Trends in Extreme Distress in the United States, 1993-2019.

Publisher: American Public Health Association Country of Publication: United States NLM ID: 1254074 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1541-0048 (Electronic) Linking ISSN: 00900036 NLM ISO Abbreviation: Am J Public Health Subsets: MEDLINE

Publication: Washington, DC : American Public Health Association
Original Publication: New York [etc.]

Socioeconomic Factors* ; Unemployment*; Stress, Psychological/*epidemiology; Adult ; Female ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires ; United States/epidemiology

Objectives. To investigate changes from 1993 to 2019 in the percentage of US citizens suffering extreme distress. Methods. Using data on 8.1 million randomly sampled US citizens, we created a new proxy measure for exceptional distress (the percentage who reported major mental and emotional problems in all 30 of the last 30 days). We examined time trends for different groups and predictors of distress. Results. The proportion of the US population in extreme distress rose from 3.6% in 1993 to 6.4% in 2019. Among low-education midlife White persons, the percentage more than doubled, from 4.8% to 11.5%. Regression analysis revealed that (1) at the personal level, the strongest statistical predictor of extreme distress was "I am unable to work," and (2) at the state level, a decline in the share of manufacturing jobs was a predictor of greater distress. Conclusions. Increasing numbers of US citizens report extreme levels of mental distress. This links to poor labor-market prospects. Inequality of distress has also widened. Public Health Implications. Policymakers need to recognize the crisis of an ever-growing group of US citizens in extreme distress.

Comment in: Am J Public Health. 2020 Oct;110(10):1452-1453. (PMID: 32903079)

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Date Created: 20200821 Date Completed: 20201110 Latest Revision: 20221003

20240105

PMC7483105

10.2105/AJPH.2020.305811

32816546