support systems in social service delivery
The peculiar successes of community psychology
The 20-year history of community psychology is considered with respect to activities on behalf of ethnic minority participation in psychotherapy, increasing cultural diversity, and to a considerably lesser extent, enhancing community systems. A discrepancy was found between community psychology in principle and community psychology in practice. For the future, community psychologists are advised to identify and seek to strengthen (a) indigenous r…
Marital Satisfaction in Pregnancy
Marital satisfaction was studied in a sample of 106 women recruited at a military medical center and evaluated both early and late in pregnancy. An explanatory model was evaluated with regard to sociodemographic factors; coping resources (self-confidence previous children religious participation); and pregnancy decision-making (wantedness intendedness and spousal disagreement). 2 medical indicators hospitalization and general health were consider…
Ethnicity and continuation in treatment at a black community mental health center
Race as a factor in premature termination from treatment was investigated at a community mental health center staffed largely by Black counselors and serving a largely Black clientele. Uncontrolled analysis revealed that race was unrelated to whether clients completed treatment, as opposed to with drawing or dropping out, but was indeed related to the intensity of services (Blacks received more services). Introducing control for social and clinic…
Low-income blacks in community mental health
Fear of Personal Death and Positive Life Regard
The purpose of the present study was to investigate differences among college students from diverse ethnic and religious backgrounds in their fear of personal death and positive life regard. A total of 280 American subjects from six ethnic groups (Chinese, Mexican, Vietnamese, Black, White/Christian, White/Jewish), filled out the Fear of Personal Death Scale (Florian & Kravitz, 1983) and the Life Regard Index (Battista & Almond, 1973). Results in…
Use of inpatient mental health services by members of ethnic minority groups
Community mental health and ethnic minority populations
Ethnic populations in public mental health
BACKGROUND. Barriers to access and use of mental health care by Asians, Blacks, and Hispanic Americans have been a source of concern for many years. Limitations in our knowledge base persist regarding patterns of use in public sector programs of certain services. Using a sample of almost 27,000 persons, this study examined access and level of use by ethnic minority groups of emergency services, inpatient care, individual outpatient visit, and cas…
Ethnic differences in emergency psychiatric care and hospitalization in a program for the severely mentally ill
Emerging trends in organizing and financing human services
Symptoms of depression among blacks and whites
OBJECTIVES. We sought to examine relationships between sociodemographic indicators of risk and depression symptoms within the Black and White populations. METHODS. In a national probability sample, differences in sex, age, marital status, religion, social class, employment status, urbanicity, and region were evaluated against a Center for Epidemiological Studies Depression Scale score of 16 or greater. Risk factors were identified within the two …
Problems in Assessing Prevalence and Membership Characteristics of Self-Help Group Participants
Emergency care avoidance
The California adult performance outcome survey
Managed care in the public mental health system
The Effects of Therapist-Client Ethnic Match in the Assessment of Mental Health Functioning
The present study empirically examined the relationship between therapist-client ethnic match and the therapists' evaluations of overall client functioning based on the Global Assessment Scale. The sample consisted of thousands of African American, Asian American, Mexican American, and White American outpatient clients in the Los Angeles County mental health system. Findings indicated that ethnically matched therapists judged clients to have high…
Expressions of Anxiety in African Americans
Ethnic differences in mental health services use among the severely mentally ill
Ethnic differences in mental health services use among the severely mentally ill
Ethnic differences were examined in patterns of service utilization among 4,000 of the most seriously impaired clients in two county mental health services systems having differing histories of specialized minority-oriented programming. Latino and Asian-American clients in one county and, to a lesser extent African-American clients, made more use than Whites of outpatient and supportive/community services. All three minority groups made less use …
Acculturation, alcohol consumption, and Aids-related risky sexual behavior among African American men
The present study examined the relationship between acculturation, alcohol consumption, and AIDS-related risky sexual behavior in a national probability sample of 338 African American men. Results indicated that acculturation did serve as an indicator of AIDS-related risk: Men at low and moderate levels of acculturation were more likely to engage in risky sexual behavior than were their more highly acculturated counterparts. In addition, interact…
Differences between Asian and White Americans' help seeking and utilization patterns in the Los Angeles area
This study examines help seeking and utilization patterns of 161 Asian or Pacific Islander Americans and 1332 White Americans randomly selected in the Los Angeles area, based on the first wave of the Epidemiological Catchment Area (ECA) study. Logistic regression analyses are performed to detect ethnic differences in disclosing mental health problems and utilizing mental health services. Results show that Asian Americans are more reticent than Wh…
Racial differences in informal help seeking for mental health problems
The present study examined the hypothesis of greater African American informal help seeking for mental health problems in a comparison of African Americans and Whites. Controlling for sociodemographic factors, symptom distress, and diagnosis, African Americans were less likely than Whites to report turning for assistance to a friend, family member, or religious figure. Nor did African Americans use informal help as a substitute for professional c…
Ethnic characteristics of mental disorders in five U.S. communities
The study examined the ethnic ratio of 16 DSM-III mental disorders among White, Black, Hispanic, and Asian Americans. A total of 18,126 residents from 5 sites and 2,939 residents from the Epidemiological Catchment Area's Los Angeles site were studied separately. Logistic regression analysis was performed. Results showed that Blacks were significantly less likely than Whites to have major depressive episode, major depression, dysthymia, obsessive-…
Medicine (61 works) · Psychology (57 works) · Psychiatry (53 works) · Mental health (47 works) · Sociology (35 works) · Ethnic group (34 works) · Political science (34 works) · Mental Health Treatment and Access (33 works) · Nursing (26 works) · Public health (25 works)