IOWA CITY

Corridor millennials report higher rates of depression, study says

Blue Cross Blue Shield data also show Iowans diagnosed at higher rate than national average in 2017

Millennials in the Corridor were diagnosed with major depression more often than their counterparts across the state and elsewhere in the nation, according to a new Blue Cross Blue Shield Health of America report.

In discussing the data, officials say the trend appears to have no clear driving factor.

“The prevalence of these conditions in a young generation, you did not see that years ago,” said Laura Jackson, chief health officer for Des Moines-based Wellmark, a Blue Cross Blue Shield company.

Millennials — those born between 1981 and 1996 — in the United States totaled 71 million, according to the U.S. Census Bureau. Roughly 40 million of them held commercial insurance plans through Blue Cross Blue Shield in 2017.

By comparing anonymous data from those millennials across the country, researchers measured the prevalence of 10 common chronic health conditions. The conditions include mental health disorders, such as depression, and physical ailments, such as Type II diabetes.

The data showed millennials were living at 95 percent of their optimum health, but these 10 conditions have increased in prevalence from 2014 to 2017. During that time, diagnosis for major depression increased 31 percent across the country.

The Health Index noted the Iowa had a 6.3 prevalence rate per 100 individuals in 2017, greater than the national average of 5 per 100 people.

However, those individuals in their 20s and 30s living in Cedar Rapids and Iowa City reported a rate of 8.1 per 100 people.

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By contrast, millennials living in the Waterloo and Cedar Falls area and in the Greater Des Moines region had a prevalence rate of 6.5. The Quad Cities had a rate of 5.9 per 100 people.

Brian Harvey, executive director of strategy and analytics at Blue Cross Blue Shield Association, said the higher rates of diagnosis aren’t necessarily a bad thing.

“The fact here is a higher rate of diagnosis could simply mean that physicians and practitioners are more in tune with diagnosing the condition, thus more people are being diagnosed at an earlier stage before they develop comorbidity” — the presence of two chronic diseases simultaneously — “around other chronic conditions,” Harvey said.

The trend is a concern for insurance officials because the cost of care for other conditions in people who have untreated depression is higher, often because they not following a health regimen as they should, Jackson said.

But these figures aren’t enough to raise any red flags just yet, said one University of Iowa psychiatrist.

Dr. William Coryell, a psychiatrist with the Iowa City-based hospital system, pointed out that the study measured people that received a major depression diagnosis as indicated by insurance codes used by doctors to bill for services. That measurement could vary on whether a doctor readily diagnoses depression or not.

“Doctors in Iowa or Cedar Rapids specifically may be more apt to diagnose in a given population than Des Moines or Atlanta,” Coryell said.

He said the study didn’t break down into certain socio-economic indicators such as education and income status — both which can influence rates of depression among a population.

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Coryell said the main challenge facing Iowa is a shortage of mental health providers and access for Iowans, particularly those living in rural areas.

Merritt Hawkins, a physician recruiting firm, ranked the state the fifth-lowest nationwide for psychiatrists per 100,000 residents, with 5.59 psychiatrists per capita. Washington, D.C., ranked the highest, with 28.53 psychiatrists per capita.

About 175 psychiatrists practiced in Iowa in 2018, most of whom were congregated around urban areas such as Des Moines and Iowa City, the report said. Because of that, Iowans of all ages outside those areas struggle to access professional help.

“Access to care is probably the thing that would have the most impact on how much people suffer and how much they’re impaired by psychiatric illness,” Coryell said.

More than 9 million commercially insured Americans were diagnosed with depression — about a 33 percent increase from 2013, according to another study published by Blue Cross Blue Shield in March.

In that study, researchers state that 2 million of those Americans diagnosed in 2016 did not seek treatment.

Other research has similarly found depression diagnoses are on the rise across the country, including a recent study in “Psychological Medicine” that found the prevalence of depression increased from 6.6 percent to 7.3 percent from the year 2005 to 2015.

There was a greater increase, from 8.7 percent to 12.7 percent, among those ages 12 to 17.

At the college level, nearly 18 percent of more than 500 University of Iowa undergraduates who completed the 2019 National College Health Assessment survey were diagnosed or treated with depression in the past year — double the 9 percent reported five years ago.

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More than 10 percent seriously considered suicide in the last 12 months. A decade ago, a much lower 4.5 percent responded similarly, according to the national survey.

Parents of a 21-year-old Iowa State University student from Iowa filed a lawsuit in Linn County District Court last month, suiing the state of Iowa for negligence in providing their son mental health services. Dane Schussler, who was found dead in November 2015, had expressed thoughts of suicide to counselors at the ISU counseling center before his death.

The Health Index findings and other research indicating a similar trend have prompted Blue Cross Blue Shield officials to spur conversation at the local level.

In recent months, the insurance company has been hosting listening sessions around the country, gathering health care providers, business leaders and millennials to discuss what may be driving the rates of depression among young Americans.

“The association can only do so much by looking at data,” Wellmark’s Jackson said. “On some level, you have to go to the local market if you will, talk to the people that can help you understand why this is happening”

A listening post was held in Des Moines this past month, along with the Greater Des Moines Partnership. Company officials are planning to host a nationwide listening post in the fall.

• Comments: (319) 368-8536; michaela.ramm@thegazette.com

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