Social Psychiatry and Psychiatric Epidemiology

, Volume 49, Issue 11, pp 1805–1821 | Cite as

Prevalence rates for depression by industry: a claims database analysis

  • Lawson WulsinEmail author
  • Toni Alterman
  • P. Timothy Bushnell
  • Jia Li
  • Rui Shen
Original Paper



To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database.


Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002–2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources.


Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity.


Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work.

Clinical significance

Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace.


Depression Occupation Industry Group medical insurance claims Work stress Prevalence rates 



We wish to gratefully acknowledge the collaboration and support of Highmark Inc., headquartered in Pittsburgh and Camp Hill, Pennsylvania, whose data is analyzed in this paper. We thank Brian Day, Andrea DeVries, and Cara Hirsch at Highmark for their assistance in establishing and guiding the project, and Jerry O’Donnell, also at Highmark, for his assistance with the data.

Funding was provided by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention.

Conflict of interest

The authors declare they have no conflicts of interest.


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Copyright information

© Springer-Verlag (outside the USA) 2014

Authors and Affiliations

  • Lawson Wulsin
    • 1
    • 2
    Email author
  • Toni Alterman
    • 3
  • P. Timothy Bushnell
    • 3
  • Jia Li
    • 3
  • Rui Shen
    • 4
  1. 1.Department of Psychiatry, Cincinnati Veterans Administration Medical CenterUniversity of CincinnatiCincinnatiUSA
  2. 2.Department of Family MedicineUniversity of CincinnatiCincinnatiUSA
  3. 3.Hazard Evaluations and Field Studies, Division of SurveillanceCenters for Disease Control and Prevention, National Institute for Occupational Safety and HealthCincinnatiUSA
  4. 4.Emergint TechnologiesCincinnatiUSA

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