Behavioral Health

Data sourcing

The data on behavioral health conditions such as frequent mental distress, depression, and excessive drinking, featured in the Health Equity Tracker, come from America’s Health Rankings (AHR) and County Health Rankings (CHR), both of which primarily rely on the Behavioral Risk Factor Surveillance System (BRFSS) survey conducted by the CDC, supplemented by data from CDC WONDER and the U.S. Census.

A note about the CDC's Behavioral Risk Factor Surveillance System (BRFSS) survey. It's important to note that because BRFSS is survey-based, it sometimes lacks sufficient data for smaller or marginalized racial and ethnic groups, making some estimates less statistically robust. America's Health Rankings provides its BRFSS analysis at the national and state levels only. Where we show county-level data for these topics, it comes from County Health Rankings, which publishes its own county estimates derived from BRFSS. Because the two analyses are produced differently, county figures are not directly comparable to the state and national figures shown alongside them. Most of these measures describe adults only. For the population comparison bar charts and relative inequity calculations, we therefore compare each group's share of cases to its share of the adult (18+) population rather than its share of the total population.

AHR provides data for several behavioral health topics via their GraphQL API. Depression, frequent mental distress, and non-medical drug use (opioid and other substance misuse) are provided as percentages, while suicide is provided as a rate per 100,000 people. Excessive drinking is displayed as a percentage rate with no conversion applied.

Formula: 5% rate = 5 out of 100 = 5,000 per 100,000 people

• Depression cases (Ages 18+): race/ethnicity: Available
• Excessive drinking cases (Ages 18+): race/ethnicity: Available
• Frequent mental distress cases (Ages 18+): race/ethnicity: Available
• Suicides: race/ethnicity: Available
• Opioid and other non-medical drug use (Ages 18+): race/ethnicity: Available

Depression cases

Measurement definition: Adults who reported being told by a health professional that they have a depressive disorder including depression, major depression, minor depression or dysthymia.

Clinical importance: Depression is a mental illness that can cause a number of problems, including sadness, fatigue, and difficulty concentrating. Populations at a higher risk for depression include women, young adults, Indigenous and multiracial Americans, individuals with lower income, and non-heterosexual individuals. Studying depression can help us understand why these disparities exist and how to address them.

Source: AHR

Excessive drinking cases

Measurement definition: Adults who reported binge drinking (four or more [females] or five or more [males] drinks on one occasion in the past 30 days) or heavy drinking (eight or more [females] or 15 or more [males] drinks per week).

Clinical importance: Excessive drinking is a major public health problem. It can lead to a number of health problems, including liver disease, heart disease, and cancer. It is more common in men, younger adults, and LGBTQ+ individuals. Studying excessive drinking can help us understand why these disparities exist and how to address them.

Source: AHR

Frequent mental distress cases

Measurement definition: Adults who reported their mental health was not good 14 or more days in the past 30 days.

Clinical importance: Frequent mental distress is a major public health problem. It can lead to a number of health problems, including heart disease, stroke, and cancer. Frequent mental distress disproportionately affects women, younger adults, individuals of multiracial, Indigenous, or Pacific Islander descent, those with lower education levels or household income, individuals experiencing cognitive difficulty disabilities, and non-heterosexual individuals. Studying frequent mental distress can help us understand why these disparities exist and how to address them.

Source: AHR

Suicides

Measurement definition: Deaths due to intentional self-harm.

Clinical importance: Suicide is a leading cause of death in the United States. Indigenous Americans, people with low incomes, and older people are more likely to die by suicide. Studying suicide can help us understand why these disparities exist and how to address them.

Opioid and other non-medical drug use

Measurement definition: Adults who reported using prescription drugs non-medically (including pain relievers, stimulants, sedatives) or illicit drugs (excluding cannabis) in the last 12 months.

Clinical importance: Opioid and other non-medical drug use is a major public health problem. It can lead to a number of health problems, including overdose and death. It is more common in people with low incomes. Studying opioid and other non-medical drug use can help us understand why these disparities exist and how to address them.

Source: AHR

• National Survey on Drug Use and Health (NSDUH)

988 Suicide & Crisis Lifeline. For 24/7, free and confidential support, prevention and crisis resources, and professional best practices, call 9-8-8 or visit 988lifeline.org. If you or a loved one is experiencing an emergency, call 911 or go to your nearest emergency room.