Social Vulnerability and Racial Disparities in Depression Screening of US Adolescents, 2016 to 2021.

Abstract

<b>Objectives.</b> To identify whether sociodemographic disparities exist by evaluating the association between rates of adolescent depression screening, social risk, and race. <b>Methods.</b> We used a US nationwide sample of Highmark Health privately insured adolescents between 2016 and 2021 to estimate the odds of well-visit depression screening receipt as a function of social factors (Social Vulnerability Index [SVI], predicted race). <b>Results.</b> Higher SVI was negatively associated with odds of screening and depended on predicted Black race (<i>P</i> for interaction < .01). Provider type was a strong predictor of screening, with pediatricians more likely to screen than other generalist specialties (odds ratio = 9.64; 95% confidence interval = 9.11, 10.2). Inclusion of variation at the practice location level attenuated the relationship with SVI and accounted for a large proportion of variability in screening (intraclass correlation coefficient = 0.76), although SVI remained significant ( <i>P</i> < .01). <b>Conclusions.</b> Adolescents are more likely to receive a depression screen if they reside in lower social-risk locations or, if likely to identify as Black, higher social-risk locations. Ultimately, screening has strong ties to where an adolescent lives and the type of provider they access. (<i>Am J Public Health</i>. 2025;115(9):1436-1444. https://doi.org/10.2105/AJPH.2025.308149).