title: Association between major depression, depressive symptoms and personal income in US adults with diabetes.
abstract: OBJECTIVE
  Although the association between diabetes and depression outcomes has been well studied, very little is known about the association between depression and personal income in adults with diabetes. We examined the association between major depression, number of depressive symptoms and personal income among individuals with diabetes.
  
  
  METHODS
  We used the two-stage Heckman procedure to estimate adjusted personal income by major depression status and number of depressive symptoms for 1818 adults with diabetes from the nationally representative 2006 Medical Expenditure Panel Survey. STATA V.10 was used for statistical analysis to account for the complex survey design.
  
  
  RESULTS
  In a fully adjusted model with major depression as a binary variable, major depression was associated with $2838 lower personal income. In a separate model with depressive symptoms as a continuous variable, each additional symptom was associated with $1235 lower personal income. Compared with being white/non-Hispanic, being black/non-Hispanic (-$4640) was associated with decreased personal income. Compared with excellent health status, fair health status (-$12,172) and poor health status (-$13,835) were associated with lower income. Relative to private insurance, public insurance only (-$8413) and being uninsured (-$9600) were associated with decreased income.
  
  
  CONCLUSIONS
  Among adults with diabetes, major depression and depressive symptoms are associated with lower personal income, after adjusting for relevant confounders. This finding suggests that aggressively diagnosing and treating depression as well as keeping people free of depressive symptoms can have huge human capital savings over the employment lifetime of individuals with diabetes and depression.
authors.affiliation: Center for Disease Prevention and Health Interventions for Diverse Populations, Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA.
authors.forename: Clara E
authors.initials: CE
authors.lastname: Dismuke
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology* / Q000523:psychology; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology* / Q000523:psychology; D003920:Diabetes Mellitus / Q000191:economics* / Q000523:psychology*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D019458:Insurance Coverage / Q000191:economics; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D013223:Statistics as Topic; D014481:United States; D055815:Young Adult