Abstract
Evidence exists that depression interacts with physical illness to amplify the impact of chronic conditions like diabetes. The co-occurrence of these two conditions leads to worse health outcomes and higher healthcare costs. This study seeks to understand what demographic and socio-economic indicators can be used to predict co-occurrence at both the state and the individual level. Diabetes and depression are modeled as a bivariate normal distribution using data from the Behavioral Risk Factor Surveillance System 2016-2017 cohorts. The tetrachoric (latent) correlation between diabetes and depression is 17.2% and statistically significant, however the likelihood of any person being diagnosed with both conditions is small-as high as 4.3% (Arizona) and as low as 2.3% (Utah). We find that demographic characteristics (sex, age, and race) operate in opposite directions in predicting diabetes and depression diagnosis. Behavioral indicators (BMI≥30, smoking, and exercise); and life outcomes, (schooling attainment, marital and veteran status) work in the same direction to produce co-occurrence and as such are more powerful predictors of co-occurrence than demographic characteristics. It is important to have a rapid and efficient instrument to diagnoses co-occurrence. Simple questions about lifestyle choices, educational attainment and family life could help bridge the gap between primary care and psychological services with beneficial spillovers for patient-doctor communication.
Highlights
During 2013–2016, 8.1% of Americans aged 20 and over reported having a depressive symptom in a given 2-week period [1]
The goal of this study is to evaluate demographic and socio-economic indicators associated with both depression and diabetes at the macro and micro level by examining the likelihood of having: i. depression with diabetes ii. depression without diabetes iii. diabetes without depression
Older adults are more likely to be diagnosed with diabetes, but after the age of 65, they are less likely to be diagnosed with depression
Summary
During 2013–2016, 8.1% of Americans aged 20 and over reported having a depressive symptom in a given 2-week period [1]. Some people with MDD never get diagnosed, either because they do not seek care or because they are misdiagnosed. Depression is a common mental health disorder and there is growing evidence that is significantly under-diagnosed. Diabetes prevalence is anticipated to grow, with estimates suggesting that the proportion of the population affected by diabetes will at least double by 2050 [5]. There is little funding on diabetes prevention yet, 1 in 4 health care dollars is spent to combat diabetes and its consequences [6]. While we lack accurate information about total and per capita cost of depression, there is evidence that comparatively, little funding has been available historically to combat depression and mental health in general. States spend approximately 2% of their health dollars to the broad spectrum of mental health problems [7]
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