Health Disparities
Trends in adult anxiety/depression by disability status, race/ethnicity, sex, and nativity in the US, 2019—2023 David Adzrago* David Adzrago Faustine Williams
Introduction: Mental health disorder symptoms, including anxiety and depression, have increased significantly with more pronounced burdens among individuals with disability, especially those with multiple minority identities. Nevertheless, trends in these symptoms based on the intersection of disability status, race/ethnicity, sex, and nativity are not examined. We assessed trends in anxiety/depression by disability status, race/ethnicity, sex, and nativity.
Methods: This national serial cross-sectional study included adults aged > 18 years (N= 150,220) from 2019 to 2023. We used Joinpoint regression to estimate trends in age-adjusted anxiety/depression and average annual percent change (AAPC) by functional disability status, race/ethnicity, sex, and nativity.
Results: From 2019 to 2023, age-adjusted anxiety/depression increased significantly among individuals without disability who identified as Black female (AAPC= 14.9%; 95% CI= 0.5%-31.4%) and male (AAPC= 8.3%; 95% CI= 3.5%-13.2%) foreign-born. Among those without disability, it increased among Hispanic male US-born (AAPC= 5.1%; 95% CI= 2.3%-7.9%) and foreign-born (AAPC= 5.3%; 95% CI= 3.4%-7.2%); White male US-born (AAPC= 4.4%; 95% CI= 1.02%-7.9%) and foreign-born (AAPC= 7.8%; 95% CI= 1.6%-14.3%); and White female US-born (AAPC= 3.4%; 95% CI= 2.1%-4.8%). No significant change was found by the intersection of race/ethnicity, sex, and nativity among persons with disability. Similarly, among persons without disability, no significant change was found among Black female and male US-born; Hispanic female US-born and foreign-born; or White female foreign-born.
Conclusions: Anxiety/depression increased among Black female and male foreign-born, Hispanic male US-born or foreign-born, and White male US-born and foreign-born or White female foreign-born without disability. These rising trends highlight the need for interventions and studies to consider unique differences in disability status, race/ethnicity, sex, and nativity.