Factors Associated with Adult Mental Health Outcomes: Evidence from CDC Open Data
Keywords:
Adult Mental Health, Psychological Distress, Chronic Comorbidities, Social Determinants, Public Health Surveillance.Abstract
This empirical quantitative investigation evaluates the complex determinants of adult mental health outcomes utilizing secondary population surveillance data from the Centers for Disease Control and Prevention Behavioral Risk Factor Surveillance System open data repository. Employing complex multistage sampling weights and multivariable regression modeling, the study examines the intersecting influences of chronic physical comorbidities, behavioral risk factors, social determinants of health, and life course developmental vulnerabilities on psychological distress. Quantitative findings demonstrate that chronic physical illnesses, particularly post acute long COVID and cardiovascular co morbidities, significantly increase the odds of frequent mental distress and clinical mood disorders. Behavioral risk factors, including hazardous alcohol consumption and physical inactivity, further exacerbate psychiatric symptom severity. Moreover, structural socioeconomic deprivation, county level poverty, and regional healthcare provider shortages create persistent health disparities that elevate psychiatric vulnerability across marginalized subpopulations. Early childhood adversity and young adult developmental transitions similarly predict long term psychological burden. These results highlight the imperative for multi sector public health interventions, proactive primary care mental health screening, and equitable behavioral healthcare infrastructure to effectively mitigate population level psychiatric morbidity.
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Alegría, M., Zhen-Duan, J., O’Malley, I. S., & DiMarzio, K. (2022). A new agenda for optimizing investments in community mental health and reducing disparities. American Journal of Psychiatry, 179(6), 402-416.
Alhabeeb, A. A., Al-Duraihem, R. A., Alasmary, S., Alkhamaali, Z., Althumiri, N. A., & BinDhim, N. F. (2023). National screening for anxiety and depression in Saudi Arabia 2022. Frontiers in public health, 11, 1213851.
Athanassiou, M., Dumais, A., Zouaoui, I., & Potvin, S. (2023). The clouded debate: A systematic review of comparative longitudinal studies examining the impact of recreational cannabis legalization on key public health outcomes. Frontiers in psychiatry, 13, 1060656.
Baiden, P., Cassidy, J., Panisch, L. S., LaBrenz, C. A., & Onyeaka, H. K. (2022). Association of adverse childhood experiences with subjective cognitive decline in adulthood: Findings from a population-based study. Aging & Mental Health, 26(11), 2214-2222.
Bolduc, M. L., Saberi, P., Neilands, T. B., Mercado, C. I., Johnson, S. B., Freggens, Z. R., ... & Bullard, K. M. (2025). Economic factors associated with county-level mental health–United States, 2019. PLoS One, 20(6), e0300939.
Centers for Disease Control and Prevention. (2024). Mental health data channel: Conditions & care. U.S. Department of Health and Human Services. https://www.cdc.gov/mental-health/about-data/conditions-care.html
Centers for Disease Control and Prevention. (2025). Behavioral Risk Factor Surveillance System (BRFSS) questionnaires. U.S. Department of Health and Human Services. https://www.cdc.gov/brfss/questionnaires/index.htm
Centers for Disease Control and Prevention. (2026, January 28). Behavioral Risk Factor Surveillance System (BRFSS) - mental health indicators [Kumpulan data]. CDC Open Data. https://data.cdc.gov/Mental-Health/Behavioral-Risk-Factor-Surveillance-System-BRFSS-M/5eh7-pjx8
Centers for Disease Control and Prevention. (2026, June 18). Mental health data sources. U.S. Department of Health and Human Services. https://www.cdc.gov/mental-health/about-data/mental-health-data-sources.html
Chaudhary, S., Hoffmann, J. A., Pulcini, C. D., Zamani, M., Hall, M., Jeffries, K. N., ... & Goyal, M. K. (2024). Youth suicide and preceding mental health diagnosis. JAMA network open, 7(7), e2423996.
Choi, N. G., Marti, C. N., Choi, B. Y., & Kunik, M. M. (2023). Recurrent falls over three years among older adults age 70+: associations with physical and mental health status, exercise, and hospital stay. Journal of applied gerontology, 42(5), 1089-1100.
Coley, R. L., Carey, N., Baum, C. F., & Hawkins, S. S. (2022). COVID-19–related stressors and mental health disorders among US adults. Public Health Reports, 137(6), 1217-1226.
Cunniff, L., Alyanak, E., Fix, A., Novak, M., Peterson, M., Mevis, K., ... & Bhatti, A. (2023). The impact of the COVID-19 pandemic on vaccination uptake in the United States and strategies to recover and improve vaccination rates: A review. Human vaccines & immunotherapeutics, 19(2), 2246502.
Elkbuli, A., Sutherland, M., Shepherd, A., Kinslow, K., Liu, H., Ang, D., & McKenney, M. (2022). Factors influencing US physician and surgeon suicide rates 2003 to 2017: analysis of the CDC-national violent death reporting system. Annals of surgery, 276(5), e370-e376.
Flanagan Balawajder, E., Ducharme, L., Taylor, B. G., Lamuda, P. A., Kolak, M., Friedmann, P. D., ... & Schneider, J. A. (2024). Factors associated with the availability of medications for opioid use disorder in US jails. JAMA Network Open, 7(9), e2434704.
Goodman, M. L., Molldrem, S., Elliott, A., Robertson, D., & Keiser, P. (2023). Long COVID and mental health correlates: a new chronic condition fits existing patterns. Health psychology and behavioral medicine, 11(1), 2164498.
Gross, B., & Hamilton, L. (2023). Student Mental Health and Well-Being: A Review of Evidence and Emerging Solutions. Center on Reinventing Public Education.
Hacker, K., Auerbach, J., Ikeda, R., Philip, C., & Houry, D. (2022). Social determinants of health—an approach taken at CDC. Journal of public health management and practice, 28(6), 589-594.
Harris, E. (2023). CDC Report Documents Disparities in Mental Health–Related ED Visits.
Holzer, K. J., Bartosiak, K. A., Calfee, R. P., Hammill, C. W., Haroutounian, S., Kozower, B. D., ... & Abraham, J. (2024). Perioperative mental health intervention for depression and anxiety symptoms in older adults study protocol: design and methods for three linked randomised controlled trials. BMJ open, 14(4), e082656.
Hua, L. L., Lee, J., Rahmandar, M. H., Sigel, E. J., Committee on Adolescence, & Council on Injury, Violence, and Poison Prevention. (2024). Suicide and suicide risk in adolescents. Pediatrics, 153(1), e2023064800.
Huang, C. X., Halfon, N., Sastry, N., Chung, P. J., & Schickedanz, A. (2023). Positive childhood experiences and adult health outcomes. Pediatrics, 152(1), e2022060951.
Kammer-Kerwick, M., Cox, K., Purohit, I., & Watkins, S. C. (2024). The role of social determinants of health in mental health: an examination of the moderating effects of race, ethnicity, and gender on depression through the all of us research program dataset. PLOS Mental Health, 1(3), e0000015.
Kessler, R. C., Ruhm, C. J., Puac-Polanco, V., Hwang, I. H., Lee, S., Petukhova, M. V., ... & Zubizarreta, J. R. (2022). Estimated prevalence of and factors associated with clinically significant anxiety and depression among US adults during the first year of the COVID-19 pandemic. JAMA Network Open, 5(6), e2217223.
Kwapong, Y. A., Boakye, E., Khan, S. S., Honigberg, M. C., Martin, S. S., Oyeka, C. P., ... & Sharma, G. (2023). Association of depression and poor mental health with cardiovascular disease and suboptimal cardiovascular health among young adults in the United States. Journal of the American Heart Association, 12(3), e028332.
Landa-Blanco, M., Vásquez, G., Portillo, G., Sproviero, F., & Echenique, Y. (2024). The impact of adverse childhood experiences on mental health, sexual risk behaviors, and alcohol consumption in adulthood. Frontiers in psychiatry, 15, 1352824.
Lee, J., & Ramírez, I. J. (2022). Geography of disparity: connecting COVID-19 vulnerability and social determinants of health in Colorado. Behavioral Medicine, 48(2), 72-84.
Mokdad, A. H., Bisignano, C., Hsu, J. M., Ababneh, H. S., Abbasgholizadeh, R., Abdelkader, A., ... & Doan, K. D. (2024). The burden of diseases, injuries, and risk factors by state in the USA, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021. The Lancet, 404(10469), 2314-2340.
Na, P. J., Bommersbach, T. J., Petrakis, I. L., & Rhee, T. G. (2022). National trends of suicidal ideation and mental health services use among US adults with opioid use disorder, 2009–2020. EClinicalMedicine, 54.
Na, P. J., Shin, J., Kwak, H. R., Lee, J., Jester, D. J., Bandara, P., ... & Jeste, D. V. (2025). Social determinants of health and suicide-related outcomes: a review of meta-analyses. JAMA psychiatry, 82(4).
Wakuta, M., Nishimura, T., Osuka, Y., Tsukui, N., Takahashi, M., Adachi, M., ... & Katayama, T. (2023). Adverse childhood experiences: Impacts on adult mental health and social withdrawal. Frontiers in public health, 11, 1277766.
Wisner, K. L., Murphy, C., & Thomas, M. M. (2024). Prioritizing maternal mental health in addressing morbidity and mortality. JAMA psychiatry, 81(5), 521-526.
Xiang, A. H., Martinez, M. P., Chow, T., Carter, S. A., Negriff, S., Velasquez, B., ... & Kumar, S. (2024). Depression and anxiety among US children and young adults. JAMA network open, 7(10), e2436906.
Zhang, Y., Chinchilli, V. M., Ssentongo, P., & Ba, D. M. (2024). Association of Long COVID with mental health disorders: a retrospective cohort study using real-world data from the USA. BMJ open, 14(2), e079267.
