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Online ISSN: 1099-176X    Print ISSN: 1091-4358
The Journal of Mental Health Policy and Economics
Volume 25, Issue 1, 2022. Pages: 3-10
Published Online: 1 March 2022

Copyright © 2022 ICMPE.


Depressive Symptoms among US Adults during the Great Recession and Economic Recovery

Annie Yu-An Chen,1* Roland Sturm2

1DDS, MS, RAND Corporation and Pardee RAND Graduate School, Santa Monica, CA, USA
2PhD, RAND Corporation, Santa Monica, CA, USA

* Correspondence to: Annie Yu-An Chen, DDS, MS, Assistant Policy Researcher, Address: RAND Corporation, PO Box 2138, 1776 Main Street, Santa Monica, CA 90407-2138, USA.
Tel.: +1-310-393-0411#6164
Email: anniec@rand.org

Source of Funding: This paper was supported through NIH grant R01HD087257.


Background and Aims: We study the trajectory of depressive symptoms among US adults before, during, and after the 2008/2009 Great Recession.

Methods: We use repeated cross-sectional surveys of the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. Mental health is assessed with the Patient Health Questionnaire-9 (PHQ-9), with the following categorization for depressive symptoms: none or mild (score 0-9), moderate or severe (score 10-27). A parallel time series was calculated from the Behavioral Risk Factor Surveillance System (BRFSS) on self-reported number of days with poor mental health.

Results:  NHANES data show a statistically significant increase in depressive symptoms from 2005/2006 to 2007/2008 (the beginning of the Great Recession), but there were no significant or consistent changes after 2007/2008. In particular, the deterioration in the adjusted predicted PHQ-9 scores occurred prior to the large increase in unemployment rate (2009/2010). As the macroeconomic situations improved and unemployment rates recovered, mental health did not return to the previous level. In the latest wave of NHANES (2017/2018), unemployment rates were at the lowest level over the analysis period; however, the adjusted predicted PHQ-9 scores were higher than that at the beginning of the Great Recession. Trends of PHQ-9 scores were similar across income groups - all groups had an increase in depressive symptoms after 2005/2006 and PHQ-9 scores were still high in 2017/2018 after controlling for sociodemographic status. Group with the lowest income had higher levels of depressive symptoms at every time point. BRFSS data shows no consistent changes in the number of days with poor mental health that parallel economic conditions.

Discussion: Depressive symptoms at the population level did not match the economic cycle before, during and after the Great Recession. Future research is needed to better understand the lack of correlation between population mental health and macroeconomic conditions.

Received 4 May 2021; accepted 20 January 2022

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