title: A population-based cross-sectional study comparing depression and health service deficits between rural and nonrural U.S. military veterans.
abstract: With involvement in two wars over the past decade, there has been a documented increase in depression prevalence and suicide incidence among U.S. military veterans. Because higher proportions of veterans come from rural communities, access to care may be an issue when behavioral health care is needed. Although the Veterans Administration has expanded health services in rural areas, this has not always resulted in increased service utilization. This study examined the prevalence of depression and associated health service deficits (HSDs) for rural versus nonrural U.S. military veterans. Using bivariate and multivariate techniques, 2006 Behavioral Risk Factor Surveillance System data were analyzed. Bivariate analysis revealed that rural veterans had greater odds of having at least one HSD, being currently depressed as measured by the Personal Health Questionnaire-8, and having lifetime depression. Logistic regression analysis confirmed that rural veterans had higher odds of both current and lifetime depression than nonrural veterans when controlling for socioeconomic status and race/ethnicity. Additionally, logistic regression analysis also revealed that rural veterans with current depression had higher odds of being Hispanic or Other/Multiracial than Caucasian, not employed for wages than employed for wages, <65 years of age, and reported having at least one HSD.
authors.affiliation: Essentia Health System, Acute Care Pharmacy Residency Program, Duluth, MN 55805.
authors.forename: Kristina A
authors.initials: KA
authors.lastname: Dittrich
authors.affiliation: University of Minnesota-Twin Cities Campus, Academic Health Center, Office of Education, Minneapolis, MN 55455.
authors.forename: M Nawal
authors.initials: MN
authors.lastname: Lutfiyya
authors.affiliation: Essentia Health System, Acute Care Pharmacy Residency Program, Duluth, MN 55805.
authors.forename: Catherine J
authors.initials: CJ
authors.lastname: Kucharyski
authors.affiliation: Essentia Health System, Acute Care Pharmacy Residency Program, Duluth, MN 55805.
authors.forename: John T
authors.initials: JT
authors.lastname: Grygelko
authors.affiliation: University of Minnesota, College of Pharmacy, Ambulatory Care Residency Program, Minneapolis, MN 55455.
authors.forename: Cassandra L
authors.initials: CL
authors.lastname: Dillon
authors.affiliation: University of Minnesota, College of Pharmacy, Ambulatory Care Residency Program, Minneapolis, MN 55455.
authors.forename: Taylor J
authors.initials: TJ
authors.lastname: Hill
authors.affiliation: University of Minnesota, College of Pharmacy, Ambulatory Care Residency Program, Minneapolis, MN 55455.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Rioux
authors.affiliation: University of Minnesota, College of Pharmacy, Ambulatory Care Residency Program, Minneapolis, MN 55455.
authors.forename: Krista L
authors.initials: KL
authors.lastname: Huot
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D012424:Rural Population / Q000706:statistics & numerical data*; D014481:United States; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*