title: Risk behaviors and healthcare coverage among adults by frequent mental distress status, 2001.
abstract: BACKGROUND
  Given the increased emphasis on chronic diseases in the United States, physicians and health survey analysts are now gathering information on patients' subjective measures of health, also known as health-related quality-of-life measures. Studies indicate that these measures can be more powerful predictors of chronic disease-related morbidity and mortality than objective measures.
  
  
  METHODS
  The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing, state-based, random-digit-dialed telephone survey of the non-institutionalized U.S. population aged 18 years or older. This study examined frequent mental distress (FMD), defined as self-reported 14 or more mentally unhealthy days in the past 30 days, and its association with adverse health behaviors and lack of healthcare coverage.
  
  
  RESULTS
  In 2001, approximately 10% of adults reported FMD. Persons reporting FMD had a higher prevalence of smoking, drinking heavily, physical inactivity, and obesity than did persons without FMD. They were also more often without healthcare coverage. In addition, persons with FMD were more likely to engage in multiple adverse behaviors than were persons without FMD.
  
  
  CONCLUSIONS
  Persons reporting FMD are at higher risk of chronic diseases because they engage in risky health behaviors and lack healthcare coverage. This study provides further support that mental health screening as well as physical health screening is important in clinical practice. Further research is needed to identify therapeutic or mental health-promoting interventions to reduce mental distress and reinforce healthy behaviors.
authors.affiliation: Division of Adult and Community Health, National Center for Chronic Disease Prenvetion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. tw2@cdc.gov
authors.forename: Tara W
authors.initials: TW
authors.lastname: Strine
authors.forename: Lina
authors.initials: L
authors.lastname: Balluz
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Chapman
authors.forename: David G
authors.initials: DG
authors.lastname: Moriarty
authors.forename: Michelle
authors.initials: M
authors.lastname: Owens
authors.forename: Ali H
authors.initials: AH
authors.lastname: Mokdad
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D016001:Confidence Intervals; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology*; D008875:Middle Aged; D011159:Population Surveillance; D011336:Probability; D011788:Quality of Life; D012016:Reference Values; D018570:Risk Assessment; D012309:Risk-Taking; D012737:Sex Factors; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology