Title: RELATIONSHIPS BETWEEN HEALTH AND MENTAL HEALTH IN NEW YORK CITY: DATA FROM THE 2002 NEW YORK CITY COMMUNITY HEALTH SURVEY KH McVeigh*, F Mostashari*, RA Wunsch-Hitzig**, SA Kuppin**, CG King**, JD Plapinger**,
1RELATIONSHIPS BETWEEN HEALTH AND MENTAL HEALTH
IN NEW YORK CITY DATA FROM THE 2002 NEW YORK
CITY COMMUNITY HEALTH SURVEYKH McVeigh, F
Mostashari, RA Wunsch-Hitzig, SA Kuppin, CG
King, JD Plapinger, LI SedererNew York
City Department of Health and Mental Hygiene
Bureau of Epidemiology Services New York City
Department of Health and Mental Hygiene Division
of Mental Hygiene
INTRODUCTION Clinical studies have documented
relationships between physical and mental health,
but until now, these relationships have not been
quantified in a representative sample of New York
City residents. This study presents findings that
document the prevalence of significant emotional
distress and its relationship to physical
health. METHOD We examined data from the New York
City Community Health Survey (NYCCHS), a random
sample telephone survey of 9,674
non-institutionalized adults conducted from
May-July 2002. Respondents were asked
standardized, cognitively tested questions about
their health status and risk factors. Respondents
were classified as having experienced
significant emotional distress during the prior
30 days if they scored above 12 on the K6 scale
(Kessler, 2002), a six-item screening measure
designed to discriminate between community cases
and non-cases of DSM-IV/SCID disorders. Multi-way
frequency analyses were conducted in SUDAAN
producing weighted, age-standardized estimates.
- RESULTS
- More than 6 (381,000 people) of all adult New
Yorkers report having clinically significant
emotional distress. Persons with this distress
often experience depression, anxiety, and other
emotional problems that may substantially
interfere with a major life activity, such as
eating, maintaining a household, working, or
developing and maintaining personal relationships
(table 1). - Significant emotional distress is reported more
frequently among women, Hispanics, people ages 45
and older, those who are divorced, separated, or
widowed, and people who earn less than 25,000
(table 1). - New Yorkers who report significant emotional
distress also report poorer overall health and
more days of poor health in the past 30 days
(chart 1). - New Yorkers who report significant emotional
distress often engage in behaviors that put them
at increased risk for health problems, including
getting no exercise, and eating a diet low in
fruits and vegetables, and smoking (table 2). - New Yorkers who report significant emotional
distress experience high rates of many conditions
that put them at risk for disability and early
death, including high cholesterol, high blood
pressure, obesity, asthma, and diabetes (chart
2). - DISCUSSION
- Approximately 381,000 New Yorkers experience
emotional distress of sufficient magnitude to
warrant a mental health assessment. The strong
correlation between significant emotional
distress and physical health suggests that both
mental health and physical health providers
should be alert to recognize, and treat or make
referrals for co-occurring conditions.
Table 2 New Yorkers Who Report Significant Emotional Distress Have More Health Risks Table 2 New Yorkers Who Report Significant Emotional Distress Have More Health Risks Table 2 New Yorkers Who Report Significant Emotional Distress Have More Health Risks
New Yorkers Who Report Significant Emotional Distress (SE) Other New Yorkers (SE)
No Exercise 53 (2.6) 30 (.64)
Poor diet 26 (2.3) 14 (.47)
Smoke 29 (2.3) 21 (.55)
Table 1 Rates of Significant Emotional Distress Among New Yorkers Table 1 Rates of Significant Emotional Distress Among New Yorkers
Percent (number) Percent (number)
Total 6.4 (381,000)
Sex Male Female 5.3 (148,000) 7.4 (233,000)
Age 18-24 25-44 45-64 65 and older 4.7 (37,000) 5.7 (144,000) 7.9 (132,000) 6.5 (58,000)
Marital Status Never married Married/Partnered Divorced/Separated/Widowed 6.6 (102,000) 5.5 (151,000) 9.6 (127,000)
Race/Ethnicity White, non-Hispanic Black, non-Hispanic Asian Hispanic 4.9 (124,000) 4.6 (62,000) 4.0 (24,000) 11.9 (157,000)
Income lt 25,000 25,000 to 50,000 gt 50,000 11.5 (198,000) 4.5 (74,000) 2.6 (41,000)
REFERENCE Kessler, R.C., Andrews, G., Colpe,
L.J., Hiripi, E., Mroczek, D.K., Normand, S-L.T.,
Walters, E.E., Zaslavsky, A.M. (2002). Short
screening scales to monitor population
prevalences and trends in non-specific
psychological distress. Psychological Medicine,
32, 959-976. We would like to thank Anjum Hajat,
CHS Survey Manager, for her assistance with this
analysis. For more information, please contact
Tina McVeigh at tmcveigh_at_health.nyc.gov. Presented
at the Second International Conference on Urban
Health, October 15-18, 2003.