Patterns and predictors of anxiety medication use among United States adults: a national analysis with a focus on racial disparities in the Asian population

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Background Anxiety disorders are highly prevalent in the United States, but treatment utilization varies substantially across racial and ethnic groups. Asian adults are known to underutilize mental health services despite experiencing psychological distress, but evidence on medication-specific patterns remains limited. The goal of this study is to quantify differences in anxiety medication use, especially among Asian Americans, and to evaluate the factors associated with their lower use of medication for anxiety disorders. Methods We analyzed data from the 2023 National Health Interview Survey (NHIS; N = 29,466) using survey-weighted logistic regression models to estimate population-level associations. Adults who reported having ever been diagnosed with an anxiety disorder ( n = 5,431) made up the initial eligible group. After excluding respondents without complete data, 3,118 adults remained in the full analytic sample used for survey-weighted logistic regression models 1 and 2. A separate sub-sample of Non-Hispanic Asian adults with complete data ( n = 87) was analyzed independently. Results Medication use varied significantly by race. Non-Hispanic White adults reported the highest use (64.3%), while Asian adults reported the lowest (45.1%), despite having a history of anxiety disorder. In fully adjusted models, Asian adults had significantly lower odds of medication use compared with White adults (OR = 0.55, 95% CI [0.32, 0.93], p < 0.05). Race × age interactions were not statistically significant, but predicted probability plots showed a declining trend of medication use with age among Asian adults, contrasting with increasing use among White adults. Subsample analyses of Asian adults showed few significant predictors due to the small sample size, although higher income was linked to increased medication use. Conclusion Asian adults in the United States have significantly lower odds of anxiety medication use. Findings highlight ongoing disparities that may stem from cultural stigma, structural barriers, and unequal access to mental health care. Targeted efforts to provide culturally responsive anxiety treatments for Asian communities are necessary.

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