New CDC data shows the number of people diagnosed with depression in their lifetime varies across states and counties nationwide.
According to a new CDC Morbidity and Mortality Weekly Report (MMWR) published on June 16, nearly one in five adults in the United States say they've been diagnosed with depression at some point in their lives.
The report is an analysis of 2020 Behavioral Risk Factor Surveillance System (BRFSS) data retrieved from a cell phone and landline survey conducted nationwide. In the survey, respondents were asked, "Has a doctor, nurse, or other health professional ever told you that you had a depressive disorder, including depression, major depression, dysthymia, or minor depression?"
If respondents answered yes, they were included in the "lifetime diagnosis of depression" category.
After analysis, data from all 50 states, the District of Columbia (D.C.), and participating U.S. territories showed the prevalence of depression in 2020 varied greatly, with folks living in the Appalachian and southern Mississippi Valley regions experiencing the highest prevalence of depression.
Among all states, the percentage of people reporting they have been diagnosed with depression ranged from 12.7% in Hawaii to 27.5% in West Virginia. After West Virginia, the states with the highest rates of depression were Kentucky, Tennessee, Arkansas, Vermont, Alabama, Louisiana, Washington, Missouri, and Montana.
County estimates ranged as well, with an estimated 10.7% of people in Aleutians East Borough County, Alaska reporting they've been depressed, to 31.9% in Logan County, West Virginia. However, the CDC's analysis found the highest prevalence of depression in counties located in the Appalachian region, the southern Mississippi Valley region, Missouri, Oklahoma, and Washington.
Depression prevalence also varied by age. According to the report, 21.5% of Americans aged 18 to 24 years report having been depressed in their lifetime. In contrast, depression impacted 14.2% of adults 65 years or older. Moreover, 24% of women reported depression versus 13.3% of men.
The data also showed that 21.9% of non-Hispanic white adults reported being depressed at some point in their lifetime, while only 7.3% of non-Hispanic Asian adults said the same.
In addition, self-reported depression was higher among those with less than a high school education level and lowest in people with a college degree.
The CDC says that depression often accompanies other chronic health conditions such as diabetes and cardiovascular disease, and these conditions are more prevalent in states within the Appalachian region. Because of these similarities, the agency suggests the variations of depression rates found in the BRFSS data could reflect patterns of chronic diseases.
In addition, social determinants of health, such as economic status and access to health care, could also play a role in higher depression rates. For instance, the agency says that adults in the Appalachian region tend to experience more financial disparities and may have lower education levels, which can impact mental and physical health.
However, the report has some limitations. For example, data collection was limited to landline and cell phone surveys, which could have missed people without access to these communication methods. In addition, respondents self-reported whether they have experienced depression in their lifetime, which could result in reporting biases.
Still, the CDC asserts that these estimates could help decision-makers determine areas in need and implement practices such as those recommended by The Guide to Community Preventive Services Task Force (CPSTF) and the Substance Abuse and Mental Health Services Administration (SAMHSA).
- CDC: Morbidity and Mortality Weekly Report. National, State-Level, and County-Level Prevalence Estimates of Adults Aged ≥18 Years Self-Reporting a Lifetime Diagnosis of Depression — United States, 2020.