Mental Health
Prevalence and risk factors of anxiety/depression by county classification among US adults Maryam Elhabashy* Maryam Elhabashy David Adzrago Faustine Williams
Introduction. Current research pays limited attention to the prevalence of anxiety/depression and its risk factors in urban, suburban, and rural areas, especially since the COVID-19 pandemic. A deeper understanding of anxiety/depression by county classification can aid in effective resource allocation and access. This research aims to estimate the prevalence of anxiety/depression among US adults and assess the potential associated factors based on county classification. Methods. Data from the 2019 and 2022 National Health Interview Surveys (NHISs) were analyzed using weighted Chi-square test and logistic regression analyses. The sample of US adults (N=43,608) was classified as living in urban (n= 21,199), suburban (n=14,463), or rural counties (n=7,946). Results. Prevalences of anxiety/depression were slightly higher in rural (10.68%) compared to urban (9.14%) and suburban (10.22%) counties. Being female, obese, and a former/current cigarette smoker were significantly associated with anxiety/depression across all county classifications. Older age was negatively associated with anxiety/depression in urban counties. Being Black was associated with lower odds of anxiety/depression in urban and suburban counties only, and being an immigrant was associated with lower odds urban counties only. Unemployment and living below the poverty threshold were associated with higher odds of anxiety/depression across all county classifications, with stronger associations in rural and urban counties, respectively. Being uninsured was significantly associated with lower odds of anxiety/depression in rural counties, but higher odds in urban and suburban counties, though these associations were not significant. Conclusion. The findings reveal some variations in anxiety/depression prevalence, with higher prevalence in rural counties, and multiple risk factors differing by county classification. Efforts in anxiety/depression prevention and intervention should be tailored accordingly.