Mental Disorders Top National List of Health Conditions

Pauline Anderson

November 30, 2016

Mood and substance abuse disorders top the list of conditions negatively affecting the health of Americans with commercial health insurance, the newly published Blue Cross Blue Shield (BCBS) Health Index shows.

On the basis of data from more than 40 million BCBS members, this first-its-kind index identified depression, anxiety, and other mood disorders as the top category of health conditions affecting longevity and quality of life. Substance use disorders were number five.

According to Maureen Sullivan, chief strategy and innovation officer for the BCBS Association, the developers of the index started with data from millions of Blue Cross claims and used other information on healthcare costs and global burden of disease. They used an algorithm to measure how debilitating a condition is and how it affects quality of life.

They measured the prevalence, claims costs, and impact of more than 200 conditions.

Problem-Solving Info

"The index measures how we as Americans are living up to our optimal health, and the top conditions are those that are driving, at the highest level, decreases in living at your optimal health."

The top five conditions according to the Index are as follows:

  1. Depression, anxiety, and other mood disorders

  2. Hypertension

  3. Diabetes

  4. High cholesterol

  5. Substance use disorders

Nationally, conditions in these five categories cause about 30% of commercially insured Americans' overall reduction in optimal health.

The new information, said Sullivan, should provide some idea of the health of local communities and indicate what areas need improving. "We are very invested in local communities in terms of outreach activities and programs," she said.

Knowing which conditions have the greatest impact will assist in "how to engage employers and providers and how we together can marshal resources to help improve the health of our local communities," said Sullivan.

The applicability of the new index will be "more for the problem-solvers than individuals," she said. "It's more to inform and foster dialogue and for problem solving."

She called it "provocative" in terms of the implications.

An analysis of the BCBS Health Index by Moody's Analytics found a direct link between healthy people and a healthy economy, with healthier counties across the country having lower unemployment and higher incomes, according to a BCBS press release. Among counties with a median BCBS Health Index result, those within the top 10% had the following characteristics:

  • A per capita income $3700 higher

  • A 10-year economic growth of 3.5% high

  • An unemployment rate half a point lower

Access to Mental Health Care for All

Commenting on the findings, American Psychiatric Association (APA) President Maria A. Oquendo, MD, PhD, said the report "highlights the impact of mental health and substance use disorders on people's health and quality of life and reinforces the importance of making access to quality mental healthcare for all a national priority."

The new data also show the need for parity when it comes to coverage of mental illness, said Saul Levin, MD, who is medical director and CEO of the APA.

Federal parity laws mandate that insurers cover treatment for mental illness just as they would for any other ailment. However, stronger enforcement of the laws is needed, said Dr Levin in a release.

"Providing effective treatment for mental health and substance use disorders will not only benefit the individuals and their families but will benefit their employers through reduced absenteeism, disability and turnover costs."

Despite much progress, many people with mental illnesses are still not getting the care they need, said Dr Levin. "Bipartisan mental health reform now before Congress will go a long way in addressing the barriers and challenges and improving access quality mental health care for all."

The House of Representatives is expected to take up mental health reform later this week, according to the APA release.

The BCBS Health Index, which includes an analysis by county, is available online.

Sources: BCBS and APA press releases; interview with Maureen Sullivan

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