Occupation and the prevalence of major depression, alcohol, and drug abuse in the United States (1993)

These data from the ECA research program clearly indicate considerable variation in prevalence among different occupational groups in the United States for major depression, alcohol abuse/dependence, and drug abuse/dependence. For example, the crude lifetime prevalences for depression ranged from 0.7 to 8.6 per 100; for alcohol it was 7.5 to 32.6, and for drugs it was 3.1 to 10.5. The results also indicate that some occupations are associated with much higher rates of ADM problems. By way of illustration, the 6-month crude prevalence of major depression for the total sample of employed persons 18-64 years of age was 2.9. Six of the occupational groups had prevalences which exceeded this rate. The overall 6-month prevalence of alcohol abuse/dependence was 5.8, and six occupational groups had prevalences in excess of this. Similarly, the overall 6-month prevalence was 2.6 for drug abuse/dependence, and five occupational groups had prevalences which exceeded this. Translated into terms of relative risk, it is clear that among the occupational groups some are at markedly increased risk of ADM disorders. For these comparisons, we used as the baseline group in logistic regression analyses, Job 1, composed of executive, administrative, and managerial occupations. This group is the first in the Census classification, had crude rates near the overall prevalence rates for depression, alcohol, and drugs, and is also one of the occupational categories with the highest prestige. Logistic regression analyses were done with and without controls for differences among occupational groups in gender, age, and educational level. As might be expected, adjustment in general narrowed differences in prevalence among occupational groups, and even on occasion, changed the rank order of groups slightly. However, in general, those groups with higher odds ratios based on crude rates also had higher adjusted odds ratios. Table 6 summarizes our findings, based on the adjusted odds ratios. In this table, we list occupational groups which had a relative risk of 30% or greater above baseline (Job 1), for both 6 month and lifetime prevalences, for each of the three ADM disorders. As can be seen, there is virtually no overlap between risk of depression, on the one hand, and risk of alcohol or drug abuse. The exceptions are Job 4 (sales) which ranked third for major depression and second for alcohol abuse in terms of 6-month prevalence, and Job 9 (farming, fishing, forestry), which had the [table: see text] highest lifetime risk for major depression and the second-highest 6-month risk for drug abuse/dependence. (ABSTRACT TRUNCATED AT 400 WORDS)