Depression prevalence and associated factors among Alaska Native people: The Alaska education and research toward health (EARTH) study

Abstract

Background Few studies have investigated depression among Alaska Native people (ANs). Depression prevalence and associated factors among EARTH Alaska study participants is described. Methods The nine-item Patient Health Questionnaire (PHQ-9) assessed depression among 3,771 ANs. Participants with PHQ-9 scores ≥ 10 out of 27 were classified as positive for depression. Logistic regression analyses evaluated odds of scoring positive versus negative for depression by demographic, cultural, then health and lifestyle factors. Results Twenty percent of women and thirteen percent of men scored positive for depression. Univariate and multivariate models were fit separately for men and women. Among demographic factors, below median income was associated with positive depression scores for both genders. Among men, odds of depression were higher if unmarried and/or if highest educational level was less than high school. Women 34 to 59 years of age had increased odds of scoring positive. Little or no identification with tribal tradition was associated with increased odds of depression in women and decreased odds in men. For both genders, chronic physical conditions and poorer self-reported health were associated with positive depression scores then binge alcohol drinking and current tobacco use increased odds of depression among women only. Limitations Factors analyzed were self-reported without clinician follow-up in a non-random convenience sample of adults. Conclusions Depression is common among ANs with rates comparable to other indigenous cross-sectional investigations. Depression is associated with lower income and poorer physical health. Prevention and intervention efforts should consider gender as other associated factors varied between men and women.

Community-Specific Risk and Protective Factors for Risky Alcohol Consumption in American Indian Women of Reproductive Potential: Informing Interventions

“…Among study participants, 115 women (34.2%) were identified as depressed (36.7% nondrinkers, 31.4% current drinkers, NS). This rate is high; comparable studies using the same depression instrument found a national prevalence of 14% (Farr et al, 2010) and an Alaska Native sample prevalence of 20% (Dillard, et al, 2012). Depression is an independent risk factor for risky drinking and was found to be meaningful in this study.…”

“…However, risk factors for an AEP have not been well characterized for these communities. Similar to the general population, depression in AIAN communities may play a role (Beals et al, 2005;Dillard et al, 2012;Duran et al, 2004;Gone & Trimble, 2012); and among several AIAN population samples, problem drinking and depression have been linked (Dillard, et al, 2012;Kunitz, 2006;Montag et al, 2015;O'Connell et al, 2006). As in other communities, healthcare provider advice may be largely ignored (O'Connor & Whaley, 2006a) and women may not understand the extent to which they are at risk (Kaskutas, 2000), nor appreciate the true amount of alcohol they consume (Branco & Kaskutas, 2001).…”

Smoking-related knowledge, attitudes, and behaviours among Alaska Native people: a population-based study

“…These findings contradict other evidence that lower addiction levels are associated with lower risks of relapse after a quit attempt (19). Finding ways to address relapse triggers such as stress and depression, which are high in Alaska Native people (20, 21), could be helpful.…”

Preventing Alcohol‐Exposed Pregnancy Among an American Indian/Alaska Native Population: Effect of a Screening, Brief Intervention, and Referral to Treatment Intervention

“…This proportion is striking when compared to the prevalence of depression among U.S. women (14% in 2006) (Farr et al, 2010) and among 2,289 adult Alaska Native women (20%) (Dillard et al, 2012) measured using the same PHQ-9 instrument. Treatment for depression was recommended for a third of the women in our sample (36%).…”

“…Treatment for depression was recommended for a third of the women in our sample (36%). This proportion is striking when compared to the prevalence of depression among U.S. women (14% in 2006) (Farr et al, 2010) and among 2,289 adult Alaska Native women (20%) (Dillard et al, 2012) measured using the same PHQ-9 instrument. In women, as opposed to men, depression appears to predate alcohol problems (Helzer and Pryzbeck, 1988).…”