Two Sides of The Same Coin: An Ecological Examination of Comorbidity of Mental and Physical Health in the United States

Caroline McKay, Columbia University
Katherine Keyes, Columbia University
Bruce Link, Columbia University
Deborah Hasin, Columbia University

Self-rated health strongly predicts future morbidity and mortality. Global assessments of health may be less informative than a subtler appraisal involving two spheres of influence – mental and physical dimensions. Although comorbidity of physical and mental health problems is an important issue in public health, little evidence exists concerning the co-occurrence of these aspects of life at the population level. This investigation estimates state-level co-occurrence of self-rated physical and mental health and investigates whether the structural environment influences covariation at the broader geographic level. Data is from the 2000 Census (N=50) and the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), conducted in 2001-2002 (N=43,098). Initial results reveal an overall positive relationship between state-level mental and physical health (β = .11 [SE=.01], p < .0001), with significant variation at state level in addition to geographic clustering, with stronger associations located in the greater southern region of the United States.