Body Mass Index, Chronic Health Conditions, and Depression Among US Adults with Disabilities: A Modeling Study of the 2020–2023 BRFSS
Simao Elias Luis
Abstract
Background US adults with disabilities report elevated rates of depression and chronic health conditions influenced by biopsychosocial factors.Purpose To examine how body mass index (BMI), chronic health conditions, and sociodemographic factors influence depression among US adults with disabilities.Methods Data from the 2020–2023 Behavioral Risk Factor Surveillance System (N = 305,633) were analyzed using logistic regression, moderated mediation, and machine learning to evaluate predictors of depression.Results Logistic regression showed increased depression odds associated with higher BMI categories (OR = 1.084–1.497), asthma (OR = 1.567), angina (OR = 1.148), heart attack (OR = 1.067), cognitive disability (OR = 4.089), and female sex (OR = 1.799). Conversely, older age (OR = 0.473), higher income (OR = 0.904), and self-employment (OR = 0.895) were associated with lower odds of depression. Moderated mediation showed significant BMI effects on depression mediated by chronic health conditions, with more substantial effects among females. The machine learning identified cognitive disability (66.7%) and age (15.0%) as leading predictors.Discussion Biopsychosocial factors influence depression, with cognitive impairments and socioeconomic disadvantage further compounding vulnerability.Translation to Health Education Practice Health education interventions must integrate obesity management, chronic health care, sex disparities, and disability accommodations to mitigate depression.