Chapter 7.3 · The young and the anxious

Mental distress in young adults

Frequent mental distress among adults 18 to 24 rose from 12.3% in 2014 to 25.3% in 2022 and was 21.8% in 2024, while the rate for adults 50 to 64 moved from 12.5% to 14.4%.

Author: Vishal Singh
Affiliation: NYU Stern
Published: 9 October 2026

In the Behavioral Risk Factor Surveillance System (BRFSS), an annual telephone survey run by the CDC with state health departments, 12.3% (95% CI 11.6% to 13.0%) of adults 18 to 24 reported frequent mental distress in 2014 and 25.3% (95% CI 24.4% to 26.2%) did in 2022. Frequent mental distress means 14 or more of the past 30 days on which the respondent's mental health was not good. Over the same years the rate for adults 50 to 64 went from 12.5% to 13.8%. In 2014 the two groups differed by −0.2 (95% CI −1.0 to 0.5) points, an interval that includes zero; in 2022 the difference was +11.6 (95% CI 10.6 to 12.6) points. By 2024 the rate for adults 18 to 24 had fallen to 21.8% (95% CI 20.9% to 22.7%), and the difference from adults 50 to 64 was +7.4 (95% CI 6.4 to 8.4) points.

The chapter describes respondents, and every rate is an estimate for adults living in a state or the District of Columbia. The BRFSS draws a new sample each year, so it is a repeated cross-section and not a panel. The youngest adults of 2022 are not the people interviewed in 2014 at an earlier age. Rates of frequent mental distress for places, which come from modeled estimates for census tracts, belong to Chapter 5.1, Health behaviors and the supply of care. How people rate their lives and describe their days is in Chapter 7.2, Life evaluation and daily feelings, and how well-being changes over the life span is in Chapter 8.2, Well-being across the life span.

What the survey asks and how it is weighted

Respondents are asked how many of the past 30 days their mental health, which includes stress, depression and problems with emotions, was not good.[1] An answer of none counts as zero days, and a respondent who does not know or refuses is left out (1.8% of respondents). The cutoff of 14 or more days is the CDC's definition of frequent mental distress.[2] The measure is what a person says about the past month. It is not a diagnosis, and a rise in it can reflect more distress, more willingness to describe it, or both. A second item asks whether a doctor, nurse or other health professional has ever told the respondent of a depressive disorder.[1] The file has answers to both items in every year from 2014 to 2024.

The file holds 4,874,919 respondent records for 2014 to 2024, 4,790,742 of them in a state or the District of Columbia. Guam, Puerto Rico and the Virgin Islands are left out, as in Chapter 5.2, Health behaviors, person by person, so that the two BRFSS chapters describe the same adults. 4,626,736 respondents have both a valid answer to the distress question and an age group.

Every estimate is design-based. It uses the survey weights (the final weight), the strata and the sampling units of the public file, with variances from Taylor linearization,[3] and a subgroup is treated as part of the whole sample so that no cell loses the design it belongs to. Intervals are 95% intervals. The weights spread the sample unevenly: the 79,822 respondents 18 to 24 in 2022 to 2024 carry the information of 24,390 respondents with equal weights, and the intervals reflect that loss. A difference between two groups in one period accounts for the groups sharing one design. A difference between two periods combines two independent estimates, because each survey year is drawn separately.

Not every state is present in every year. In this file New Jersey is missing in 2019, Florida in 2021, and Kentucky and Pennsylvania in 2023, and CDC reports that Tennessee could not collect enough data to be included in the 2024 public file.[4] Limiting every estimate to the 46 jurisdictions (states and the District of Columbia) present in all years moves no age-by-year estimate by more than 0.5 points, so the national series is not an artifact of which states are missing. The BRFSS has used raking and included cell phone respondents since 2011, and every year in this file follows that method, so the series does not cross the 2011 change in weighting.[4]

Frequent distress was level across adult ages in 2014 and now falls with age

Figure 1 plots the rate for six age groups. In 2014 the four younger groups lay within 0.3 points of one another, from adults 18 to 24 to adults 50 to 64, while adults 65 to 74 and 75 and older were lower. By 2024 the four were spread out, from 21.8% for adults 18 to 24 to 14.4% for adults 50 to 64.

Figure 1

Frequent mental distress among adults 18 to 24 rose from 12.3% in 2014 to 25.3% in 2022, while the rate for adults 50 to 64 moved from 12.5% to 13.8%

Adults reporting 14 or more of the past 30 days with mental health not good, percent, by age group and survey year, 50 states and DC, 2014 to 2024

Adults with frequent mental distress (%)

Show data

Data for Frequent mental distress among adults 18 to 24 rose from 12.3% in 2014 to 25.3% in 2022, while the rate for adults 50 to 64 moved from 12.5% to 13.8%
age_group	conf_high	conf_low	n	rate	year
18 to 24	13.02	11.63	23,152	12.31	2014
25 to 34	13.14	12.02	41,901	12.57	2014
35 to 49	12.73	11.87	83,788	12.29	2014
50 to 64	12.89	12.19	140,980	12.53	2014
65 to 74	8.46	7.66	87,891	8.05	2014
75 and older	6.97	6.14	65,066	6.54	2014
18 to 24	13.94	12.50	23,237	13.20	2015
25 to 34	12.85	11.76	41,226	12.29	2015
35 to 49	12.83	12.01	78,275	12.41	2015
50 to 64	12.69	11.99	131,942	12.34	2015
65 to 74	8.29	7.53	85,003	7.90	2015
75 and older	7.16	6.28	62,287	6.71	2015
18 to 24	15.19	13.78	25,698	14.47	2016
25 to 34	13.36	12.34	46,871	12.84	2016
35 to 49	12.63	11.81	84,600	12.21	2016
50 to 64	12.91	12.18	141,807	12.54	2016
65 to 74	8.24	7.50	96,271	7.86	2016
75 and older	7.03	6.11	68,252	6.56	2016
18 to 24	17.36	15.73	25,372	16.53	2017
25 to 34	14.13	13.06	45,868	13.59	2017
35 to 49	13.43	12.50	79,509	12.96	2017
50 to 64	13.20	12.40	128,729	12.79	2017
65 to 74	8.99	8.11	88,940	8.54	2017
75 and older	7.44	6.35	62,621	6.88	2017
18 to 24	18.69	17.11	25,142	17.89	2018
25 to 34	15.75	14.59	45,106	15.16	2018
35 to 49	13.06	12.20	78,100	12.62	2018
50 to 64	13.19	12.39	120,693	12.78	2018
65 to 74	9.04	8.20	85,844	8.61	2018
75 and older	7.31	6.28	61,123	6.78	2018
18 to 24	21.36	19.62	24,005	20.47	2019
25 to 34	17.05	15.87	41,979	16.45	2019
35 to 49	14.12	13.20	71,943	13.65	2019
50 to 64	13.43	12.63	110,630	13.03	2019
65 to 74	9.57	8.67	83,604	9.11	2019
75 and older	7.15	6.32	62,675	6.72	2019
18 to 24	19.92	18.08	24,611	18.98	2020
25 to 34	17.37	16.05	42,467	16.70	2020
35 to 49	14.85	13.80	74,669	14.31	2020
50 to 64	13.29	12.29	104,594	12.78	2020
65 to 74	9.27	8.29	76,936	8.77	2020
75 and older	7.85	6.55	55,856	7.17	2020
18 to 24	23.54	21.71	25,110	22.61	2021
25 to 34	18.98	17.69	45,683	18.33	2021
35 to 49	15.88	14.82	83,630	15.34	2021
50 to 64	13.91	13.05	112,559	13.47	2021
65 to 74	9.48	8.46	85,976	8.96	2021
75 and older	8.55	7.39	61,800	7.95	2021
18 to 24	26.23	24.42	25,815	25.32	2022
25 to 34	20.91	19.60	45,803	20.25	2022
35 to 49	16.77	15.83	83,622	16.30	2022
50 to 64	14.19	13.33	110,334	13.75	2022
65 to 74	10.66	9.69	87,158	10.17	2022
75 and older	8.75	7.66	65,683	8.19	2022
18 to 24	24.19	22.32	25,296	23.24	2023
25 to 34	21.39	19.98	44,320	20.67	2023
35 to 49	17.38	16.27	79,779	16.82	2023
50 to 64	14.30	13.37	103,393	13.83	2023
65 to 74	9.99	8.98	86,587	9.47	2023
75 and older	8.17	7.24	70,449	7.69	2023
18 to 24	22.65	20.95	28,711	21.79	2024
25 to 34	21	19.62	48,280	20.30	2024
35 to 49	17.76	16.73	85,851	17.24	2024
50 to 64	14.89	13.94	106,111	14.41	2024
65 to 74	10.05	9.15	89,682	9.59	2024
75 and older	8.01	7.05	75,841	7.52	2024

The four younger groups start together in 2014 and fan out, with the youngest groups rising most, the youngest peaking in 2022 and falling in 2024, and the two oldest groups staying lowest. Each line plots the weighted share of respondents who reported 14 or more days of poor mental health; bands are 95% intervals and are drawn for the youngest group and for adults 50 to 64 only.Note: Respondents are adults in the 50 states and the District of Columbia. Each survey year is a new sample, not the same people followed over time, and every interval is design-based (final weight, stratum and primary sampling unit).Note: Some states are missing in some years: New Jersey in 2019, Florida in 2021, Kentucky and Pennsylvania in 2023 and Tennessee in 2024. Restricting every estimate to the 46 jurisdictions present in every year moves no age-by-year estimate by more than 0.5 points.Note: Interviews in 2020 took place during the first year of the pandemic.Source: CDC BRFSS, 2014-2024, adults in the 50 states and DC; weighted (BRFSS final weight), design-based intervals

Every group's rate was higher in 2024 than in 2014, and the rise was larger for the younger groups: 9.5 (95% CI 8.4 to 10.6) points for adults 18 to 24 and 7.7 (95% CI 6.8 to 8.6) for adults 25 to 34, against 1.9 (95% CI 1.3 to 2.5) for adults 50 to 64 and 1.0 (95% CI 0.3 to 1.6) for adults 75 and older, whose rate went from 6.5% (95% CI 6.1% to 7.0%) to 7.5% (95% CI 7.1% to 8.0%). Taken together, adults went from 11.4% (95% CI 11.2% to 11.6%) in 2014 to 15.8% (95% CI 15.5% to 16.0%) in 2022 and 15.6% (95% CI 15.3% to 15.8%) in 2024.

The path for the youngest group is not smooth. Its rate peaked in 2022 and was 3.5 (95% CI 2.3 to 4.8) points lower in 2024 than in 2022, while the rate for adults 35 to 49 was 0.9 (95% CI 0.2 to 1.6) points higher. In 2020, the first pandemic year, the rate for adults 18 to 24 was 1.5 (95% CI 0.2 to 2.8) points lower than in 2019, and no other age group has a lower rate in 2020 by an amount the survey can distinguish from zero. The data do not say why 2020 differs. Interviews that year took place under unusual conditions, and a fall in a self-reported measure could come from who answered as well as from how respondents felt.

Figure 2 tests the comparison directly, as the difference between the rate for adults 18 to 24 and the rate for adults 50 to 64 in each year. The difference was −0.2 (95% CI −1.0 to 0.5) points in 2014. The interval first lies above zero in 2015, at +0.9 (95% CI 0.1 to 1.7) points, where it only just clears zero, and it stays above zero in every later year. The difference reached +11.6 (95% CI 10.6 to 12.6) points in 2022 and narrowed to +7.4 (95% CI 6.4 to 8.4) in 2024.

Figure 2

The difference in frequent distress between adults 18 to 24 and adults 50 to 64 went from −0.2 points in 2014 to +11.6 points in 2022

Rate for adults 18 to 24 minus rate for adults 50 to 64, percentage points, design-based difference by survey year, 50 states and DC, 2014 to 2024

Difference in frequent mental distress (percentage points)

Show data

Data for The difference in frequent distress between adults 18 to 24 and adults 50 to 64 went from −0.2 points in 2014 to +11.6 points in 2022
conf_high	conf_low	gap	n	year
0.550	−1	−0.230	164,132	2014
1.67	0.070	0.870	155,179	2015
2.73	1.14	1.93	167,505	2016
4.65	2.83	3.74	154,101	2017
5.99	4.22	5.11	145,835	2018
8.40	6.49	7.45	134,635	2019
7.25	5.15	6.20	129,205	2020
10.15	8.13	9.14	137,669	2021
12.56	10.56	11.56	136,149	2022
10.45	8.36	9.41	128,689	2023
8.36	6.41	7.38	134,822	2024

The line crosses zero between 2014 and 2015, the interval only just clears zero in 2015 and stays above zero in every later year, and the difference is largest in 2022 and smaller in 2024. Each point is the weighted share for adults 18 to 24 minus the weighted share for adults 50 to 64 in that year, with a 95% interval that accounts for the two groups sharing one survey design.Source: CDC BRFSS, 2014-2024, adults in the 50 states and DC; weighted (BRFSS final weight), design-based intervals

Figure 3 shows the same change as a profile across age. In 2014 to 2016 the rate in every five-year band from the youngest through the late fifties lay between 11.7% and 13.3%, and it fell only in the sixties, to 6.4% (95% CI 6.1% to 6.7%) in the oldest band. In 2022 to 2024 the rate was 23.4% (95% CI 22.9% to 23.9%) in the youngest band, against 13.3% (95% CI 12.9% to 13.7%) in 2014 to 2016. It then falls with age, with a flat stretch through the fifties near 14.7% (95% CI 14.2% to 15.2%), to 7.1% (95% CI 6.7% to 7.5%) in the oldest band, a small distance above that band's earlier level. The profile for 2017 to 2019 lies between the other two in every band.

Figure 3

Frequent distress was close to flat from the youngest band to the late fifties in 2014 to 2016 and falls with age in 2022 to 2024

Adults reporting 14 or more of the past 30 days with mental health not good, percent, by five-year age band, three periods of three survey years, 50 states and DC

Adults with frequent mental distress (%)

Show data

Data for Frequent distress was close to flat from the youngest band to the late fifties in 2014 to 2016 and falls with age in 2022 to 2024
age_band	age_lower	conf_high	conf_low	n	period_label	rate
18 to 24	18	13.74	12.93	72,087	2014 to 2016	13.33
25 to 29	25	13.32	12.40	60,352	2014 to 2016	12.85
30 to 34	30	12.73	11.90	69,646	2014 to 2016	12.31
35 to 39	35	12.13	11.31	74,688	2014 to 2016	11.71
40 to 44	40	12.82	11.98	79,127	2014 to 2016	12.40
45 to 49	45	13.26	12.42	92,848	2014 to 2016	12.83
50 to 54	50	13.46	12.75	121,236	2014 to 2016	13.10
55 to 59	55	13.27	12.57	141,051	2014 to 2016	12.92
60 to 64	60	11.63	10.93	152,442	2014 to 2016	11.28
65 to 69	65	8.84	8.23	151,105	2014 to 2016	8.53
70 to 74	70	7.48	6.84	118,060	2014 to 2016	7.15
75 to 79	75	7.24	6.46	85,601	2014 to 2016	6.84
80 and older	80	6.72	6.07	110,004	2014 to 2016	6.39
18 to 24	18	23.95	22.91	79,822	2022 to 2024	23.43
25 to 29	25	21.84	20.66	64,452	2022 to 2024	21.24
30 to 34	30	20.25	19.18	73,951	2022 to 2024	19.71
35 to 39	35	18.24	17.23	81,594	2022 to 2024	17.73
40 to 44	40	16.99	16.02	86,224	2022 to 2024	16.50
45 to 49	45	16.64	15.50	81,434	2022 to 2024	16.06
50 to 54	50	15.19	14.23	92,862	2022 to 2024	14.71
55 to 59	55	15.20	14.23	101,915	2022 to 2024	14.71
60 to 64	60	13.16	12.35	125,061	2022 to 2024	12.75
65 to 69	65	10.44	9.68	136,072	2022 to 2024	10.05
70 to 74	70	9.82	9.01	127,355	2022 to 2024	9.41
75 to 79	75	9.04	8.22	100,143	2022 to 2024	8.62
80 and older	80	7.47	6.66	111,830	2022 to 2024	7.05
18 to 24	18	18.75	17.80	74,519	2017 to 2019	18.27
25 to 29	25	16.28	15.31	63,191	2017 to 2019	15.79
30 to 34	30	14.88	13.98	69,762	2017 to 2019	14.43
35 to 39	35	13.63	12.75	74,577	2017 to 2019	13.19
40 to 44	40	13.31	12.38	72,712	2017 to 2019	12.84
45 to 49	45	13.67	12.77	82,263	2017 to 2019	13.21
50 to 54	50	13.58	12.76	100,551	2017 to 2019	13.17
55 to 59	55	14.03	13.21	122,243	2017 to 2019	13.61
60 to 64	60	12.25	11.46	137,258	2017 to 2019	11.85
65 to 69	65	9.81	9.09	138,341	2017 to 2019	9.44
70 to 74	70	8.30	7.60	120,047	2017 to 2019	7.94
75 to 79	75	7.33	6.57	84,547	2017 to 2019	6.94
80 and older	80	7.09	6.26	101,872	2017 to 2019	6.66

The 2014 to 2016 line is nearly level through the late fifties and drops in the sixties; the 2022 to 2024 line starts at 23.4% for the youngest band and falls with age, and the 2017 to 2019 line lies between the two. Each point is the weighted share of a five-year age band, plotted at the band's lowest age, with 95% intervals; the pandemic years 2020 and 2021 are in the by-year chart only.Note: Each band is plotted at its lowest age: 18 stands for ages 18 to 24, 25 for 25 to 29, and so on, and 80 for 80 and older.Source: CDC BRFSS, 2014-2019 and 2022-2024, adults in the 50 states and DC; weighted (BRFSS final weight), design-based intervals

Two other studies bear on this. Blanchflower, Bryson and Xu report, from repeated cross-sections for the United States and the United Kingdom and from a survey of many countries, that ill-being used to peak in midlife and now declines steadily with age. Their US analysis uses the BRFSS itself, so for the United States it repeats this chapter's source and is not an independent check.[5] Twenge and colleagues used the National Survey on Drug Use and Health, a different survey and measure, and found that the share of young adults with a major depressive episode in the past year rose between 2009 and 2017; their models attributed the adult trends mainly to birth cohort, and the study does not describe an age profile like the one above.[6] A repeated cross-section like the BRFSS cannot separate age, survey year and birth cohort without extra assumptions, and this chapter makes none. It reports how the age profile of one self-reported measure looked in each period.

Women report more frequent distress than men at every age

Figure 4 shows the rate for women minus the rate for men in two periods. The difference lies above zero in every age group in both periods. The difference rose most among adults 18 to 24. In 2014 to 2016 women in that group reported 16.2% and men 10.6%, a difference of 5.5 (95% CI 4.7 to 6.3) points. In 2022 to 2024 the rates were 29.0% and 18.1%, a difference of 10.8 (95% CI 9.8 to 11.9) points, so the difference itself rose by 5.3 (95% CI 4.0 to 6.7) points. Among adults 25 to 34 the difference rose by 2.7 (95% CI 1.7 to 3.7) points, and among adults 50 to 64 it went from 4.2 (95% CI 3.8 to 4.6) to 5.2 (95% CI 4.7 to 5.8), a rise of 1.0 (95% CI 0.4 to 1.7) points.

Figure 4

Women reported frequent distress more often than men in every age group, and the gap among adults 18 to 24 rose from 5.5 to 10.8 points

Rate for women minus rate for men, percentage points, by age group, 2014 to 2016 and 2022 to 2024, 50 states and DC

2014 to 2016
2022 to 2024

Show data

Data for Women reported frequent distress more often than men in every age group, and the gap among adults 18 to 24 rose from 5.5 to 10.8 points
Age group	Women, 2014 to 2016 (%)	Men, 2014 to 2016 (%)	Gap, 2014 to 2016 (points)	Women, 2022 to 2024 (%)	Men, 2022 to 2024 (%)	Gap, 2022 to 2024 (points)	Change in the gap (points)	Change, lower limit	Change, upper limit	Respondents, 2014 to 2016	Respondents, 2022 to 2024
18 to 24	16.2	10.6	5.5	29.0	18.1	10.8	5.3	4.0	6.7	72,079	79,822
25 to 34	14.3	10.9	3.4	23.5	17.4	6.1	2.7	1.7	3.7	129,987	138,403
35 to 49	14.4	10.2	4.3	19.3	14.2	5.1	0.8	0.1	1.6	246,657	249,252
50 to 64	14.5	10.3	4.2	16.6	11.3	5.2	1.0	0.4	1.7	414,725	319,838
65 to 74	9.2	6.6	2.6	11.5	7.7	3.8	1.2	0.5	1.9	269,158	263,427
75 and older	7.3	5.6	1.7	8.7	6.5	2.3	0.5	−0.2	1.3	195,599	211,973

Every dumbbell sits to the right of zero in both periods, and the youngest group moves farthest to the right. The open dot is the 2014 to 2016 gap and the filled dot the 2022 to 2024 gap, each with a 95% interval that accounts for women and men sharing one survey design; the last column is the change in the gap.Note: The rates behind each gap, and the change in the gap with its interval, are in the data table. The two periods are different survey years, so the change in the gap combines two independent estimates.Note: The survey's sex item changed over the period: in the early questionnaires sex could be filled in at screening or recorded by the interviewer, later questionnaires ask whether the respondent is male or female at screening, and the latest add a question on sex at birth. The groups are labeled women and men as the survey codes them, so the change in a gap compares groups defined slightly differently.Source: CDC BRFSS, 2014-2016 and 2022-2024, adults in the 50 states and DC; weighted (BRFSS final weight), design-based intervals

The survey's sex item changed over these years. In the early questionnaires sex could be filled in at screening or recorded by the interviewer, later questionnaires ask whether the respondent is male or female at screening, and the latest add a question on sex at birth. The chapter calls the groups women and men as the survey codes them, so the change in a gap between 2014 to 2016 and 2022 to 2024 compares groups defined slightly differently.

The item records what respondents say, and the data do not show whether the difference between women and men reflects different experience, different willingness to report, or both. They show that the difference exists at every age and that it grew fastest where the overall rise was largest.

The rise among the youngest adults reached every sex, income and education group

Among adults 18 to 24 as a whole, the rate went from 13.3% (95% CI 12.9% to 13.7%) in 2014 to 2016 to 23.4% (95% CI 22.9% to 23.9%) in 2022 to 2024, a rise of 10.1 (95% CI 9.4 to 10.8) points. Figure 5 splits that rise by sex, household income, education and metro status. The rise has an interval above zero in each group defined by sex, household income or education.

Figure 5

Frequent distress among adults 18 to 24 rose from 13.3% to 23.4%, and rose in every group by sex, household income and education

Adults 18 to 24 reporting 14 or more of the past 30 days with mental health not good, percent, 2014 to 2016 and 2022 to 2024, by group, 50 states and DC

2014 to 2016
2022 to 2024

Show data

Data for Frequent distress among adults 18 to 24 rose from 13.3% to 23.4%, and rose in every group by sex, household income and education
Dimension	Group	2014 to 2016 (%)	2022 to 2024 (%)	Rise (points)	Rise, lower limit	Rise, upper limit	Respondents, 2014 to 2016	Respondents, 2022 to 2024
All	All adults 18 to 24	13.3	23.4	10.1	9.4	10.8	72,087	79,822
Sex	Men	10.7	18.1	7.5	6.7	8.3	37,580	45,502
Sex	Women	16.2	29.0	12.8	11.8	13.9	34,499	34,320
Household income	Under $20,000	16.9	25.7	8.8	6.8	10.9	13,932	6,442
Household income	$20,000 to $34,999	13.2	28.4	15.1	13.5	16.8	13,656	12,185
Household income	$35,000 to $49,999	11.7	24.4	12.7	10.8	14.6	7,745	9,476
Household income	$50,000 to $74,999	11.9	21.9	10.0	8.0	11.9	6,523	9,518
Household income	$75,000 or more	11.6	21.1	9.5	8.0	11.0	11,152	17,893
Education	Did not finish high school	17.3	23.8	6.5	4.2	8.9	5,549	5,785
Education	High school graduate	13.4	24.1	10.6	9.6	11.7	26,802	34,737
Education	Some college or technical school	13.3	24.4	11.1	10.0	12.3	27,183	23,430
Education	College graduate	8.9	18.6	9.7	8.4	10.9	12,255	15,515
Metro status (respondents with a code)	Center city of a metro area	12.1	16.3	4.2	−2.1	10.5	4,713	295
Metro status (respondents with a code)	Outside the center city, in its county	15.1	25.6	10.5	−5.4	26.5	2,311	103
Metro status (respondents with a code)	Suburban county of a metro area	12.3	19.6	7.2	−2.5	16.9	1,592	160
Metro status (respondents with a code)	Not in a metro area	13.4	22.9	9.5	1.2	17.8	3,958	384

In every row the 2022 to 2024 dot is to the right of the 2014 to 2016 dot, and the interval for the rise clears zero in every row except the metro-status rows, where it clears zero in one of the four. The open dot is 2014 to 2016 and the filled dot 2022 to 2024, each with a 95% interval; the last column is the rise in points. The rise is larger for women than for men and larger in the second household income bracket than in the lowest, and the metro-status rows have wide intervals because few respondents carry a metro code in recent years.Note: Respondents are adults in the 50 states and the District of Columbia. Each survey year is a new sample, not the same people followed over time, and every interval is design-based (final weight, stratum and primary sampling unit).Note: Household income brackets are in current dollars and are not adjusted for prices. Education is the highest level completed, so adults 18 to 24 are at different stages of schooling. Household income and education are missing for some respondents, who are left out of those rows.Note: Metro status is coded for only part of the respondents, and the share falls over time: 38.7% of adults in 2014 to 2016 and 11.4% in 2022 to 2024. The recent metro-status rows rest on 103 to 384 respondents each.Source: CDC BRFSS, 2014-2016 and 2022-2024, adults in the 50 states and DC; weighted (BRFSS final weight), design-based intervals

Women rose by 12.8 (95% CI 11.8 to 13.9) points and men by 7.5 (95% CI 6.7 to 8.3) points, and the rise for women exceeded the rise for men by 5.3 (95% CI 4.0 to 6.7) points. By household income the second bracket rose by 15.1 (95% CI 13.5 to 16.8) points and the lowest by 8.8 (95% CI 6.8 to 10.9), and the second bracket's rise exceeded the lowest bracket's by 6.3 (95% CI 3.7 to 9.0) points. The top bracket, $75,000 or more, rose by 9.5 (95% CI 8.0 to 11.0) points, and its rise differs from the lowest bracket's by 0.7 (95% CI −1.8 to 3.2) points, an interval that includes zero. The differences among the other brackets are not tested here. In 2022 to 2024, young adults in households at the top bracket reported 21.1% (95% CI 20.0% to 22.2%), a higher rate than young adults in households below $20,000 had reported in 2014 to 2016, 16.9% (95% CI 16.0% to 17.9%). Household income counts everyone in the household, so for an adult living with parents it describes the parents' means more than the respondent's own.

By education, college graduates went from 8.9% (95% CI 8.3% to 9.7%) to 18.6% (95% CI 17.6% to 19.6%), a rise of 9.7 (95% CI 8.4 to 10.9) points, and respondents who had not finished high school went from 17.3% (95% CI 15.9% to 18.8%) to 23.8% (95% CI 22.0% to 25.7%), a rise of 6.5 (95% CI 4.2 to 8.9) points. Education is the highest level completed, and many adults 18 to 24 are still in school, so these groups describe where respondents are in their schooling as much as their attainment.

The survey cannot say much about metro status. The BRFSS codes it for only part of the respondents, and the share falls from 38.7% of adults in 2014 to 2016 to 11.4% in 2022 to 2024. The recent metro-status groups of adults 18 to 24 hold 103 to 384 respondents each, and the intervals for their rises are between 12.6 and 31.9 points wide. The interval lies above zero for one of the four. The respondents with a metro code had a rate of 20.6% (95% CI 16.2% to 25.9%) in 2022 to 2024, and the interval includes the 23.4% for all adults 18 to 24, so the data show no clear difference between them and the rest, though the interval is too wide to rule one out. The data support no ranking of center cities, suburbs and areas outside metro areas, and they do not rule out differences among them.

Causal evidenceStaggered difference-in-differences across colleges (natural experiment)

Social media and the mental health of college students

The BRFSS comparisons above have no before and after for any respondent and no comparison group that changed for a known reason, so they cannot say why distress rose. One study that does have such a design is by Braghieri, Levy and Makarin. Facebook was introduced at US colleges in stages between 2004 and 2006, so students at colleges that received it earlier can be compared before and after with students at colleges that received it later. Using survey data on student mental health, the authors found that the introduction of Facebook at a college worsened student mental health and raised the likelihood that students reported poor mental health impairing their academic performance.[7]

The result applies to college students in the first years of one platform. It does not cover the platforms, the age groups, the years or the pandemic that mark the 2014 to 2024 changes above, and it does not test the BRFSS rise.

Household income separates middle-aged adults more than the youngest adults

Figure 6 crosses age group with household income in 2022 to 2024. Among adults 50 to 64, 31.7% (95% CI 30.5% to 32.9%) in the lowest income bracket reported frequent distress against 8.0% (95% CI 7.7% to 8.3%) in the top bracket, a difference of 23.7 (95% CI 22.5 to 24.9) points. Among adults 18 to 24 the rates were 25.7% (95% CI 24.0% to 27.6%) and 21.1% (95% CI 20.0% to 22.2%), a difference of 4.7 (95% CI 2.6 to 6.8) points. The highest cell in the grid, 32.9% (95% CI 31.3% to 34.5%), is for adults 35 to 49 in the lowest bracket, and its interval overlaps that of adults 50 to 64 in the same bracket, 31.7% (95% CI 30.5% to 32.9%). The cell for the youngest adults in that bracket is lower than both.

Figure 6

Frequent distress among adults 18 to 24 was 25.7% in the lowest household income bracket and 21.1% in the top, against 31.7% and 8.0% among adults 50 to 64

Adults reporting 14 or more of the past 30 days with mental health not good, percent, by age group and annual household income, 2022 to 2024, 50 states and DC

0.035.0

Heat map with six age groups as rows and five household income brackets as columns, each cell showing the share of adults with frequent mental distress. In the row for adults 18 to 24 the values vary less across brackets than in the rows for adults 35 to 49 and 50 to 64, where they fall steeply from the lowest to the top bracket. The rows for older adults are lower throughout.
Age6	Under $20,000	$20,000 to $34,999	$35,000 to $49,999	$50,000 to $74,999	$75,000 or more
18 to 24	25.7, interval 24.0 to 27.6, n = 6,442	28.4, interval 27.0 to 29.8, n = 12,185	24.4, interval 22.9 to 25.9, n = 9,476	21.9, interval 20.5 to 23.4, n = 9,518	21.1, interval 20.0 to 22.2, n = 17,893
25 to 34	27.1, interval 25.4 to 28.7, n = 9,188	25.1, interval 24.0 to 26.3, n = 18,236	24.6, interval 23.4 to 25.9, n = 16,326	22.4, interval 21.3 to 23.5, n = 21,228	15.6, interval 15.0 to 16.2, n = 51,332
35 to 49	32.9, interval 31.4 to 34.5, n = 16,152	22.6, interval 21.7 to 23.6, n = 26,204	20.8, interval 19.8 to 21.9, n = 21,544	18.5, interval 17.6 to 19.4, n = 29,848	11.9, interval 11.6 to 12.3, n = 121,548
50 to 64	31.7, interval 30.5 to 32.9, n = 27,662	22.1, interval 21.1 to 23.0, n = 36,505	15.8, interval 14.9 to 16.7, n = 27,226	13.3, interval 12.5 to 14.1, n = 39,413	8.0, interval 7.7 to 8.3, n = 137,852
65 to 74	18.3, interval 17.0 to 19.7, n = 19,938	13.4, interval 12.7 to 14.2, n = 39,906	10.9, interval 10.1 to 11.8, n = 32,992	7.9, interval 7.3 to 8.5, n = 41,346	5.4, interval 5.0 to 5.8, n = 76,414
75 and older	13.5, interval 12.2 to 15.0, n = 13,098	10.0, interval 9.2 to 10.8, n = 37,533	7.1, interval 6.5 to 7.8, n = 29,842	6.7, interval 6.1 to 7.3, n = 30,253	5.4, interval 4.9 to 5.9, n = 44,963

Show data

Data for Frequent distress among adults 18 to 24 was 25.7% in the lowest household income bracket and 21.1% in the top, against 31.7% and 8.0% among adults 50 to 64
age6	conf_high	conf_low	inc5	n	rate
18 to 24	29.81	27	$20,000 to $34,999	12,185	28.38
18 to 24	25.88	22.88	$35,000 to $49,999	9,476	24.35
18 to 24	23.37	20.46	$50,000 to $74,999	9,518	21.88
18 to 24	22.17	19.99	$75,000 or more	17,893	21.06
18 to 24	27.58	23.98	Under $20,000	6,442	25.74
25 to 34	26.30	24.02	$20,000 to $34,999	18,236	25.14
25 to 34	25.85	23.44	$35,000 to $49,999	16,326	24.62
25 to 34	23.53	21.29	$50,000 to $74,999	21,228	22.39
25 to 34	16.19	15.01	$75,000 or more	51,332	15.59
25 to 34	28.73	25.44	Under $20,000	9,188	27.05
35 to 49	23.57	21.66	$20,000 to $34,999	26,204	22.60
35 to 49	21.89	19.80	$35,000 to $49,999	21,544	20.83
35 to 49	19.39	17.64	$50,000 to $74,999	29,848	18.50
35 to 49	12.30	11.56	$75,000 or more	121,548	11.92
35 to 49	34.52	31.35	Under $20,000	16,152	32.91
50 to 64	23.03	21.14	$20,000 to $34,999	36,505	22.07
50 to 64	16.73	14.87	$35,000 to $49,999	27,226	15.78
50 to 64	14.06	12.52	$50,000 to $74,999	39,413	13.27
50 to 64	8.32	7.71	$75,000 or more	137,852	8.01
50 to 64	32.89	30.54	Under $20,000	27,662	31.71
65 to 74	14.15	12.66	$20,000 to $34,999	39,906	13.39
65 to 74	11.76	10.13	$35,000 to $49,999	32,992	10.92
65 to 74	8.49	7.33	$50,000 to $74,999	41,346	7.89
65 to 74	5.79	4.97	$75,000 or more	76,414	5.36
65 to 74	19.73	17.02	Under $20,000	19,938	18.33
75 and older	10.84	9.24	$20,000 to $34,999	37,533	10.01
75 and older	7.80	6.50	$35,000 to $49,999	29,842	7.12
75 and older	7.32	6.12	$50,000 to $74,999	30,253	6.69
75 and older	5.92	4.88	$75,000 or more	44,963	5.37
75 and older	15	12.16	Under $20,000	13,098	13.52

Cells in the row for adults 18 to 24 vary less across the five brackets than cells in the rows for adults 35 to 49 and 50 to 64, which run from the high end of the key in the lowest bracket to the low end in the top bracket. Each cell is the weighted share for one age group and household income bracket, with its value printed; adults who did not report household income are left out.Note: In 2022 to 2024 household income is missing for 22.1% of adults and 32.8% of adults 18 to 24; brackets are in current dollars.Source: CDC BRFSS, 2022-2024, adults in the 50 states and DC; weighted (BRFSS final weight), design-based intervals

The age pattern therefore depends on income. In the top bracket, adults 18 to 24 exceeded adults 50 to 64 by +13.0 (95% CI 11.9 to 14.2) points, and they were also higher in the three brackets between the top and the lowest. In the lowest bracket the sign reversed, at −6.0 (95% CI −8.1 to −3.8) points, so the youngest adults reported less frequent distress than adults 50 to 64 in households of the same bracket. Across all ages, the lowest bracket reported 26.9% (95% CI 26.3% to 27.6%) and the top bracket 11.1% (95% CI 10.9% to 11.3%). The difference between the lowest and the top bracket rises across the younger age groups, from 4.7 points for adults 18 to 24 to 11.5 (95% CI 9.7 to 13.2) for adults 25 to 34 and 21.0 (95% CI 19.4 to 22.6) for adults 35 to 49, is similar for adults 50 to 64, and is smaller among adults 65 to 74 and 75 and older. For a respondent who lives with parents, household income describes the parents' means.

In 2022 to 2024 household income is missing for 22.1% of adults and 32.8% of adults 18 to 24. Adults who did not report it had a rate of 14.9% (95% CI 14.6% to 15.2%) in those years, against 15.8% (95% CI 15.7% to 16.0%) for those who did, so leaving them out does not hide a group with higher rates. The brackets are in current dollars, so rising prices move households across them over the period.

Current distress and a depression diagnosis

A rise in a self-reported item may partly reflect how people answer, which a more concrete item can help to check. Figure 7 sets frequent distress beside whether a health professional has ever told the respondent of a depressive disorder. The diagnosis share is higher than the distress share at every age in both periods. In 2022 to 2024 the diagnosis share for adults 18 to 24 was 25.6% (95% CI 25.1% to 26.1%) against 23.4% with frequent distress. Among respondents who answered both items the difference was 2.4 (95% CI 1.8 to 3.0) points, a little different from the difference of the two shares because each share covers everyone who answered that item. It was 2.8 (95% CI 2.3 to 3.3) points in the oldest band and larger in between, for example 7.6 (95% CI 7.1 to 8.1) points at ages 65 to 69, so the two measures are closest at the youngest and oldest ages. For adults 18 to 24 the difference was 2.2 (95% CI 1.7 to 2.7) points in 2014 to 2016.

Figure 7

In 2022 to 2024 the share of adults 18 to 24 ever told of depression was 25.6%, close to the 23.4% with frequent distress now

Adults with frequent mental distress and adults ever told by a health professional of a depressive disorder, percent, by five-year age band, 50 states and DC

Show data

Data for In 2022 to 2024 the share of adults 18 to 24 ever told of depression was 25.6%, close to the 23.4% with frequent distress now
age_band	age_lower	conf_high	conf_low	measure	n	period_label	rate
18 to 24	18	13.74	12.93	Frequent mental distress now	72,087	2014 to 2016	13.33
18 to 24	18	15.96	15.13	Ever told of a depressive disorder	72,503	2014 to 2016	15.54
25 to 29	25	13.32	12.40	Frequent mental distress now	60,352	2014 to 2016	12.85
25 to 29	25	17.21	16.23	Ever told of a depressive disorder	60,803	2014 to 2016	16.72
30 to 34	30	12.73	11.90	Frequent mental distress now	69,646	2014 to 2016	12.31
30 to 34	30	17.95	17.03	Ever told of a depressive disorder	70,162	2014 to 2016	17.49
35 to 39	35	12.13	11.31	Frequent mental distress now	74,688	2014 to 2016	11.71
35 to 39	35	17.47	16.56	Ever told of a depressive disorder	75,282	2014 to 2016	17.01
40 to 44	40	12.82	11.98	Frequent mental distress now	79,127	2014 to 2016	12.40
40 to 44	40	18.27	17.35	Ever told of a depressive disorder	79,754	2014 to 2016	17.81
45 to 49	45	13.26	12.42	Frequent mental distress now	92,848	2014 to 2016	12.83
45 to 49	45	19.12	18.22	Ever told of a depressive disorder	93,627	2014 to 2016	18.67
50 to 54	50	13.46	12.75	Frequent mental distress now	121,236	2014 to 2016	13.10
50 to 54	50	20.13	19.30	Ever told of a depressive disorder	122,414	2014 to 2016	19.71
55 to 59	55	13.27	12.57	Frequent mental distress now	141,051	2014 to 2016	12.92
55 to 59	55	21.61	20.78	Ever told of a depressive disorder	142,659	2014 to 2016	21.19
60 to 64	60	11.63	10.93	Frequent mental distress now	152,442	2014 to 2016	11.28
60 to 64	60	20.78	19.99	Ever told of a depressive disorder	154,204	2014 to 2016	20.38
65 to 69	65	8.84	8.23	Frequent mental distress now	151,105	2014 to 2016	8.53
65 to 69	65	18.54	17.75	Ever told of a depressive disorder	152,844	2014 to 2016	18.14
70 to 74	70	7.48	6.84	Frequent mental distress now	118,060	2014 to 2016	7.15
70 to 74	70	15.42	14.61	Ever told of a depressive disorder	119,817	2014 to 2016	15.01
75 to 79	75	7.24	6.46	Frequent mental distress now	85,601	2014 to 2016	6.84
75 to 79	75	13.09	12.17	Ever told of a depressive disorder	87,307	2014 to 2016	12.62
80 and older	80	6.72	6.07	Frequent mental distress now	110,004	2014 to 2016	6.39
80 and older	80	10.73	9.96	Ever told of a depressive disorder	113,372	2014 to 2016	10.34
18 to 24	18	23.95	22.91	Frequent mental distress now	79,822	2022 to 2024	23.43
18 to 24	18	26.13	25.07	Ever told of a depressive disorder	80,455	2022 to 2024	25.60
25 to 29	25	21.84	20.66	Frequent mental distress now	64,452	2022 to 2024	21.24
25 to 29	25	25.95	24.73	Ever told of a depressive disorder	65,019	2022 to 2024	25.34
30 to 34	30	20.25	19.18	Frequent mental distress now	73,951	2022 to 2024	19.71
30 to 34	30	25.48	24.36	Ever told of a depressive disorder	74,693	2022 to 2024	24.92
35 to 39	35	18.24	17.23	Frequent mental distress now	81,594	2022 to 2024	17.73
35 to 39	35	23.36	22.28	Ever told of a depressive disorder	82,379	2022 to 2024	22.81
40 to 44	40	16.99	16.02	Frequent mental distress now	86,224	2022 to 2024	16.50
40 to 44	40	21.83	20.81	Ever told of a depressive disorder	87,077	2022 to 2024	21.32
45 to 49	45	16.64	15.50	Frequent mental distress now	81,434	2022 to 2024	16.06
45 to 49	45	21.70	20.52	Ever told of a depressive disorder	82,305	2022 to 2024	21.11
50 to 54	50	15.19	14.23	Frequent mental distress now	92,862	2022 to 2024	14.71
50 to 54	50	20.82	19.77	Ever told of a depressive disorder	93,866	2022 to 2024	20.29
55 to 59	55	15.20	14.23	Frequent mental distress now	101,915	2022 to 2024	14.71
55 to 59	55	21.23	20.18	Ever told of a depressive disorder	103,090	2022 to 2024	20.70
60 to 64	60	13.16	12.35	Frequent mental distress now	125,061	2022 to 2024	12.75
60 to 64	60	20.15	19.22	Ever told of a depressive disorder	126,705	2022 to 2024	19.68
65 to 69	65	10.44	9.68	Frequent mental distress now	136,072	2022 to 2024	10.05
65 to 69	65	18.27	17.35	Ever told of a depressive disorder	137,909	2022 to 2024	17.80
70 to 74	70	9.82	9.01	Frequent mental distress now	127,355	2022 to 2024	9.41
70 to 74	70	17.11	16.14	Ever told of a depressive disorder	129,175	2022 to 2024	16.62
75 to 79	75	9.04	8.22	Frequent mental distress now	100,143	2022 to 2024	8.62
75 to 79	75	14.81	13.86	Ever told of a depressive disorder	101,808	2022 to 2024	14.33
80 and older	80	7.47	6.66	Frequent mental distress now	111,830	2022 to 2024	7.05
80 and older	80	10.50	9.59	Ever told of a depressive disorder	114,825	2022 to 2024	10.04

The diagnosis line is above the distress line at every age, and the two are closest in the youngest and oldest bands. Each line is plotted at the band's lowest age, with 95% intervals; the buttons switch between 2022 to 2024 and 2014 to 2016.Note: The diagnosis question asks whether a doctor, nurse or other health professional ever told the respondent of a depressive disorder, so it depends on contact with care as well as on symptoms.Note: The lines plot the share answering each item. The difference between them quoted in the text is a paired difference among respondents who answered both items, so it can differ slightly from the difference of the two plotted shares.Source: CDC BRFSS, 2014-2016 and 2022-2024, adults in the 50 states and DC; weighted (BRFSS final weight), design-based intervals

The diagnosis share for the youngest adults rose by 10.1 (95% CI 9.4 to 10.7) points between 2014 to 2016 and 2022 to 2024, close to the 10.1 points by which frequent distress rose. The shape across age changed as well. In 2014 to 2016 the diagnosis share rose with age from 15.5% (95% CI 15.1% to 16.0%) among the youngest adults to 21.2% (95% CI 20.8% to 21.6%) at ages 55 to 59, as an accumulating count of lifetime diagnoses would. In 2022 to 2024 it was 25.6% among the youngest and 20.7% (95% CI 20.2% to 21.2%) at ages 55 to 59, so the youngest adults now have a diagnosis share among the highest of any age band. The difference from adults 25 to 29 is +0.3 (95% CI −0.5 to 1.1) points and from adults 30 to 34 +0.7 (95% CI −0.1 to 1.5) points, neither distinguishable from zero, and the youngest adults exceed every band from the late thirties upward.

A diagnosis depends on contact with care, which differs by age, insurance and period, so the second measure is not a cleaner gauge of illness. It does show that the change is not confined to one survey question, because a different item with a different time frame moves in the same direction for the same adults.

What these data cannot show

The BRFSS is a repeated cross-section. The youngest adults in 2022 are a different set of people from those in 2014, and the data cannot separate age, survey year and birth cohort. They also cannot say whether a fall from 2022 to 2024 will continue.

Frequent mental distress is self-reported. It reflects how respondents experience the past month and how willing they are to say so, and willingness may have changed more among the young than among the old. The BRFSS reaches adults who live in households and answer a telephone call, so it misses people in hospitals, prisons and other institutions and people without a stable phone, and nonresponse can change over time in ways the weights may not fully correct. The state of residence is known and no smaller area is, so nothing here describes a neighborhood or a county.

Several comparisons rest on thin or imperfect measures. Household income is missing for a large part of the youngest adults and describes a household, not the respondent. Education among adults 18 to 24 is unfinished. Metro status is coded for a shrinking part of the sample, and the sex item changed wording over the period. The 2020 and 2021 interviews took place during the pandemic and are shown by year but left out of the three periods. Some states are absent in some years. Intervals describe sampling variation under the survey design and do not carry any bias from nonresponse or measurement.

The chapter makes no causal claim outside the study in the box above. Differences between groups, such as the difference between women and men or between income brackets, are patterns in who reports distress, and the data do not identify what produces them.

Data sources

BRFSSBRFSS public-use microdata, 2014-2024: days of poor mental health (core item, all years), ever told of a depressive disorder (core item, all years), age, sex, household income, education and metro status; adults in the 50 states and DCYears: 2014-2024 · Weights: design-based: final weight, stratum and primary sampling unit · License: Public domain (CDC)

All data sources

Methods

These estimates compare adults in the 2014 to 2024 BRFSS public-use files on frequent mental distress and on ever having been told of a depressive disorder, by age, sex, household income, education and metro status, in three periods: 2014 to 2016, 2017 to 2019 and 2022 to 2024. Every estimate is design-based, using the final weight, the stratum and the primary sampling unit, and the survey is a repeated cross-section: each year draws new respondents and nobody is followed. Some state-years have no respondents in the public files, metro status is missing for most respondents in recent years, and the sex item changed over the period, so comparisons of women and men between 2014 to 2016 and 2022 to 2024 compare groups defined slightly differently.

Who is in the sample and which years are covered

Respondents are adults in the 50 states and the District of Columbia in the 2014 to 2024 BRFSS public-use files; Guam, Puerto Rico and the Virgin Islands are excluded, as in the chapter Health behaviors, person by person. Both questions were asked in every year.

The three periods are 2014 to 2016, 2017 to 2019 and 2022 to 2024, which leaves out the pandemic years 2020 and 2021. Every cell has at least 30 respondents.

New Jersey in 2019, Florida in 2021, Kentucky and Pennsylvania in 2023 and Tennessee in 2024 have no respondents in the public files; estimates limited to the states present in every year are within the margin stated in the text.

The survey is a repeated cross-section: each year draws new respondents and nobody is followed.

Figure explained here: Figure 1

How the measures and groups are defined

Frequent mental distress is 14 or more of the past 30 days with mental health not good (88 means none and counts as 0 days; 77 and 99 are missing). A depression diagnosis is a yes to having ever been told by a doctor, nurse or other health professional of a depressive disorder (7 and 9 are missing).

Age groups are built from the five-year BRFSS age categories; household income is collapsed into five brackets (under $20,000, $20,000 to $34,999, $35,000 to $49,999, $50,000 to $74,999 and $75,000 or more, in current dollars) and education into four; metro status is the BRFSS code (center city, outside the center city in its county, suburban county, not in a metro area), which is missing for most respondents in recent years.

The share of adults with no valid household income is for 2022 to 2024.

The difference between the diagnosis share and the distress share is a paired difference among respondents who answered both items.

Figures explained here: Figure 7 and Figure 6

How the sex item changed

The sex item changed over the period: in the early questionnaires sex could be filled in at screening or recorded by the interviewer, later questionnaires ask whether the respondent is male or female at screening, and the latest add a question on sex at birth; the chapter's women and men are the survey's sex variable, coded male and female, so comparisons between 2014 to 2016 and 2022 to 2024 compare groups defined slightly differently.

Figure explained here: Figure 4

How the survey weights and design enter the estimates

Every estimate is design-based: the final weight, the stratum and the primary sampling unit (each respondent is its own unit in the public file), with strata specific to a state and year and strata that hold one unit merged with the next stratum in the same state and year.

A subgroup is a domain of the whole design, so every cell keeps the strata and units of the full survey.

BRFSS has used raking and included cell phone respondents since 2011, so all years in the file use one weighting method.

How uncertainty and differences are computed

Variances come from Taylor linearization and intervals are 95% intervals on the design degrees of freedom, logit intervals for shares and normal intervals for differences.

A difference between two groups in one period uses a linearized difference with a shared design; a difference between two periods combines two independent estimates, because survey years are drawn separately, and the change in a gap is the difference of two such differences.

Figures explained here: Figure 2 and Figure 5

References

Centers for Disease Control and Prevention, Disability and Health Data System (2025). Data Guides: Mental and Emotional Health. CDC Disability and Health Data System web page, last reviewed April 3, 2025. www.cdc.gov/dhds/data-guides/mental-and-emotional-health.html
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Binder, David A. (1983). On the variances of asymptotically normal estimators from complex surveys. International Statistical Review 51(3): 279-292. doi:10.2307/1402588
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How to cite

@misc{singh2026mentaldistressinyoungadults,
  author = {Singh, Vishal},
  title = {Mental distress in young adults},
  year = {2026},
  url = {https://vishalsingh.org/zipcode/mental-distress-in-young-adults},
  note = {In ZIP Code Destiny. Published 9 October 2026.}
}

Same question at another grain

These chapters take up the same axis with a different unit of analysis.

Age and well-being
- Chapter 8.2, Well-being across the life span Individuals