A History of Heart Attack and Experiencing Frequent Mental Distress Among US Veterans and Adult Civilians: A 2019 National Level Cross-Sectional Study

Abstract

Introduction Frequent mental distress (FMD) is poor mental health for ≥14 days in the past month. Prevalence and risk for depression and suicide are higher among US veterans (USV) than US civilians (USC). Limited research has been done among USV regarding FMD. Anyone can experience mental distress without being clinically depressed—examining FMD more broadly captures health burden of poor mental state. This study’s purpose was to examine the association between having a history of heart attack (HHHA) and FMD among USV vs USC. Methods This cross-sectional study used the 2019 Behavioral Risk Factor Surveillance System (n = 274 352) data. Weighted and adjusted logistic regression models were conducted overall and by USV/USC status. Results HHHA increases weighted adjusted odds (WAO) of FMD. Among insured not obese USV with HHHA, the WAO of FMD were 1.4x significantly greater ( P < .05) than among insured not obese USV without HHHA. Among uninsured obese USC with HHHA, the WAO of FMD were 3.2x significantly greater ( P < .0001) than among uninsured obese USC without HHHA, and significantly lower among USV. Conclusions Study findings suggest a distinction in FMD among USV/USC with HHHA. Understanding this association can inform policy for FMD screening post-heart attack as another potential intervention to prevent/reduce suicide among USV/USC.