Interdependence of mental health, physical health and health risk from the Maine BRFSS

Research describing the negative impact of mental illness on morbidity and mortality from chronic medical conditions suggests that mental health is inextricably intertwined with physical health and addressing mental health is essential for promoting optimal health. The BRFSS, a major tool for tracking health status, has for many years tracked mentally unhealthy days, and in 2006 and 2007 added modules on Depression and Serious Psychological Distress. Data is presented on 16,903 Maine BRFSS respondents for 2000-2005 sorted by number of mentally unhealthy days. Those with zero days and 14 or more days (Frequent Mental Distress) were studied on demographics, health insurance status, preventive care, health risk behaviors, oral health and prevalence of chronic disease. A similar analysis, linking mental health and health behaviors,is presented for 2818 respondents to the 2006 Depression module. Compared to persons with no report of mental ill-health, persons with FMD have higher rates of smoking, obesity, heavy drinking, physical inactivity and poor nutrition as well as increased prevalence of diabetes, hypercholesterolemia and asthma. Persons with diabetes or asthma report FMD at a rate 1.7 times that of persons without these conditions. Rates of preventive care, or appropriate care for existing medical conditions is lower for persons with FMD. Similar analyses are reported for persons with Depression. The association between mental ill health, health risk and chronic medical conditions suggests that public health programs on prevention and disease control must address both somatic and mental health issues in an integrated fashion.