Health> Vol.5 No.4, April 2013

Population-based study of health service deficits in US adults with depression: Does chronic disease co-morbidity and/or rural residency make a difference?

ABSTRACT

Introduction: Rural residents are at higher risk for a depressive disorder than their non-rural counterparts. Recent research has indicated that co-morbidities are also associated with depression. Health service deficits (HSDs) is an analytic concept that facilitates the examination of how a population uses health services relevant to their condition. A HSD is present when, over the preceding 12 months, an individual has had no health insurance, no specified health care provider, deferred medical care due to cost, or did not have a routine medical exam. Research has shown a high prevalence of HSDs in populations with individual chronic conditions. No study that we know of has examined if there is an association between the constellation of chronic conditions of depression and the co-morbidities of asthma, arthritis, and diabetes, with HSDs. Methods: 2011 Behavioral Risk Factor Surveillance Survey (BRFSS) data were analyzed to identify important dimensions of the epidemiology of depression by ascertaining whether there were differences in the prevalence of health service deficits in rural versus non-rural adults with depression and at least one additional chronic disease (arthritis, asthma, or diabetes). Data analyses entailed both bivariate and multivariate techniques. All analyses were performed on weighted data. Results: Logistic regression analysis performed using the presence of at least one HSD as the dependent variable yielded that for US adults with lifetime depression those who were African American, Hispanic and other/multiracial in comparison to Caucasian had higher odds of having at least one health service deficit. Low socioeconomic status (SES) and middle SES in comparison to high SES were also risk factors for US adults with lifetime depression having at least one HSD. Rural residency in comparison to non-rural residency also emerged as an independent risk factor (for US adults with lifetime depression having at least one HSD. Chronic disease, however, emerged as protective against US adults with lifetime depression having at least one health service deficit. Conclusions: This study demonstrated that race/ethnicity, SES, and rural residency are important predictors of health service deficits for individuals with a lifetime diagnosis of depression while having one or more chronic conditions for these same individuals was protective.

KEYWORDS


Cite this paper

Lemieux, A. , Saman, D. and Lutfiyya, M. (2013) Population-based study of health service deficits in US adults with depression: Does chronic disease co-morbidity and/or rural residency make a difference?. Health, 5, 774-782. doi: 10.4236/health.2013.54103.

References

[1] Murray, C.J., Vos, T., Lozano, R., Naghavi, A., Flaxman, A.D., Michaud, C., Ezzati, M., et al. (2013) Disability- adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: A systematic analysis for the global burden of disease study 2010. Lancet, 380, 2197- 2223. doi:10.1016/S0140-6736(12)61689-4
[2] Vos, T., Flaxman, A.D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., et al. (2013) Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990-2010: A systematic analysis for the global burden of disease study 2010. Lancet, 380, 2163-2196. doi:10.1016/S0140-6736(12)61729-2
[3] Lutfiyya, M.N., Bianco, J.A., Quinlan, S.K., Hall, C. and Waring, S.C. (2012) Mental health and mental health care in rural America: The hope of redesigned primary care. Disease-a-Month, 58, 629-638. doi:10.1016/j.disamonth.2012.08.004
[4] Bocker, E., Glasser, M., Nielsen, K. and Weidenbacher- Hoper, V. (2012) Rural older adults’ mental health: Status and challenges in care delivery. Rural Remote Health, 12, 2199.
[5] National Advisory Committee on Rural Health and Human Services (2008) The 2008 Report to the Secretary: Rural Health and Human Services Issues. National Advisory Committee on Rural Health and Human Services Washington, DC.
[6] Hartley, D., Loux, S., Gale, J., Lambert, D. and Yousefian, A. (2010) Characteristics of inpatient psychiatric units in small rural hospitals. Psychiatric Services, 61, 620-623. doi:10.1176/appi.ps.61.6.620
[7] Johnsen, M.C., Morrissey, J.P., Calloway, M.O., Fried, B.J., Blank, M. and Starrett, B.E. (1997) Rural mental health leaders’ perceptions of stigma and community issues. Journal of Rural Health, 13, 59-70. doi:10.1111/j.1748-0361.1997.tb00834.x
[8] Mathur, A. (2012) Health expenditures and personal bankruptcies. Health, 4, 1305-1316. doi:10.4236/health.2012.412192
[9] Ganzini, L., McFarland, B.H. and Cutler, D. (1990) Prevalence of mental disorders after catastrophic financial loss. The Journal of Nervous and Mental Disease, 178, 680-685. doi:10.1097/00005053-199011000-00002
[10] Adams, J., Sibbritt, D. and Lui, C.W. (2012) Health service use among persons with self-reported depression: A longitudinal analysis of 7164 women. Archives of Psychiatric Nursing, 26, 181-191. doi:10.1016/j.apnu.2011.10.002
[11] Rosemann, T., Laux, G. and Kuehlein, T. (2007) Osteoarthritis and functional disability: Results of a cross sectional study among primary care patients in Germany. BMC Musculoskeletal Disorders, 8, 79. doi:10.1186/1471-2474-8-79
[12] Walters, P., Schofield, P., Howard, L., Ashworth, M. and Tylee, A. (2011) The Relationship between asthma and depression in primary care patients: A historical cohort and nested case control study. PLoS One, 6, e20750. doi:10.1371/journal.pone.0020750
[13] Yavari, A. and Mashinchi, A. (2010) Diabetes and depression. Journal of Stress Physiology & Biochemistry, 6, 38-43.
[14] Lutfiyya, M.N., McCullough, J.E. and Lipsky, M.S. (2011) A population-based study of health service deficits for US adults with asthma. Journal of Asthma, 48, 931-944. doi:10.3109/02770903.2011.619023
[15] Mokdad, A.H., Stroup, D.F. and Giles, W.H. (2003) Public health surveillance for behavioral risk factors in a changing environment: Recommendations from the Behavioral Risk Factor Surveillance Team. Morbidity and Mortality Weekly Report, 52, RR09.
[16] Sanchez-Villegas, A., Schlatter, J., Ortuno, F., Lahortiga, F., Pla, J., Benito, S. and Martinez-Gonzalez, M.A. (2008) Validity of a self-reported diagnosis of depression among participants in a cohort study using the Structured Clinical Interview for DSM-IV (SCID-I). BMC Psychiatry, 17, 43. doi:10.1186/1471-244X-8-43
[17] Musgrove, P., Creese, A., Preker, A., Baeza, C., Anell, A. and Prentice, T. (2000) Health systems: Improving performance. WHO, Geneva.
[18] American Psychological Association, Task Force on Socioeconomic Status (2007) Report of the APA Task Force on Socioeconomic Status. American Psychological Association, Washington DC.
[19] Department of Defense (2000) Population representation in the military services: Fiscal year 1999. Office of the Assistant Secretary of Defense, Force Management and Personnel, Washington DC.
[20] Woolfolk, A. (2007) Educational psychology. 10th Edition, Allyn and Bacon, Boston.
[21] Lutfiyya, M.N., McCullough, J.E., Haller, I.V., Waring, S.C., Bianco, J.A. and Lipsky, M.S. (2012) Rurality as a root or fundamental social determinant of health. Disease-a-Month, 58, 620-628. doi:10.1016/j.disamonth.2012.08.005
[22] Bell, R.A., Franks, P., Duberstein, P.R., Epstein, R.M., Feldman, M.D., Fernandez y Garcia, E. and Kravitz, R.L. (2011) Suffering in silence: Reasons for not disclosing depression in primary care. Annals of Family Medicine, 9, 439-446. doi:10.1370/afm.1277

comments powered by Disqus

Copyright © 2014 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.