title: Medical cost and frequent mental distress among the non-elderly US adult population.
abstract: BACKGROUND
  Frequent mental distress (FMD) is an important measure of perceived poor mental health. With the rising cost of health care, it is not uncommon for working adults to delay seeking care. The objective of this study was to determine the relationship between avoidance of medical care due to cost and FMD among the non-elderly US population.
  
  
  METHODS
  We analyzed data from 282 044 non-elderly US population from a 2008 Behavioral Risk Factor Surveillance System survey. Multivariable logistic regression models were used to assess the association between avoidance of medical care due to cost and FMD adjusted for covariates.
  
  
  RESULTS
  The overall prevalence of FMD in the non-elderly population was 11.1%; whereas it was 24.2% for those reporting avoiding medical care due to cost. Approximately 18% of the population had no health insurance coverage and the prevalence of FMD was significantly greater in this group. The odds of FMD were >2-fold elevated for respondents who were unable to see a doctor because of cost (adjusted odds ratio: 2.40, 99% confidence interval: 2.19, 2.63).
  
  
  CONCLUSIONS
  These findings highlight the need for affordable medical care for reducing mental distress and improving population health.
authors.affiliation: District Health Department No. 4, Alpena Michigan, USA.
authors.forename: John
authors.initials: J
authors.lastname: Bruning
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Arif
authors.forename: James E
authors.initials: JE
authors.lastname: Rohrer
mesh_terms: D000293:Adolescent; D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003695:Delivery of Health Care / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013315:Stress, Psychological / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: BRFSS; frequent mental distress; medical cost