Table 4. Prevalence ratios of mental health symptoms associated with lifetime stroke, the 2019 and 2018 National Health Interview Survey (NHIS).
| Moderate-to-severe depression symptoms n=30 872 |
Moderate-to-severe anxiety symptoms n=30 872 |
Serious psychological distress n=24 593 |
|
|---|---|---|---|
| aPR (95% CI) | aPR (95% CI) | aPR (95% CI) | |
| Stroke ever | |||
| No | Ref | Ref | Ref |
| Yes | 1.59*** (1.36 to 1.86) | 1.52*** (1.24 to 1.86) | 1.76*** (1.34 to 2.30) |
| Sex | |||
| Male | Ref | Ref | Ref |
| Female | 1.35*** (1.21 to 1.50) | 1.64*** (1.46 to 1.84) | 1.43*** (1.21 to 1.70) |
| Race and ethnicity | |||
| NH white | Ref | Ref | Ref |
| Hispanic | 0.80* (0.68 to 0.95) | 0.71*** (0.59 to 0.85) | 0.99 (0.77 to 1.27) |
| NH black | 0.70*** (0.59 to 0.83) | 0.64*** (0.53 to 0.78) | 0.68** (0.51 to 0.90) |
| NH other single or multiple races | 0.71** (0.56 to 0.90) | 0.79* (0.63 to 0.98) | 1.01 (0.72 to 1.40) |
| Age (years) | |||
| ≥65 | Ref | Ref | Ref |
| 45–59 | 2.35*** (1.96 to 2.83) | 3.01*** (2.39 to 3.79) | 2.82*** (2.12 to 3.74) |
| 18–44 | 3.20*** (2.61 to 3.92) | 4.82*** (3.76 to 6.18) | 3.42*** (2.50 to 4.67) |
| Marital status or living arrangement | |||
| Not married and not living with a partner | Ref | Ref | Ref |
| Married or living with a partner | 0.77*** (0.69 to 0.85) | 0.86** (0.77 to 0.95) | 0.65*** (0.55 to 0.78) |
| Census region | |||
| Northeast | Ref | Ref | Ref |
| Midwest | 1.00 (0.85 to 1.17) | 1.01 (0.85 to 1.19) | 0.98 (0.76 to 1.28) |
| South | 0.96 (0.82 to 1.12) | 1.02 (0.87 to 1.20) | 0.99 (0.78 to 1.24) |
| West | 0.98 (0.82 to 1.17) | 1.06 (0.88 to 1.28) | 1.11 (0.85 to 1.44) |
| Highest education among family members | |||
| Less than HS | Ref | Ref | Ref |
| HS graduate | 0.93 (0.79 to 1.09) | 0.83* (0.70 to 1.00) | 1.04 (0.81 to 1.32) |
| Some college | 1.03 (0.88 to 1.21) | 0.90 (0.76 to 1.07) | 0.98 (0.79 to 1.22) |
| College degree or more | 0.99 (0.83 to 1.19) | 0.80* (0.66 to 0.97) | 0.99 (0.76 to 1.29) |
| Worked last week | |||
| No* | Ref | Ref | Ref |
| Yes† | 0.56*** (0.50 to 0.64) | 0.64*** (0.56 to 0.73) | 0.51*** (0.42 to 0.62) |
| Family poverty level‡ | |||
| 400+% FPL | Ref | Ref | Ref |
| 200–399% FPL | 1.52*** (1.31 to 1.77) | 1.60*** (1.35 to 1.91) | 1.88*** (1.44 to 2.44) |
| 0–199% FPL | 1.85*** (1.56 to 2.19) | 1.93*** (1.60 to 2.34) | 1.98*** (1.51 to 2.59) |
| Current insurance status | |||
| Private insurance only (excluding Medicare)§ | Ref | Ref | Ref |
| Any public insurance (excluding Medicare Medicare)¶ | 1.57*** (1.34 to 1.84) | 1.49*** (1.26 to 1.78) | 1.89*** (1.43 to 2.50) |
| Any Medicare coverage** | 1.43*** (1.16 to 1.76) | 1.48** (1.16 to 1.88) | 1.55* (1.09 to 2.20) |
| Uninsured | 1.38*** (1.14 to 1.66) | 1.17 (0.97 to 1.42) | 1.71*** (1.27 to 2.29) |
| Unknown | 1.48** (1.14 to 1.94) | 1.34* (1.03 to 1.75) | 1.74** (1.18 to 2.58) |
| Body mass index | |||
| 18.5–25.0 (underweight) | 1.31 (0.94 to 1.83) | 1.02 (0.73 to 1.43) | 1.28 (0.77 to 2.14) |
| <18.5 (healthy weight) | Ref | Ref | Ref |
| 25.0–30.0 (overweight) | 1.02 (0.89 to 1.17) | 1.01 (0.86 to 1.17) | 0.94 (0.76 to 1.16) |
| ≥30.0 (obese) | 1.26*** (1.12 to 1.43) | 1.17* (1.01 to 1.35) | 1.30** (1.07 to 1.57) |
| Unknown | 0.89 (0.65 to 1.22) | 0.82 (0.58 to 1.16) | N/A†† |
| Smoking frequency | |||
| Not at all | Ref | Ref | Ref |
| Some days | 1.54*** (1.25 to 1.89) | 1.61*** (1.29 to 2.00) | 1.61** (1.18 to 2.20) |
| Every day | 1.66*** (1.46 to 1.88) | 1.69*** (1.47 to 1.94) | 1.96*** (1.61 to 2.40) |
| History of other chronic conditions (reference=never had this condition) | |||
| COPD | 1.63*** (1.41 to 1.87) | 1.59*** (1.37 to 1.85) | 1.52*** (1.19 to 1.93) |
| Cancer | 1.11 (0.97 to 1.27) | 0.96 (0.80 to 1.14) | 0.94 (0.76 to 1.18) |
| Diabetes | 1.39*** (1.21 to 1.60) | 1.32*** (1.14 to 1.53) | 1.19 (0.98 to 1.45) |
| Connective tissue disease (eg, arthritis) | 2.10*** (1.86 to 2.38) | 2.00*** (1.74 to 2.29) | 2.14*** (1.79 to 2.56) |
Models are estimated using Poisson log-linear regression with robust SE, adjusting for sample weights and survey design elements.
*p<0.05 **p<0.01 ***p<0.001.
Includes adults who were unemployed and those who were not in the labour force.
Includes adults who worked for and not for pay.
Family poverty level is drawn from NHIS imputed income files.
Includes adults covered by non-Medicare private insurance; excludes adults covered by any publicly funded insurance.
Includes adults covered by non-Medicare publicly funded insurance, regardless of whether they were also covered by non-Medicare private insurance; excludes adults covered by any Medicare plans.
Includes adults covered by Medicare, regardless of whether they were also covered by other private or public insurance plans.
Body mass index had no missing values in 2018 NHIS.
aPR, adjusted prevalence ratio; NH, non-Hispanic; HS, high school; FPL, federal poverty level; COPD, chronic obstructive pulmonary disease.