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

[摘要] This report presents national, state-level, and county-level point estimates and 95% CIs for the prevalence of depression. National values were directly estimated from weighted BRFSS 2020 data for groups defined by age, sex, race or ethnicity, and education, and state-level estimates were directly estimated from weighted BRFSS 2020 data for each state and DC. Point estimates from survey data were estimated as weighted means and pairwise t-tests were used to determine differences (compared with a reference category) by age group, sex, race or ethnicity, and education level. Differences with p<0.05 were considered statistically significant. Because BRFSS is not designed to provide estimates at the county level, county-level estimates were obtained for all 3,143 U.S. counties using multilevel logistic regression and post-stratification. The multilevel logistic regression model included depression as the binary dependent variable. The model’s independent variables included each respondent’s age group, sex, race and ethnicity, and education level from BRFSS 2020 data, county-level poverty data (<150% of the poverty level) from the 2016–2020 American Community Survey,†† and random effects for state and county. The model parameters were then applied to the U.S. Census Bureau Vintage 2020 county population data to generate model-based county-level estimates of depression prevalence.§§ A Monte Carlo simulation was used to generate 95% Cis for county-level estimates. These model-based county-level estimates were validated by comparing them with the weighted direct survey estimates from counties with sample size ≥500 (183) in BRFSS (Pearson correlation coefficient = 0.88). All national and state-level analyses were conducted using SAS-callable SUDAAN software (version 11; RTI International) to account for the BRFSS complex sample design and weighting, and county-level estimation was conducted using SAS software (version 9.4; SAS Institute). All prevalence estimates were age standardized to the 2000 U.S. Census Bureau population.This activity was reviewed by CDC and was conducted consistent with applicable federal law and CDC policy.

[学科分类] 医学（综合）