Burning Bosom

Theology, History, Culture, Politics & Life from a LDS (Mormon) Perspective

Why Are Utahns So Depressed?

Posted by Andrew on March 26, 2008

DepressedA recent news article cites a study that portrays Utah as the most depressed state in the U.S. The article suggests Mormon culture is at least partly to blame for Utahns’ depression, and features photos of a pill bottle and a depressed-looking woman superimposed over the Salt Lake temple.


A post by Kaimi Wenger at T&S touched off a flurry of debate and speculation about whether Utahns are, in fact, more depressed than their fellow Americans and, if so, whether Mormon culture is at least partly to blame. The most common theories and conclusions were:

Conclusion #1: Utahns are not significantly more depressed than anyone else. The main theories advanced to support this conclusion are:
a. Utahns are simply more honest in reporting their depression.
b. Utahns report more depression than non-Utahns because they are not self-medicating with alcohol to mask their depression from themselves.
c. The high amount of anti-depressant prescriptions in Utah exists, not because Utahns are more depressed than anyone else, but because Utah has an excellent mental health care system that provides treatment to those who need it.

Conclusion #2: Utahns are significantly more depressed than others, but Mormon culture has nothing to do with it. The main theories advanced to support this opinion are:
a. Lower education levels correlate with higher depression levels, and Utahns have comparatively lower education levels.
b. Utahns have less available mental health care facilities and professionals.
c. Utahns cannot afford to use the mental health care that is available to them, perhaps because of a lack of health insurance coverage.
d. Utah has a smaller gene pool than other states, which can result in higher depression rates.

Conclusion #3: Utah is significantly more depressed than other states, and Mormon culture is at least partly to blame. The overall theory behind this conclusion is that Mormons, who comprise 70% of Utah’s population, have a Church culture that is demanding, emphasizes perfection, obedience and conformity, and creates an undercurrent of competition that leads to feelings of inadequacy, depression, and suicide.

Over the past week or so, I’ve been able to digest the study and its underlying data, and to compare it against the theories outlined above. I was quite surprised by what I learned, and thought you might be interested to hear about it. But first, I should make an important disclaimer: I have absolutely no formal training whatsoever in psychology, statistics, or any other discipline that would qualify me to write this post. However, to be fair to myself, I should mention that I am a Doctor of Metaphysics, as well as a Certified Jedi Knight, so that ought to more than make up for it.

The Key Findings

The key findings reported by the Mental Health America study are as follows:

  • Utah has the highest percentage of adults reporting a major depressive episode from 2004-05. (10.14%)
  • Utah has the 3rd-highest percentage of adults reporting serious psychological distress from 2004-05 (14.58%)
  • Utah has the 4th-highest percentage of adolescents reporting a major depressive episode from 2004-05. (10.14%)
  • Utah has the 7th-highest suicide rate in the nation.

When these factors are combined and compared to others states, Utah comes out as the most depressed state in the U.S. 😦

Some Interesting Correlations on a National Level

The study states that depression and suicide rates are generally influenced by three factors: biology, environment, and access to mental health care. When it comes to access to mental health care, some interesting correlations on a national level were noted:

  • On average, the higher the number of psychologists, psychiatrists, and social workers per capita in a state, the lower the state’s suicide rate.
  • The lower the percentage of a state’s population reporting they could not obtain mental health care because of cost, the lower the depression and suicide rates.
  • The lower the percentage of a state’s population reporting unmet mental health care needs, the lower the depression rates.
  • The higher the number of anti-depressant prescriptions per capita in a state, the lower the suicide rate.
  • The higher the percentage of population covered by health insurance, the lower the suicide rate.
  • The more educated a state’s population is, the lower the depression and suicide rates.

Utah: A Peculiar State

Based on the documented correlations listed above, one would expect Utah’s high depression and suicide rates to be easily explained by low numbers of mental health care professionals, low anti-depressant prescriptions, low education levels, low health insurance coverage levels, and high numbers of people reporting unmet health care needs and an inability to obtain mental health care due to cost. But Utah is not the worst when it comes to any of those factors.

Here is how Utah ranks in comparison to other states when it comes to the availability of mental health care (including the District of Columbia, so all the ranks below are out of 51):

  • State mental health authority expenditures per capita: 26th
  • No. of specialty mental health organizations providing 24 hr. treatment: 38th
  • No. of specialty mental health organizations providing less than 24 hr. treatment: 45th
  • No. psychiatrists per 100,000 population: 44th
  • No. psychologists per 100,000 population: 24th
  • No. socialworkers per 100,000 population: 23rd

As you can see, Utah has mid-to-low rankings when it comes to the availability of mental health care, but it is by no means the worst. As an example, Texas ranks even lower than Utah in all but one of the categories above, and yet still manages to be in the top 10 least-depressed states. So the availability of mental health care doesn’t seem to be what’s driving Utah’s depression numbers.

When it comes to the affordability of mental health care, Utah ranks mid-to-low again:

  • Percent of population reporting could not get health care because of cost: 23rd
  • Percent of population with health insurance: 35th

But Utah is by no means the worst in these categories either. Again, by way of comparison, Texas ranks even lower than Utah on both these factors, but still falls within the top 10 least-depressed states.

And despite any shortcomings in the availability and affordability of mental health care in Utah, Utah has the 4th highest percentage of population receiving mental health care treatment (17.4%). And Utah ranks above-average (18th) in anti-depressants prescribed per-capita, which one would expect to correlate with lower suicide rates in Utah, but for some reason does not.

What is more perplexing is that even though Utah ranks 4th-highest in percentage of population receiving mental health care treatment, somehow Utah also has the highest percentage of population reporting unmet needs for mental health care treatment in the past year (8.2%). One would expect a state with high percentage of population receiving treatment (like Utah) to have a correspondingly low amount of unmet treatment needs. But not in Utah. This gives you an idea of how great the demand is for mental health care treatment in Utah.

Why would Utah’s demand for mental health care treatment be so high? It is unclear. But we can also probably rule out economic and educational factors, because Utah has the 8th-highest median household income in the nation, and 24th-highest percentage of population with a college degree.

So What Is Behind Utah’s Depression?

The data above suggest there is something strange going on in Utah. When it comes to depression and suicide, Utah just doesn’t “act like” other states. It defies most of the correlations that exist on a national level. Which leads to the obvious question: if Utah’s depression numbers don’t seem to be driven by the “normal” factors, what is behind Utah’s depression and suicide numbers? What makes Utah so peculiar?

In my next post, I will address two peculiar theories about Utah’s depression and suicide numbers: the “Shrunken Gene Pool” theory, the “Lack of Alcoholic Self-Medication” theory, as well as the 2,000 pound elephant in the room: Mormon culture.

(P.S. For any readers who actually are qualified to analyze these matters, please feel free to completely rip my amateur analysis to shreds.)

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15 Responses to “Why Are Utahns So Depressed?”

  1. Brian Essing said

    Question: why is that woman in the photo taking cookie-sized viagra?

  2. Andrew said

    Answer: She’s depressed. 🙂

  3. Brian Essing said

    This is a very insightful related post: http://www.scribblevillage.com/?p=1256

  4. Shawn L said

    Is Utah the only state with such anomalous findings? What have been the contributing factors in those states?

    I haven’t spent much time parsing the data, and I know I’m getting ahead of this post, but I have a very difficult time believing that Mormonism plays much, if any, role in these findings. Maybe I’m being a bit of a Pollyanna here, but I don’t see how Mormonism imposes a social structure that is any more draconian (i.e., depression inducing) than that imposed in other places. Do the Southern states, where evangelical Christriany is arguably even more a part of daily life that Utah Mormonism, have similar results? Am I missing something?

  5. Kerry said

    Brian #3: Hilarious! Loved it.

  6. I am a master of statistics student, and we had an interesting discussion earlier this week regarding observational studies vs randomized clinical trials. These depression studies deal with observational studies.

    Observational studies are helpful, but we need to be careful about conclusions. Let me quote from the New York Times Magazine, Sept 2007.

    The catch with observational studies, no matter how well designed and how many tens of thousands of subjects they might include, is that they have a fundamental limitation – they cannot inherently determine causation. Testing these hypothesis in any definitive way requires a randomized-controlled trial (RCT) – an experiment, not an observational study.

    In class, we talked about Hormone Replacement Therapy, and Beta Carotene and Lung Cancer. In the HRT, there were plenty of observational studies which indicated that women who did HRT, were nearly 1/2 as likely to get heart disease and cancer. However, when a randomized clinical trial was done, one study showed no effect, while another study actually showed an increased risk.

    Observational studies of Beta Carotene’s ability to prevent lung cancer in smokers at first showed a positive effect of reducing lung cancer in smoker. However, when a randomized clinical trial was done, Beta Carotene actually increased the risk of lung cancer.

    Why the discrepency? Observational studies do not have the ability to control for age, sex, or other confounders. Now that is not to say that Observational studies are not without merit. They seem to have correctly shown the beneficial effects of penicillin, as well as the harmful effects of smoking.

    RCT’s are not perfect either, as they can often suffer from selection bias. One only need look at the drug industry for evidence. Initial trials showed Vioxx, and other pain relievers to be safe, yet when released to the general public, signs of heart problems showed up later.

    So what’s the moral of the story? Observational studies are not conclusive, and we are foolish to make conclusions based on them. However, they are a good starting point, and further studies need to be made which can isolate these potential confounders. Perhaps religion is a confounder, perhaps age, perhaps genetics, perhaps alcohol consumption. Frankly these observational studies can’t tell us, but they do help us look at possibilities. RCT’s need to done for stronger conclusions.

  7. Flipper said

    Most of the depressed people I see in Utah are the non Mormons. I live here. National media is hogwash. I do not see major depression in Utah. I see it when I leave the state. Non Mormons are simply liars or stupid and do not even know if they are depressed.

  8. Tegan said

    My theory is that non-mormons can and often do use alcohol and drugs to numb their feelings of depression. Where as Mormons are taught not to even touch those harmful substances, therefore have to find other means to deal with their depression. I know members who rely completely on Prayer to help them get through their day and it truely does work.

    • Viagra Smih said

      What a fucking joke. Mormons are THE worst people in the nation and UTAH has the highest internet porn use in the nation. Irony?????

  9. Kurt said

    As a former researcher, I would take these results seriously, and seek for a causal factor. This is no accident, due to the large numbers of people involved (millions per state), these types of statistics are very valid, but probably can be explained. I agree with the above comment about cause vs. correlation, this is a correlational result only. But regardless of the correlational element, it is a fact that for some reason a significant subset of people in Utah have more depression.

    Some possibilities that come to mind after reading this post:

    -Are the depressed the non-LDS? If so, perhaps they feel socially dis-enfranchised in Utah. Or maybe indeed they have a harder time finding alcohol in Utah.

    -Are the depressed the less-successful LDS? If so, then indeed pressures to conform, succeed, and have large happy families are way too much for many people.

    -Are the depressed the original pioneer descendants? If so, then a genetic issue may be involved and the entire issue is less sensational. This actually would be my personal guess, after all, who would have joined the LDS church in the early days anyway? People who do not fit in well with the esablished social power/religion structure. They might have more ‘issues’. Also, common genetic illness is a recurring problem among any somewhat homogeneous population, and early LDS were primarily British and Scandinavian converts, mixed with New Englanders, also primarily British ancestry.

    To establish if genetics is involved, maybe look at a few other somewhat genetically homogeneous states, such as North Dakota (mostly Scandinavian). How does their depression rate compare with Utah, or with modern Scandinavian countries?

    -One other possibility comes to mind, there may be some local allergens, or pathogens (like Rocky Mountain fevers), that are somewhat unique to this area and are involved. Health problems are often behind depression. In fact there could even be ‘loose’ biological agents here, after all, a military chemical and biological warfare storage and testing depot is upwind of the Wasatch Front. And an accidental release decades ago could still be reverberating through the Utah population. After all, something similar happened in Southern Utah with the Atomic testing a few decades ago.

    The next step of this type of research is to characterize the subset of people who has more depression, find out which group presents the worst rates of depression… There is much more left to explore before any conclusions can be draw, at least in ‘real’ science. But of course the agenda-driven pseudo-scientists will have a heyday with these types of preliminary findings. An honest scientist sees an opportunity in this type of data, a chance to find out what is really happening.

    • Kurt said

      one more thought about the above comment, the polygamy history of Utah is also a mechanism for possible genetic elements of widespread depression. Polygamy narrows a gene pool significantly. So another subset to study is the descendants of polygamists, are they the ones experiencing more depression?

      Also, if the LDS culture is to blame, then that can be partially validated by studies of depression rates in LDS outside Utah.

      The answer can be found, but the researchers must be looking for the truth.

  10. Mike H. said

    But, there’s other studies like this:

    http://www.livescience.com/8091-happiest-states-2009-list.html

    Utah #2 for happiness?

  11. Cathy said

    Most of the people I know who struggle with depression do so in and around childbirth. Does the average woman in Utah have more kids? If so, these women have a greater risk of pregnancy/baby blues-type depression. I also recall reading that the population of Utah is quite young compared to other states, which would increase the number of women in their child bearing years, skewing the numbers further.

  12. alfiesaden said

    hi – is it just me !! can any one explain why when i type in the yahoo browser “burningbosom.wordpress.com” i get a different site yet whe i type it in google its ok? could this be a bug in my system or is any one else having same probs ?
    alf

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