Subtitle Major depression rising fastest among adolescents and millennials - Wide variations exist in diagnosis rates between states and cities Chicago – Major depression diagnoses surged, especially among adolescents and millennials, from 2013 through 2016, according to a study of medical claims by the Blue Cross Blue Shield Association (BCBSA)’s Health of America Report. The report, based on medical claims data from the Blue Cross Blue Shield Health IndexSM (BCBS Health IndexSM), also shows how major depression diagnoses are linked to other chronic health conditions. The study finds that: • Major depression has a diagnosis rate of 4.4 percent for BCBS members. Diagnosis rates rose by 33 percent from 2013 through 2016 and climbed fastest among adolescents (up 63 percent) and millennials (up 47 percent). • Diagnosis rates vary by as much at 300 percent by state from a high of 6.4 percent in Rhode Island to lows of 2.1 in Hawai‘i and 3.2 percent in Nevada in 2016. By city, diagnosis rates range more than 400 percent from a high of 6.8 percent in Topeka, Kansas, to lows of 1.5 percent in Laredo, Texas, and 2 percent in McAllen/Edinburg/Mission, Texas. • Women are diagnosed with major depression at double the rate of men (6 percent and 3 percent, respectively). • Those diagnosed with major depression are nearly 30 percent less healthy on average than those not diagnosed with major depression, according to the BCBS Health Index measurement. Chronic conditions are strongly linked to major depression, as 85 percent of people who are diagnosed with major depression also have one or more serious chronic health conditions. Nearly 30 percent of these members have four or more other health conditions. • Those diagnosed with major depression use health care services more than those without a depression diagnosis. This results in two times the health care spending (about $10,673 compared to $4,283). “Major depression diagnoses are growing quickly, especially for adolescents and millennials,” said Trent Haywood, senior vice president and chief medical officer for BCBSA. “The high rates for adolescents and millennials could have a substantial health impact for decades to come. Further education and research is needed to identify methods for both physicians and patients to effectively treat major depression and begin a path to recovery and better overall health.” “It is possible that the increased rates of depression in adolescents are related to a combination of increased electronics use and sleep disruptions in already vulnerable individuals,” said Dr. Karyn Horowitz, a psychiatrist affiliated with Emma Pendleton Bradley Hospital in Rhode Island. “Increased use of electronics, video games more commonly in boys and social media/texting more commonly in girls, can lead to increased conflict both within the home and with peers.” “In preliminary literature, high users of social media have been linked with higher rates of social isolation than low users,” Haywood added. “It is important to further explore this relationship.” The report, titled Major Depression: The Impact on Overall Health, is based on medical claims data from the BCBS Health Index, a first-of-its-kind measurement of health for nearly every county in America. It encompasses more than 200 conditions that impact health and identifies those health conditions with the greatest impact on the commercially insured population. The BCBS Health Index is powered by de-identified medical claims data from more than 41 million commercially insured members of BCBS companies. The interactive website allows people to measure the overall health and identify the top 10 conditions that negatively impact health at the state and county levels. This is the twentieth study of the Blue Cross Blue Shield: The Health of America Report® series, a collaboration between BCBSA and Blue Health Intelligence, which uses a market-leading claims database to uncover key trends and insights into health care affordability and access to care. For more information, visit www.bcbs.com/healthofamerica. About BHI Blue Health Intelligence (BHI) is the nation’s premier resource for data-driven insights about healthcare trends and best practices, promoting healthier lives and more affordable access to safe and effective care. BHI leverages a team of analytics experts and advanced technology, coupled with access to the greatest number of healthcare claims—172 million lives—gathered over 10 years in a safe, HIPAA-compliant, secure database. The resulting conformed, reliable data set has the broadest, deepest pool of integrated medical and pharmacy claims, reflecting medical utilization in every ZIP code. Blue Health Intelligence (BHI) is an Independent Licensee of the Blue Cross Blue Shield Association. BHI is a trade name of Health Intelligence Company, LLC. www.bluehealthintelligence.com.