Stress and Depression Vary by Region, Says Study

Certain geographic areas of the U.S. have consistently higher or lower incidence of an indicator of stress and depression called Frequent Mental Distress (FMD), according to a new study which will appear in the June 2009 issue of the American Journal of Preventative Medicine.

The researchers defined FMD as having 14 or more days in the previous month when stress, depression and emotional problems were not good.

By combining data from annual large-scale surveys in 1993-2001 and 2003-2006 conducted by the Centers for Disease Control and Prevention, the researchers found that the adult prevalence of FMD was 9.4% overall and ranged from a low of 6.6% in Hawaii to a high of 14.4% in Kentucky. FMD prevalence varied both over time and by geographic area. Over time, the average prevalence of FMD increased by at least 1% in 27 states and by more than 4% in Mississippi, Oklahoma and West Virginia. The Appalachian and Mississippi Valley regions had high and increasing FMD prevalence, while the upper Midwest had low and decreasing FMD prevalence.

In the report, the authors speculate that differences in FMD prevalence could be due to differences in physical condition (such as disability or chronic illness), stressful life events (such as job loss) or social circumstances (such as low income).

"Because FMD often indicates potentially unmet health and social service needs, programs for public health, community mental health and social services whose jurisdictions include areas with high FMD levels should collaborate to identify and eliminate the specific preventable sources of distress," said lead investigator Dr. Matthew M. Zack. "With the growing scientific literature linking FMD to treatable mental illnesses and preventable mental health problems, the increased use of these surveillance data in community mental health decision making is especially warranted. The continued surveillance of mental distress may help these programs to identify unmet needs and disparities, to focus their policies and interventions and to evaluate their performance over time."