tions for every 100,000 persons resident in catchment areas with CMHC's under private auspices. The parallel rate for centers under públic auspices was 1,125. This differential held for all four color-sex groups and was especially marked for black males and black females. Table 3d shows a number of relatively high age-specific addition rates, particularly among the black population entering centers under public auspices. For example, black males and females aged 25 to 44 who entered centers under public auspices experienced respective addition rates of 2,339 and 2,197 per 100,000 population. And black females aged 20 to 24 who entered centers under public auspices experienced an addition rate of 2,405 per 100,000 population.

Variations by Degree of Urbanization of Catchment Area

That patient addition experience differed markedly according to the degree of urbanization of the catchment areas in which CMHC's are 10cated is evident from the data presented in Tables 4a through 4e and text Tables J and K. Whether the center is located in an inner city, urban, suburban, or rural catchment area is quite strikingly associated with variations in age, color and sex among additions to CMHC's. Table J shows that among the four color-sex groups under study, the relative percentages of black male and black female patient additions were highest at inner city centers and lowest at suburban and rural centers. Table 4c shows additional variations by color and sex within degree of urbanization categories for specific age groups. For example, black males between the ages of 5 and 14 were quite highly represented in inner city

centers.

Variations in patient addition experience by residence classification are dramatically pointed up in the rates shown in Tables K and 4d and illustrated in Figure 2. For all color-sex groups combined, there were 1,151 additions to inner city centers for every 100,000 persons resident in corresponding catchment areas. By contrast, the rate for additions to rural centers was 594. Additions to urban and suburban centers fell between these extremes with rates of 943 and 742 per 100,000 population, respectively. This pattern held for white males and white females. However, among black males and especially among black females, rates were higher for rural than for suburban additions. Table K also shows a higher addition rate for males than for females at inner city centers, although female rates exceeded those for males at urban, suburban, and rural centers.

The excess of rates among inner city blacks in specific age groups is shown in Table 4d. Thus, for example, black males between the ages of 25 and 44 had a rate of 2,489 additions per 100,000 population. Other items of note are also shown in Table 4d. One striking statistic is that white females aged 20 to 24 and 25 to 44 had markedly high addition rates

TABLE J.

PERCENT DISTRIBUTION BY COLOR AND SEX AND DEGREE OF URBANIZATION
OF CATCHMENT AREA, ADDITIONS TO 69 SELECTED COMMUNITY MENTAL
HEALTH CENTERS, UNITED STATES 1971*

Where percents do not add up to totals shown, discrepancies are due to rounding error

TABLE K.

ADDITION RATES PER 100,000 POPULATION FOR COLOR-SEX GROUPS BY
DEGREE OF URBANIZATION OF CATCHMENT AREA, ADDITIONS TO 69
SELECTED COMMUNITY MENTAL HEALTH CENTERS, UNITED STATES 1971

TABLE L.

PERCENT DISTRIBUTION BY COLOR AND SEX AND POVERTY STATUS OF
CATCHMENT AREA, ADDITIONS TO 69 SELECTED COMMUNITY MENTAL
HEALTH CENTERS, UNITED STATES 1971*

*

Where percents do not add up to totals shown, discrepancies are due to rounding error

TABLE M. ADDITION RATES PER 100,000 POPULATION FOR COLOR-SEX GROUPS BY POVERTY STATUS OF CATCHMENT AREA, ADDITIONS TO 69 SELECTED COMMUNITY MENTAL HEALTH CENTERS, UNITED STATES 1971

to suburban centers

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1,485 and 1,529 per 100,000 population, respectively. It may also be seen that rates for the elderly were especially low at rural centers, except for black females:

Variations by Poverty Status of Catchment Area

Like residence classification, whether or not the catchment area in which the CMBC is located is designated as a poverty area was associated with considerable variations in the age, color and sex of patients entering centers. Tables 5a through 5e and text Tables L and M contain data relevant to this nonpatient variable.

Tables L and 5c show that the color-sex distributions of patient additions did not vary greatly according to poverty status. However, there were substantial variations along this dimension in patient addition rates. Table M shows that the overall rate of additions was 797 per 100,000 population in poverty areas and 1,015 per 100,000 population in nonpoverty areas. The highest single rate of additions for individual color-sex groups was found among black females in nonpoverty areas 1,163 per 100,000 population.

Footnotes

1/ The present Note examines only white and black additions to CMHC's. Other color groups have been omitted from this analysis because the absolute number of their additions when broken down into subgroups of age, sex, and nonpatient variable categories was so small that the resultant rates were distorted. In the sub-set of 69 centers included here, there was a total of 4,429 patient additions belonging to color groups other than white and black. These patients accounted for 5.0 percent of all CMHC additions during the study period. That other nonwhites were not underrepresented among additions is evident from the fact that the catchment areas in which the centers under study are located contained 124,939 other nonwhites only 1.3 percent of the total population in these areas.

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2/ Patient additions may be defined as an unduplicated count of persons admitted to care in CMHC's during the period under study (1971). They are thus distinguished from admissions which ordinarily represent duplicated counts. The count of patient additions may include readmissions (persons previously treated in the center), so long as their earlier admissions occurred prior to the study period. However, patients admitted more than once during the study period were counted as single additions.

3/ The terms "community mental health center," "center,'

are used interchangeably in this Note.

4/ See Statistical Notes 13, 59, and 67.

" "center," and "CMHC"

5/ The 69 community mental health centers analyzed in this Note were selected according to: (1) availability of detailed demographic data for the catchment areas in which the centers are located, and (2) criteria for completeness of reporting on. Inventory forms. The Inventory of Community Mental Health Centers is an annual survey conducted in January of each year by the Biometry Branch of the NIMH in cooperation with State Mental Health Authorities. Comparisons of the age, color and sex of additions to all centers during 1971 and to the sub-set of 69 selected centers are shown in Tables 6 and 7.

6/ See, for example, Leo Srole, "Urbanization and Mental Health: Some Reformulations," American Scientist Vol. 60, September-October 1972, pp. 576-583.

7/ Population figures for the catchment areas were derived from the 1970 United States Census of Population.