The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56468

Anthony Kouzis, PhD, School of Medicine, Johns Hopkins University, 4100 North Charles St, #411, Baltimore, MD 21218-1024, 410-243-1717, akouzis@jhsph.edu

Social and psychiatric factors are increasingly recognized as influencing morbidity and mortality. We investigated the role of: social (age, sex, race, household income, marital status), social support (SS) (perceived emotional confiding), social network (SN) (contact with friends and contact with family) variables, and the occurrence of major depressive disorder (MDD) (DSM-III-R) on all-cause mortality utilizing prospective data from the Baltimore Epidemiologic Catchment Area (n=3481) Follow-up, 1981-1998. Cox proportional hazards regression was utilized to examine the adjusted relative risk (RR) and 95% confidence intervals (CI) of a lifetime diagnosis of MDD on excess mortality. We statistically adjusted for the effects of significant sociodemographic, social relationship, and physical health status variables. Separate analyses were repeated for men and for women. Persons with MDD had a 3.3 RR (95% CI=2.07, 5.18) of dying. Women were at less risk than men of premature death. Older, poverty income, and physically ill persons were at greater RR. Absence of SS resulted in a 70% greater likelihood of excess mortality. SNs, marital status, and race were not significant, however. Absence of SS (2.4 RR, 95% CI=1.31, 4.35) posed a greater hazard for women. Men with MDD were 8 times (RR=7.9, 95% CI=3.69, 16.93) as likely to die prematurely than men without MDD. Further research on the relationship between social factors and mental health status is recommended. Interventions aimed at fostering binding, intimate relations and the targeting of mental health treatment services for persons with physical health problems or living in poverty appear warranted.

Learning Objectives:

At the conclusion of the session, the participant in this session will be able to:
• Identify social determinants influencing morbidity and mortality.
• Assess the influence of mental health (major depressive disorder) on premature mortality.
• List and prioritze relevant interventions and target subgroups in the society requiring greater treatment services.

Keywords: Depression, Mortality

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.