National, State-Level, and County-Level Prevalence Estimates of Adults Aged ≥18 Years Self-Reporting a Lifetime Diagnosis of Depression - United States, 2020

Abstract

Depression is a major contributor to mortality, morbidity, disability, and economic costs in the United States (1). Examining the geographic distribution of depression at the state and county levels can help guide state- and local-level efforts to prevent, treat, and manage depression. CDC analyzed 2020 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate the national, state-level, and county-level prevalence of U.S. adults aged ≥18 years self-reporting a lifetime diagnosis of depression (referred to as depression). During 2020, the age-standardized prevalence of depression among adults was 18.5%. Among states, the age-standardized prevalence of depression ranged from 12.7% to 27.5% (median = 19.9%); most of the states with the highest prevalence were in the Appalachian* and southern Mississippi Valley^† regions. Among 3,143 counties, the model-based age-standardized prevalence of depression ranged from 10.7% to 31.9% (median = 21.8%); most of the counties with the highest prevalence were in the Appalachian region, the southern Mississippi Valley region, and Missouri, Oklahoma, and Washington. These data can help decision-makers prioritize health planning and interventions in areas with the largest gaps or inequities, which could include implementation of evidence-based interventions and practices such as those recommended by The Guide to Community Preventive Services Task Force (CPSTF) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

FIGURE

Model-based age-standardized county estimates of the percentage of adults aged ≥18 years self-reporting a lifetime diagnosis of depression — Behavioral Risk Factor Surveillance System, United States, 2020 * Age-standardized to the 2000 projected U.S. Census Bureau population aged ≥18 years using 13 age groups (18–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 50–59, 60–64, 65–69, 70–74, 75–79, and ≥80 years). https://www.cdc.gov/nchs/data/statnt/statnt20.pdf ^† By quartile. ^§ Respondents were classified as having depression if they responded “yes” to the question, “Has a doctor, nurse, or other health professional ever told you that you had a depressive disorder, including depression, major depression, dysthymia, or minor depression?”