A population-based cross-sectional study of health service deficits among U.S. adults with depressive symptoms

Abstract

BackgroundDepression is a psychiatric condition that affects approximately one in five U.S. adults in their lifetime. No study that we know of has examined depressive symptoms and health service deficits in rural compared with non-rural populations. Four factors constitute the variable health service deficits: did not have health insurance, did not have a healthcare provider, deferred medical care because of cost and did not have a routine medical exam, all within the last 12 months. The aim of this study was to ascertain the prevalence of health service deficits in rural versus non-rural adults with depressive symptoms. Examining depressive symptoms by health service deficits is important because it allows us to approximate those with the condition who might not be receiving care for it. By analyzing national, population-based data, this study sought to fill in some important epidemiological gaps regarding depressive symptoms and health service deficits.MethodsFor this analysis the population of interest was U.S. adults identified as currently having depressive symptoms using the PHQ-8 criteria. Behavior Risk Factor Surveillance Survey 2006 data were used in this analysis. Health service deficits was the primary dependent variable. Multivariate logistic regression analysis was performed to examine health service deficits experienced by adults with depression controlling for socioeconomic status, race and ethnicity and geographic locale (rural or non-rural).ResultsLogistic regression analysis yielded that U.S. adults currently having depressive symptoms who were of low socioeconomic status, Hispanic ethnicity, or living in a rural locale were more likely to have at least one health service deficit.ConclusionAnalyzing data collected by a large surveillance system such as BRFSS, allows for an analysis incorporating an array of covariates not available from clinically-based data such as electronic health records. By identifying clinically depressed U.S. adults who also have at least one health service deficit, we were able to ascertain those most likely not receiving care for this debilitating condition. We believe community pharmacists are well suited to assist in connecting depressed, vulnerable populations with appropriate and needed care. This care would be best provided by an inter-professional team led by a primary care provider.

Cancer survivors’ access to care and quality of life: Do sexual minorities fare worse than heterosexuals?

“…20 Survivors were defined as having poor access to care if they were lacking any 1 of the 4 access to care conditions. Consistent with prior research, we derived a dichotomous summary measure of poor access to care or access deficit.…”

“…Consistent with prior research, we derived a dichotomous summary measure of poor access to care or access deficit. 20 Survivors were defined as having poor access to care if they were lacking any 1 of the 4 access to care conditions. From the available health-related QOL measures in the BRFSS, we selected 3 measures to capture different dimensions of cancer survivors' QOL.…”

“…8 For example, insured survivors may find copayments to be an obstacle, leading to a delay in needed care. [14][15][16][18][19][20] Although sexual minorities in the general population are known to have poorer access to care compared with their heterosexual counterparts, 7,21 to the best of our knowledge sexual minority cancer survivors' access to care is unknown and its association with QOL has not been examined to date. [14][15][16][18][19][20] Although sexual minorities in the general population are known to have poorer access to care compared with their heterosexual counterparts, 7,21 to the best of our knowledge sexual minority cancer survivors' access to care is unknown and its association with QOL has not been examined to date.…”

“…8,16,17 Poor access to care has been linked to adverse outcomes among cancer survivors, namely disease recurrence, poorer disease-free and overall survival, and poorer quality of life (QOL). [14][15][16][18][19][20] Although sexual minorities in the general population are known to have poorer access to care compared with their heterosexual counterparts, 7,21 to the best of our knowledge sexual minority cancer survivors' access to care is unknown and its association with QOL has not been examined to date. The current study examined the link be tween access to care and QOL using 4 years of the Behavioral Risk Factor Surveillance System (BRFSS) data…”

Reliability of In Vitro and In Vivo Methods for Predicting the Effect of P-Glycoprotein on the Delivery of Antidepressants to the Brain

“…Currently, diagnoses of depression are increasing and it is proposed that depression will be counted among the top 3 most important world health problems by 2020 [9]. Depression affects patients’ quality of life and work, and leads to higher rates of many other chronic diseases.…”