NCHS Data Brief ■ No. 303 ■ February 2018

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Prevalence of Depression Among Adults Aged 20 and Over: 

United States, 2013–2016

Debra J. Brody, M.P.H., Laura A. Pratt, Ph.D., and Jeffery P. Hughes, M.P.H.

Key findings 

Data from the National 

Health and Nutrition 

Examination Survey

● During 2013–2016, 8.1% of

American adults aged 20 and

over had depression in a given

2-week period.

● Women (10.4%) were almost

twice as likely as were men

(5.5%) to have had depression.

● Depression was lower

among non-Hispanic Asian 

adults, compared with 

Hispanic, non-Hispanic black, 

or non-Hispanic white adults. 

● The prevalence of depression

decreased as family income 

levels increased. 

● About 80% of adults with

depression reported at least

some difficulty with work,

home, and social activities

because of their depression.

● From 2007–2008 to

2015–2016, the percentage

of American adults with

depression did not change

significantly over time.

Major depression is a common and treatable mental disorder characterized 

by changes in mood, and cognitive and physical symptoms over a 2-week 

period (1). It is associated with high societal costs (2) and greater functional 

impairment than many other chronic diseases, including diabetes and arthritis 

(3). Depression rates differ by age, sex, income, and health behaviors (4). 

This report provides the most recent national estimates of depression among 

adults. Prevalence of depression is based on scores from the Patient Health 

Questionnaire (PHQ-9), a symptom-screening questionnaire that allows for 

criteria-based diagnoses of depressive disorders (5). Estimates for non-Hispanic 

Asian persons are presented for the first time. 

Keywords: mental health • NHANES 

During 2013–2016, 8.1% of Americans aged 20 and over had 

depression in a given 2-week period.

Figure 1. Percentage of persons aged 20 and over with depression, by age and sex:

United States, 2013–2016

1

Significantly different from females in same age group.

NOTES: Depression was defined as a score greater than or equal to 10 on the Patient Health Questionnaire. Access data table for 

Figure 1 at: https://www.cdc.gov/nchs/data/databriefs/db303_table.pdf#1.

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 303 ■ February 2018

■ 2 ■

● Overall, women (10.4%) were almost twice as likely to have depression as men (5.5%). This 

pattern also was observed among each age group (Figure 1).

● Among both men and women, the percentage with depression did not differ statistically 

across age groups.

The prevalence of depression was lower among non-Hispanic Asian adults 

than among any other race and Hispanic-origin group. 

● Overall, non-Hispanic Asian adults had the lowest prevalence of depression (3.1%) 

compared with Hispanic (8.2%), non-Hispanic white (7.9%), and non-Hispanic black 

(9.2%) adults. This pattern was observed among both men and women (Figure 2).

● The prevalence of depression was not statistically different for Hispanic, non-Hispanic 

white, and non-Hispanic black adults, overall and among both men and women. 

● Among all race and Hispanic-origin groups, except non-Hispanic Asian, men had a 

significantly lower prevalence of depression compared with women. 

 

 

Figure 2. Percentage of persons aged 20 and over with depression, by race and Hispanic origin and sex:

United States, 2013–2016

1

Significantly lower than Hispanic, non-Hispanic white, and non-Hispanic black. 

2

Significantly lower than women of the same race and Hispanic-origin group. 

NOTES: Depression was defined as a score greater than or equal to 10 on the Patient Health Questionnaire. Access data table for Figure 2 at: 

https://www.cdc.gov/nchs/data/databriefs/db303_table.pdf#2. 

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 303 ■ February 2018

■ 3 ■

The prevalence of depression among adults decreased as family income 

levels increased.

● Overall, 15.8% of adults from families living below the federal poverty level (FPL) had 

depression. The prevalence of depression decreased to 3.5% among adults at or above 400% 

of the FPL (Figure 3).

● Among both men and women, the prevalence of depression decreased with increasing levels 

of family income.

● Men with family incomes at or above 400% of the FPL had the lowest prevalence of 

depression (2.3%), while women with family incomes below the FPL had the highest 

prevalence (19.8%).

 

 

 

 

 

 

 

 

 

Figure 3. Percentage of persons aged 20 and over with depression, by family income level: United States, 2013–2016

1

Significant decreasing linear trend.

2

Significantly lower than women in same family income level. 

NOTES: Family income levels are defined by the federal poverty level (FPL). Depression was defined as a score greater than or equal to 10 on the Patient Health 

Questionnaire. Access data table for Figure 3 at: https://www.cdc.gov/nchs/data/databriefs/db303_table.pdf#3. 

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 303 ■ February 2018

■ 4 ■

About 80% of adults with depression reported at least some difficulty with 

work, home, or social activities because of their depression symptoms.

● 50.2% of adults with depression reported some difficulty with work, home, or social 

activities because of their depression symptoms (Figure 4). 

● 30.0% of adults with depression reported moderate or extreme difficulty with work, home, 

or social activities because of their depression symptoms.

● The percentage of adults with depression reporting difficulty with work, home, or social 

activities due to depression symptoms was similar in men and women.

 

 

Figure 4. Percentage of persons aged 20 and over with depression who reported difficulty with work, home, or social 

activities due to depression symptoms: United States, 2013–2016

NOTES: Depression was defined as a score greater than or equal to 10 on the Patient Health Questionnaire. Access data table for Figure 4 at: 

https://www.cdc.gov/nchs/data/databriefs/db303_table.pdf#4. 

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2013–2016.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 303 ■ February 2018

■ 5 ■

Over a 10-year period, from 2007–2008 to 2015–2016, the percentage of 

adults with depression did not change significantly.

● Among men, the prevalence of depression was 5.7 % in 2007–2008 and 5.4% in 2015–2016 

(Figure 5).

● Among women, the prevalence of depression was 10.4% in 2007–2008 and 9.3% in

2015–2016.

Summary

During 2013–2016, 8.1% of American adults had depression in a given 2-week period. As 

observed in other studies (4,6), depression was almost twice as common among women as 

among men. Depression prevalence did not differ by age. Non-Hispanic Asian adults had the 

lowest prevalence of depression, a finding noted in other studies (7). Depression prevalence did 

not vary significantly among the other race and Hispanic-origin groups studied. The proportion 

of adults with depression increased with decreasing family income level. About 80% of adults 

with depression reported at least some difficulty with work, home, or social activities due to their 

depression symptoms. From 2007–2008 to 2015–2016, the prevalence of depression among both 

men and women showed no significant changes, similar to the results of another major federal 

survey that tracks depression estimates in the United States (8). 

 

Figure 5. Prevalence of depression among persons aged 20 and over: United States, 2007–2008 to 2015–2016

1

Women had a higher prevalence of depression than men at every time point.

NOTES: Depression was defined as a score greater than or equal to 10 on the Patient Health Questionnaire. Access data table for Figure 5 at: 

https://www.cdc.gov/nchs/data/databriefs/db303_table.pdf#5. 

SOURCE: NCHS, National Health and Nutrition Examination Survey, 2007–2016.

 

 

 

 

 

 

 

 

 
NCHS Data Brief ■ No. 303 ■ February 2018

■ 6 ■

Prevalence estimates reported here do not include populations considered at higher risk for 

depression (i.e., those in nursing homes or other institutions). Persons currently treated for 

depression (i.e., medication or therapy) may not have screened positively for depression using the 

PHQ-9. Finally, some persons with depression may not have been able or willing to participate in 

the National Health and Nutrition Examination Survey (NHANES). Therefore, these findings may 

represent conservative estimates of depression among adults in the United States. 

Definitions

Depression: Measured using the score from the Patient Health Questionnaire (PHQ-9), a nineitem depression-screening instrument that asks about the frequency of symptoms of depression 

in the past 2 weeks (5). Response categories of “not at all,” “several days,” “more than half the 

days,” and “nearly every day” are given a score of 0 to 3. Summary scores ranged from 0 to 27. 

Depression was defined using a score of 10 or higher, a well-validated cut point used in primary 

care settings (5).

Difficulties related to depression: Persons with a score of 1 or more on the PHQ-9 symptoms are 

asked: “How difficult have these problems made it for you to do your work, take care of things 

at home, or get along with other people?” Responses are 0 (not at all difficult), 1 (somewhat 

difficult), 2 (moderately difficult), or 3 (extremely difficult). In Figure 4, 1 was defined as “some 

difficulty,” 2 and 3 were defined as “moderate or extreme difficulty.”

Percent of federal poverty level: Based on the income-to-poverty ratio, a measure of the annual 

total family income divided by the poverty guidelines, adjusted for family size.

Data sources and methods

Data from the NHANES 2007–2016 were used for these analyses. Data from two combined 

cycles (2013–2016) were used to test differences between subgroups. Trends in depression 

prevalence reflect a 10-year period of five 2-year NHANES survey cycles, 2007–2016.

NHANES is a cross-sectional survey designed to monitor the health and nutritional status of 

the noninstitutionalized civilian U.S. population (9). The survey consists of home interviews 

and standardized physical examinations in mobile examination centers (MEC). The PHQ-9 was 

administered by trained interviewers during a private interview in the MEC. Approximately 89% 

of MEC-examined adults completed the PHQ-9. 

The NHANES sample is selected through a complex, multistage probability design. During 

2007–2016, non-Hispanic black, non-Hispanic Asian, and Hispanic persons, among other groups, 

were oversampled to obtain reliable estimates for these population subgroups. Race and Hispanic 

origin-specific estimates reflect individuals reporting only one race. Persons reporting another 

race or multiple races are included in the total but are not reported separately. 

Examination sample weights, which account for the differential probabilities of selection, 

nonresponse, and noncoverage, were incorporated into the estimation process. The standard 

errors of the percentages were estimated using Taylor series linearization (10), a method that 

incorporates the sample weights and sample design.
NCHS Data Brief ■ No. 303 ■ February 2018

■ 7 ■

A t statistic was used to test for difference between groups. Tests for trends by family income 

and survey cycle were evaluated using orthogonal polynomials to determine linear or quadratic 

trends. The significance level for statistical testing was set at p < 0.05. All differences reported are 

statistically significant unless otherwise indicated. All estimates presented are statistically reliable 

based on a relative standard error of the estimate being at or below 30%. Statistical analyses 

were conducted using SAS System for Windows (release 9.4; SAS Institute Inc., Cary, N.C.) and 

SUDAAN (release 11.1; RTI International, Research Triangle Park, N.C.).

About the authors

Debra J. Brody and Jeffery P. Hughes are with the National Center for Health Statistics, Division 

of Health and Nutrition Examination Surveys; Laura A. Pratt is with the National Center for 

Health Statistics, Office of Analysis and Epidemiology. 

References

1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 

(DSM-5). Fifth edition. Arlington, VA. 2013.

2. Kessler RC. The cost of depression. Psychiatr Clin North Am. 35(1):1–14. 2012.

3. Wells KB, Stewart A, Hays RD, Burnam MA, Rogers W, Daniels M, et al. The functioning 

and well-being of depressed patients. Results from the medical outcomes study. JAMA 

262(7):914–9. 1989.

4. Blanco C, Okuda M, Markowitz JC, Liu S-M, Grant BF, Hasin DS. The epidemiology 

of chronic major depressive disorder and dysthymic disorder: Results from the national 

epidemiologic survey on alcohol and related conditions. J Clin Psychiatry 71(12):1645–56. 2010.

5. Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. Validity of a brief depression severity 

measure. J Gen Intern Med 16(9):606–13. 2001.

6. Pratt LA, Brody DJ. Depression in the U.S. household population, 2009–2012. NCHS Data 

Brief, no 172. Hyattsville, MD: National Center for Health Statistics. 2014.

7. Kalibatseva Z, Leong FTL. Depression among Asian Americans: Review and 

recommendations. Depress Res Treat. 2011:1–9. 2011.

8. Center for Behavioral Health Statistics and Quality. Key substance use and mental health 

indicators in the United States: Results from the 2015 National Survey on Drug Use and Health 

(HHS Publication No. SMA 16–4984, NSDUH Series H-51). 2016. Available from:

https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2015/NSDUH-FFR1-2015/

NSDUH-FFR1-2015.htm.

9. National Center for Health Statistics. National Health and Nutrition Examination Survey: 

Questionnaires, datasets, and related documentation. Available from: https://wwwn.cdc.gov/nchs/

nhanes/Default.aspx.

10. Wolter KM. Chapter 6: Taylor series methods. In: Introduction to variance estimation. 2nd ed. 

New York, NY: Springer 2007.
NCHS Data Brief ■ No. 303 ■ February 2018

Suggested citation

Brody DJ, Pratt LA, Hughes J. Prevalence 

of depression among adults aged 20 and 

over: United States, 2013–2016. NCHS Data 

Brief, no 303. Hyattsville, MD: National 

Center for Health Statistics. 2018.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Kathryn S. Porter, M.D., M.S., Director

Ryne Paulose-Ram, Ph.D., Associate 

Director for Science

Office of Analysis and Epidemiology

Irma E. Arispe, Ph.D., Director

Makram Talih, Ph.D., Associate Director for 

Science

For e-mail updates on NCHS publication 

releases, subscribe online at: 

https://www.cdc.gov/nchs/govdelivery.htm.

For questions or general information

about NCHS:

Tel: 1–800–CDC–INFO (1–800–232–4636)

TTY: 1–888–232–6348

Internet: https://www.cdc.gov/nchs

Online request form: https://www.cdc.gov/info

ISSN 1941–4927 Print ed.

ISSN 1941–4935 Online ed.

DHHS Publication No. 2018–1209

CS289143

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road, Room 4551, MS P08

Hyattsville, MD 20782–2064

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

For more NCHS Data Briefs, visit:

https://www.cdc.gov/nchs/products/databriefs.htm.

FIRST CLASS MAIL 

POSTAGE & FEES PAID 

CDC/NCHS

PERMIT NO. G-284