Racial and ethnic disparities in prevalence and correlates of depressive symptoms and suicidal ideation among adults in the United States, 2017–2020 pre-pandemic

Abstract

BackgroundThis study aims to estimate the pre-COVID-19 pandemic prevalence of mild, major depressive symptoms, and suicide ideation among U.S. adults and evaluate their correlates and racial/ethnic disparities. MethodsThis is a cross-sectional analysis of a nationally representative sample of adults ≥20 years from the National Health and Nutrition Examination Survey study 2017–2020 Pre-Pandemic. Overall and racial/ethnic-specific weighted prevalence and 95%CI of mild and major depressive symptoms and suicidal ideation assessed by the Patient Health Questionnaire-9 were calculated. Multivariable logistic regression modelings were used to examine overall and racial/ethnic-specific correlates. ResultsData on 7917 US adults (Weighted N = 210,200,829; 51.8 % females) were analyzed. The prevalence of mild, major depressive symptoms, and suicidal ideation was 8.5 %, 16.5 %, and 3.2 %, respectively. Overall, consistent correlates for all three conditions included smoking, short/long sleep duration, and obesity. Females, non-Hispanic Blacks, low family-poverty-income ratio, prolonged sitting time, and a history of cardiovascular disease were consistent correlates for mild and major depressive symptoms. Younger age, never married/living without a partner, physical inactivity, drinking alcohol, and a history of diabetes were related to major depressive symptoms. Never married/living without a partner and having a low family-poverty-income ratio correlate with suicide ideation. Having cancer diagnosis was only negatively associated with major depressive symptoms in non-Hispanic Blacks. Females, current smoking, short/long sleep duration, and having cardiovascular disease were correlated with suicidal ideation among Hispanics. ConclusionsThe prevalence of mild, major depressive symptoms, and suicidal ideation were high among U.S. adults. Unique correlates were identified among different racial and ethnic groups.