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BACKGROUND: Although links between depression, anxiety and chronic disease are well-documented, state public health programs have not commonly integrated these issues into chronic disease-related interventions. We analyzed Maine Behavioral Risk Factor Surveillance System (BRFSS) data to increase Maine chronic disease program staff’s awareness of the importance of depression/anxiety.
METHODS: We examined interrelationships between chronic conditions (hypertension, high cholesterol, prediabetes, diabetes, asthma, cancer, cardiovascular disease) and risk factors (obesity, physical activity, fruit/vegetable intake, smoking, heavy drinking) and lifetime depression/anxiety (current moderate/severe symptoms as measured by PHQ-8 or lifetime diagnosed depression or anxiety) among Maine adults using 2009-2010 BRFSS data. We used SAS 9.2 procedures appropriate for the design; all data were weighted.
RESULTS: One in ten Maine adults had current depression; three in ten had lifetime depression/anxiety. With few exceptions (drinking, fruit/vegetable intake, cardiovascular disease, cancer), the prevalence of lifetime depression/anxiety was significantly higher among Maine adults with chronic conditions and risk factors compared to those without (insufficient physical activity: 34.6% vs. 27.6%, smoking: 46.7% vs. 25.2%, obesity: 40.2% vs. 24.6%, hypertension: 35.5% vs. 28.4%, high cholesterol: 34.1% vs. 27.1%, prediabetes: 48.1% vs. 27.0%, diabetes: 38.2% vs. 28.4%, asthma: 46.5% vs. 27.3%).
CONCLUSIONS: Given the substantial prevalence of depression/anxiety among Maine adults with chronic conditions and risk factors and the impact depression/anxiety can have on making lifestyle changes and controlling chronic conditions, Maine public health programs must incorporate mental health issues into chronic disease-related interventions to be successful. We are using multiple dissemination approaches to reach Maine public health professionals.