Laura A Pratt1, Benjamin G Druss2, Ronald W Manderscheid3, Elizabeth Reisinger Walker4. 1. Centers for Disease Control and Prevention/National Center for Health Statistics, 3311 Toledo Road, Room 6333, Hyattsville, MD 20782, USA. Electronic address: lpratt@cdc.gov. 2. Department of Health Policy and Management, Center for Behavioral Health Policy Studies, Rollins School of Public Health, 1518 Clifton Road, NE, Room 638, Atlanta, GA 30322, USA. Electronic address: bdruss@emory.edu. 3. National Association of County Behavioral Health and Developmental Disability Directors, 25 Massachusetts Avenue, NW, Suite 500, Washington, DC 20001, USA. Electronic address: rmanderscheid@nacbhd.org. 4. Department of Health Policy and Management, Center for Behavioral Health Policy Studies, Rollins School of Public Health, 1518 Clifton Road, NE, Room 638, Atlanta, GA 30322, USA. Electronic address: ereisin@emory.edu.
Abstract
OBJECTIVES: We compared the mortality of persons with and without anxiety and depression in a nationally representative survey and examined the role of socioeconomic factors, chronic diseases and health behaviors in explaining excess mortality. METHODS: The 1999 National Health Interview Survey was linked with mortality data through 2011. We calculated the hazard ratio (HR) for mortality by presence or absence of anxiety/depression and evaluated potential mediators. We calculated the population attributable risk of mortality for anxiety/depression. RESULTS: Persons with anxiety/depression died 7.9 years earlier than other persons. At a population level, 3.5% of deaths were attributable to anxiety/depression. Adjusting for demographic factors, anxiety/depression was associated with an elevated risk of mortality [HR=1.61, 95% confidence interval (CI)=1.40, 1.84]. Chronic diseases and health behaviors explained much of the elevated risk. Adjusting for demographic factors, people with past-year contact with a mental health professional did not demonstrate excess mortality associated with anxiety/depression while those without contact did. CONCLUSIONS: Anxiety/depression presents a mortality burden at both individual and population levels. Our findings are consistent with targeting health behaviors and physical illnesses as strategies for reducing this excess mortality among people with anxiety/depression. Published by Elsevier Inc.
OBJECTIVES: We compared the mortality of persons with and without anxiety and depression in a nationally representative survey and examined the role of socioeconomic factors, chronic diseases and health behaviors in explaining excess mortality. METHODS: The 1999 National Health Interview Survey was linked with mortality data through 2011. We calculated the hazard ratio (HR) for mortality by presence or absence of anxiety/depression and evaluated potential mediators. We calculated the population attributable risk of mortality for anxiety/depression. RESULTS:Persons with anxiety/depression died 7.9 years earlier than other persons. At a population level, 3.5% of deaths were attributable to anxiety/depression. Adjusting for demographic factors, anxiety/depression was associated with an elevated risk of mortality [HR=1.61, 95% confidence interval (CI)=1.40, 1.84]. Chronic diseases and health behaviors explained much of the elevated risk. Adjusting for demographic factors, people with past-year contact with a mental health professional did not demonstrate excess mortality associated with anxiety/depression while those without contact did. CONCLUSIONS:Anxiety/depression presents a mortality burden at both individual and population levels. Our findings are consistent with targeting health behaviors and physical illnesses as strategies for reducing this excess mortality among people with anxiety/depression. Published by Elsevier Inc.
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