Table 1.
Change in the univariate and multivariate associations of sociodemographic variables with clinically significant anxiety-depression (PHQ-4 = 6+) between the 2018-2019 CDC Behavioral Risk Factors Surveillance Survey (n = 839,366) and April 2020 to July 2021 CDC Household Pulse Survey (n = 2,373,044)a
| Behavioral Risk Factors Surveillance Survey (BRFSS) |
Household Pulse Survey (HPS) |
HPS: BRFSS |
||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Prevalence |
Univariate |
Multivariate |
Prevalence |
Univariate |
Multivariate |
Univariate |
Multivariate |
|||||||||
| % | (SE) | RR | (95% CI) | RR | (95% CI) | % | (SE) | RR | (95% CI) | RR | (95% CI) | RR | (95% CI) | RR | (95% CI) | |
| Sex | ||||||||||||||||
| Female | 12.0 | (0.1) | 1.2b | (1.2–1.3) | 1.3b | (1.3–1.3) | 28.8 | (0.0) | 1.2b | (1.2–1.2) | 1.3b | (1.3–1.3) | 1.0b | (0.9–1.0) | 1.0 | (1.0–1.0) |
| Male | 9.8 | (0.1) | 1.0 | 1.0 | 24.2 | (0.0) | 1.0 | 1.0 | 1.0 | 1.0 | ||||||
| χ21 | 229.7b | 387.2b | 310.3b | 748.2b | 3.9b | 0.5 | ||||||||||
| Age | ||||||||||||||||
| 18–29 | 14.4 | (0.1) | 1.8b | (1.8–1.9) | 2.0b | (1.9–2.0) | 41.8 | (0.1) | 3.1b | (3.0–3.2) | 2.9b | (2.8–3.0) | 1.7b | (1.6–1.8) | 1.5b | (1.4–1.6) |
| 30–44 | 11.2 | (0.1) | 1.4b | (1.4–1.5) | 1.7b | (1.6–1.7) | 29.9 | (0.1) | 2.2b | (2.1–2.3) | 2.3b | (2.2–2.4) | 1.6b | (1.5–1.6) | 1.4b | (1.3–1.5) |
| 45–59 | 11.5 | (0.1) | 1.5b | (1.4–1.5) | 1.6b | (1.5–1.6) | 31.4 | (0.1) | 2.3b | (2.3–2.4) | 2.3b | (2.2–2.4) | 1.6b | (1.5–1.7) | 1.5b | (1.4–1.5) |
| 60+ | 7.9 | (0.0) | 1.0 | 1.0 | 13.5 | (0.0) | 1.0 | 1.0 | 1.0 | |||||||
| χ23 | 1029.0b | 1345.9b | 4231.6b | 4135.6b | 507.3b | 311.0b | ||||||||||
| Education | ||||||||||||||||
| Less than high school | 19.5 | (0.2) | 4.2b | (4.0–4.3) | 5.0b | (4.8–5.2) | 59.5 | (0.2) | 6.8b | (6.6–7.0) | 6.5b | (6.3–6.7) | 1.6b | (1.5–1.7) | 1.3b | (1.2–1.4) |
| High school graduate | 13.4 | (0.1) | 2.9b | (2.8–3.0) | 2.9b | (2.8–3.0) | 37.3 | (0.1) | 4.3b | (4.2–4.4) | 4.4b | (4.3–4.5) | 1.5b | (1.4–1.6) | 1.5b | (1.5–1.6) |
| Some college | 10.7 | (0.1) | 2.3b | (2.2–2.4) | 2.3b | (2.2–2.3) | 34.2 | (0.1) | 3.9b | (3.8–4.0) | 3.8b | (3.8–3.9) | 1.7b | (1.6–1.8) | 1.7b | (1.6–1.8) |
| College graduate/more | 4.7 | (0.0) | 1.0 | 1.0 | 8.8 | (0.0) | 1.0 | 1.0 | 1.0 | |||||||
| χ23 | 4706.8b | 5395.0b | 22,755.0b | 21,496.2b | 625.1b | 623.3b | ||||||||||
| Race | ||||||||||||||||
| Non-Hispanic black | 15.8 | (0.1) | 1.5b | (1.4–1.5) | 1.2b | (1.2–1.3) | 39.9 | (0.1) | 1.8b | (1.8–1.9) | 1.3b | (1.3–1.3) | 1.2b | (1.2–1.3) | 1.1b | (1.0–1.1) |
| Hispanic | 9.5 | (0.1) | 0.9b | (0.8–0.9) | 0.6b | (0.5–0.6) | 34.1 | (0.1) | 1.6b | (1.5–1.6) | 1.0 | (1.0–1.0) | 1.8b | (1.7–1.9) | 1.7b | (1.6–1.8) |
| Other race | 8.9 | (0.1) | 0.8b | (0.8–0.9) | 0.8b | (0.7–0.8) | 32.5 | (0.1) | 1.5b | (1.4–1.6) | 1.3b | (1.2–1.3) | 1.8b | (1.7–1.9) | 1.6b | (1.5–1.7) |
| Non-Hispanic white | 10.7 | (0.0) | 1.0 | 1.0 | 21.7 | (0.0) | 1.0 | 1.0 | 1.0 | |||||||
| χ23 | 578.7b | 744.0b | 2838.6b | 533.1b | 722.6b | 517.1b | ||||||||||
| Total | 10.9 | (0.0) | 26.4 | (0.0) | ||||||||||||
Estimated using robust Poisson regression models.102 The dependent variable was a random 0/1 draw from a Bernoulli distribution with a fixed random seed from a separate predicted probability assigned to each respondent from an imputed predicted probability generated by a separate internally cross-validated logistic regression in each sample. These models are described in Appendix Tables 3 (BRFSS) and 4 (HPS). The imputation was necessary in BRFSS because the PHQ-4 was administered only in 3 stated in 2018, although, as detailed in Appendix Table 3, other measures assessed in the entre sample were strongly associated with PHQ 4 = 6+ (AUC = .90). The imputation was not necessary in HPS because the PHQ-4 was administered in the entire sample. However, for purposes of making a fair comparison of predictors with the outcome across the 2 surveys, we coarsened the PHQ score (Appendix Table 4) to make the association between true scores and predicted probabilities comparable across surveys. In addition, a propensity score 1/p weight was imposed on the HPS data to adjust for the fact that the 12% of respondents missing the PHQ-4 questions were not random with respect to sociodemographic characteristics, geography, or time. Logistic regression with the same predictors as in the substantive model as well as dummy variables for state and survey wave was used to estimate predicted probability of answering the PHQ-4 questions for purposes of generating the 1/p weight.
Significant at the 0.05 level.