Temporal Differences and Trends in General Health Associated with Anxiety/Depression Symptoms among Hispanics/Latinos

Temporal Differences and Trends in General Health Associated with Anxiety/Depression Symptoms among Hispanics/Latinos | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Temporal Differences and Trends in General Health Associated with Anxiety/Depression Symptoms among Hispanics/Latinos Lohuwa Mamudu, Jorge L. Rodriguez, Erasmus Tetteh-Bator, Joshua Yang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8637874/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background General health has been linked with anxiety/depression symptoms in the general population, but there is limited information on Hispanic/Latino populations, who are the fastest-growing ethnic minority group. We investigated the temporal trend, disparities, and the association between general health and anxiety/depression symptoms among Hispanics/Latinos in the US. Methods A weighted retrospective cross-sectional national population-based data from the Health Information National Trends Survey (2011–2012, 2014, 2017–2019, and 2022) involving 1,927 Hispanics/Latinos aged ≥ 18 years was analyzed. Semi-elastic annual average percentage change (AAPC), bivariate Chi-square, and multivariate logistic regression were conducted to examine the prevalence trends, differences, and odds of anxiety/depression symptoms with general health, adjusting for sociodemographic, socioeconomic, and behavioral health factors. Results Among Hispanics/Latinos, the overall prevalence of anxiety/depression symptoms was 51.8% and 75.3% among those with fair/poor general health. There was an increasing relative risk of severity of anxiety/depression symptoms among Hispanics/Latinos with fair/poor general health. There was a 23.5% increase and 6.0% decrease in AAPC of anxiety/depression among Hispanics/Latinos with excellent/very good/good and fair/poor general health, respectively, across the survey years. Additionally, Hispanics/Latinos with fair/poor general health had higher odds of anxiety/depression symptoms than those with excellent/very good/good general health, after adjusting for the sociodemographic (AOR = 3.95, 95% CI = 2.76–5.64), socioeconomic (AOR = 3.56, 95% CI = 2.46–5.15), and behavioral health risk factors (AOR = 3.66, 95% CI = 2.47–5.44), respectively. Conclusion Our study shows Hispanics/Latinos with fair/poor general health are at a higher risk of experiencing anxiety/depression symptoms. We recommend additional research to better understand specific disease/health conditions that disproportionately contribute to anxiety/depression symptoms among Hispanics/Latinos. Depression Anxiety Hispanics/Latinos General Health Status Mental Health Figures Figure 1 Figure 2 Figure 3 1. Introduction Despite the Hispanic/Latino population expanding at a substantially faster rate in the United States (US), their mental health and its risk factors are not well understood 1 . The Hispanic/Latino population was 63.7 million individuals in 2022, making up around 19% of the total US population 2 . The total population of Hispanics/Latinos in the US is projected to be 110 million by 2060, accounting for 28% of the total US population 3 . As of 2021, 20.7% of the Hispanic population was reported to have some kind of mental illness 4 . About 6.8% of Hispanics in the US reported experiencing a major depressive episode in 2019, representing an estimated prevalence rate of 4.1 million Hispanics suffering from mental illness annually 5 . In the same year, 14.5% of Hispanics were reported to experience mild to severe anxiety symptoms by the National Center for Health Statistics, compared to non-Hispanic White (16.5%) and Asian (8.5%) adults 6 . Thus, it is important to identify potential risk factors for mental illness, including anxiety/depression symptoms, to support mental health prevention and intervention efforts in Hispanic/Latino communities. The perceived general health of individuals can influence their mental health status, such as depression 7 – 11 . Hispanics have been reported to have higher odds of fair/poor health and serious depression in a study that assessed monthly trends and disparities by race, ethnicity, and socioeconomic status during the COVID-19 pandemic 12 . Studies, including meta-analysis, reported a strong association between depressive symptoms and poor general health status 8 , 10 , 11 . A national study among US adults aged 50 and older reported a strong association between poor perceived mental health and poor/fair health status 13 . Additionally, a study among Mexican American adults reported that poorer general health status was associated with depression 14 . However, none of these studies evaluated these associations in a nationally representative sample of Hispanic/Latino population in the US. Also, although there are studies on the trends and disparities in anxiety and depression across multiple racial groups, no study has specifically focused on Hispanics/Latinos. For instance, studies have reported an increase and disparities in the prevalence trend of anxiety 15 and depression 16 among all races and sexes. Other factors, including sociodemographic and socioeconomic characteristics, and health behaviors, have also been associated with depression/anxiety. A study investigating the distributions of depressive symptoms by gender reported that females have higher depressive symptoms than males 17 . Younger adults and those with low income and educational levels were more at risk for depression symptoms 18 , 19 . Health behavior factors such as body mass index (BMI), in particular obesity, was reported to have a significant association with depression and anxiety 20 . Moreover, the prevalence of depression has been reported to be increasing with widening disparities in the US 21,22 . It is imperative to also assess within-race-specific prevalence trends of anxiety/depression symptoms for improved mental health interventions. Although previous studies have assessed general health influence on mental health, the link between general health and anxiety/depression symptoms among the US Hispanic/Latino populations is understudied and less understood. The present study aims to assess the temporal trends and associations between general health and anxiety/depression symptoms among Hispanics/Latinos in the US. Specifically, this study aims to: (1) estimate the relative risk of anxiety/depression symptoms by general health status among the Hispanic/Latino populations, (2) assess the prevalence and difference in anxiety/depression symptoms by general health status in the Hispanic/Latino population, adjusting for sociodemographic and socioeconomic characteristics, and health behaviors, (3) examine the temporal trend and annual average percent change of anxiety/depression symptoms over time among Hispanic/Latino population based on general health status, adjusting for sociodemographic and socioeconomic characteristics, and health behaviors, and (4) evaluate the odds of anxiety/depression symptoms among the Hispanic/Latino populations. We hypothesize that Hispanics/Latinos will experience an increasing prevalence of anxiety/depression symptoms, and those who reported having fair/poor general health are more likely to experience anxiety/depression symptoms. This study provides a better understanding of the complexities between general health status and anxiety/depression symptoms among the Hispanic/Latino population, which is essential for tailored and effective interventions toward mitigating the impact of mental health disorders, hence, improving the health and quality of life of the Hispanic/Latino populations. 2. Methodology 2.0 Study Design and Data Source This study utilized publicly available de-identified, nationally representative, population-based retrospective cross-sectional data from the Health Information National Survey (HINTS) of US adults aged 18 years and older. As such, an Institutional Review Board approval was not required to access the data for this study. The survey measures health-related determinants and outcomes, including sociodemographic, socioeconomic, behavioral health, and mental health factors. We aggregated and utilized seven HINTS datasets in this study: 2011–2012 and 2014 (from HINTS 4 Cycles 1–2, 4), 2017–2019 (from HINTS 5 Cycles 1–3), and 2022 (from HINTS 6). Datasets from 2013 (HINTS 4 Cycle 3), 2015 (HINTS FDA), and 2017 (HINTS FDA Cycle 2) were excluded due to missing anxiety/depression variable, 2020 (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 (HINTS SEER) was excluded in this study as it is not publicly available. 2.1 Sampling Study Participants The total participants included 17,923 adults who completed any of the seven surveys (HINTS 4 Cycle 1, October 2011 through February 2012 [n = 2,591]; Cycle 2, October 2012 through January 2013 [n = 2,233]; Cycle 4, August 2014 through November 2014 [n = 2,287]; HINTS 5 Cycle 1, January 2017 through May 2017 [n = 2,162]; Cycle 2, January 2018 through May 2018 [n = 2,283]; Cycle 3, January 2019 through April 2019 [n = 3,771]; HINTS 6, March 2022 through November 2022 [n = 2,596]). Participants in this study are individuals who self-reported or identified as Hispanic/Latino. The total sample included 1,927 Hispanic/Latino adults in the six surveys (HINTS4 Cycle 1 [n = 267, 17.8%], Cycle 2 [n = 197, 11.2%], Cycle 4 [n = 193, 11.9%]; HINTS5 Cycle 1 [n = 132, 10.8%], Cycle 2 [n = 137, 9.0%], Cycle 3 [n = 275, 13.7%]; HINTS 6 [n = 726, 25.4%]). 2.2 Measures 2.2.0 Outcome/Dependent Variable: Anxiety/Depression Symptoms The dependent variable in this study is anxiety/depression symptoms measured using the Patient Health Questionnaire-4 (PHQ4). The PHQ4 has been used as a screening tool for anxiety/depression symptoms. It is comprised of a screening tool for depression (PHQ-2) and generalized anxiety disorder (GAD-2). The first two questions measure the level of anxiety (GAD-2), and the last two measure the depression level (PHQ-2). Having a GAD-2 score ≥ 3 suggests anxiety, and a PHQ-2 score ≥ 3 suggests depression. Participants were asked the following four questions based on the PHQ4: “Over the past 2 weeks, how often have you been bothered by” little interest, hopeless, nervous, and worrying. Overall, the PHQ4 score ranges from 0–12, often categorized as none (0–2), mild (3–5), moderate (6–8), and severe (9–12) anxiety/depression symptoms 23 – 25 . We recategorized the PHQ-4 scores as no anxiety/depression symptoms (none) with scores ≤ 2 and anxiety/depression symptoms (mild, moderate, and severe) with scores > 2 23 . 2.2.1 Independent Variable: General Health The primary independent variable of interest in this study is general health. HINTS survey asked participants: “In general, would you say your health is?” and provided the answer choices of excellent, very good, good, fair, and poor. General health was dichotomized as excellent/very good/good and fair/poor 26 . 2.2.2 Covariate Other variables/covariates included sociodemographic, socioeconomic, and behavioral health factors. The sociodemographic factors included sex at birth (male or female), age (18–25, 26–34, 35–49, 50–64, or 65+), marital status (married/living as married, divorced, widowed, separated, or single/never married), and census region (Northeast, Midwest, South, or West). Socioeconomic factors included annual family income (< $ 20,000, $ 20,000- $ 34,999, $ 35,000- $ 49,999, $ 50,000- $ 74,999, or ≥ $ 75,000), healthcare coverage (yes or no), self-perceived quality healthcare (excellent, very good, good, fair, or poor; recategorized as excellent/very good/good or fair/poor), and education (less than high school, 12 years or completed high school, some college or post high school training other than college, or college graduate or greater). Health behavior factors included the number of times moderately exercised (recategorized as none, at least 1 per day), BMI calculated by the given height and weight, provided by the survey respondents (recategorized as underweight [< 18.5], normal weight [18.5–24.9], overweight [25.0-29.9], obese [≥ 30]), and smoking status (current smoker, former smoker, or never smoked). 2.3 Statistical Analysis Statistical analyses conducted in this study included temporal trends, differences in prevalence, bivariate, and multivariate analyses. To achieve nationally representative estimates, our samples were weighted with the survey weight to account for the complex survey design from the primary sample unit, the sample strata, and the sample weight. In Table 1 , population characteristics of Hispanics/Latinos were obtained from frequency and percentages. Bivariate Chi-square tests were conducted to examine the differences in anxiety/depression symptoms among the levels of individual general health and covariates. In Table 2 , we estimated the relative risk of anxiety/depression symptoms for general health among Hispanics/Latinos, calculating the absolute percentage difference and relative risk/odds ratio. In Table 3 , prevalence measures of the temporal trend for anxiety/depression symptoms and annual average percentage change (AAPC) over the survey period were estimated from 2011–2012, 2014, 2017–2019, and 2022. The AAPC was calculated using the semi-elasticity index approach by the US Bureau of Labor Statistics 27 . In Table 4 , adjusted multivariable logistic regression analysis models were conducted to obtain adjusted odds of anxiety/depression among Hispanics/Latinos. Four logistic regression models were examined: (1) general health adjusted for sociodemographic factors, (2) general health adjusted for socioeconomic factors, (3) general health adjusted for health behavior factors, and (4) fully adjusted (general health adjusted for all covariates) models. The summary of our analyses was reported using percentages, adjusted odds ratio (AOR), 95% confidence interval (95% CI), and p-value < 0.05 for statistical significance. Our analyses were conducted using IBM SPSS Statistics Software (Version 29.0.0.0). Table 1 Sample Characteristics, Prevalence, and Bivariate Analysis of Anxiety/Depression Symptoms Status among Hispanic/Latinos in the US, 2011–2022 Overall [N = 1927, 100%] N (%) No Anxiety/Depression Symptoms [n = 951, 48.2%] n (%) Anxiety/Depression Symptoms [n = 976, 51.8%] n (%) Chi-square; p-value Year < 0.001 2011 267 (17.8) 161 (69.2) 106 (30.8) 2012 197 (11.2) 67 (45.7) 130 (54.3) 2014 193 (11.9) 66 (34.6) 127 (65.4) 2017 132 (10.8) 61 (33.3) 71 (66.7) 2018 137 (9.0) 46 (26.6) 91 (73.4) 2019 275 (13.7) 106 (41.5) 169 (58.5) 2022 726 (25.4) 444 (58.8) 282 (41.2) General Health Status < 0.001 Excellent/Very good/Good 1412 (74.5) 798 (56.3) 614 (43.7) Fair/Poor 515 (25.5) 153 (24.7) 362 (75.3) Age 0.654 18–25 138 (16.5) 56 (51.4) 82 (48.6) 26–34 (20.3) 135 (45.6) 172 (54.4) 35–49 553 (32.1) 268 (45.5) 285 (54.5) 50–64 555 (21.9) 284 (50.7) 271 (49.3) ≥ 65 374 (9.2) 208 (52.3) 166 (47.7) Sex 0.078 Male 704 (46.5) 383 (52.2) 321 (47.8) Female 1223 (53.5) 568 (44.8) 655 (55.2) Marital Status 0.012 Single/Never Married 383 (34.1) 140 (41.6) 243 (58.4) Married/Living as Married 1036 (53.9) 569 (53.4) 467 (46.6) Divorced/Separated 385 (9.6) 191 (46.1) 194 (53.9) Widowed 123 (2.4) 51 (35.3) 72 (64.7) US Census Region 0.171 Northeast 274 (15.1) 136 (55.1) 138 (44.9) Midwest 123 (9.0) 61 (57.6) 62 (42.4) South 800 (35.3) 399 (45.7) 401 (54.3) West 730 (40.6) 355 (45.8) 375 (54.2) Level of Education Completed 0.546 <High school 284 (16.9) 115 (51.5) 169 (48.5) High school graduate 349 (22.4) 170 (43.5) 179 (56.5) Some college or post high school training 635 (37.1) 298 (47.8) 337 (52.2) ≥College graduate 659 (23.6) 368 (51.2) 291 (48.8) Total Annual Family Income 0.001 < $ 20,000 499 (19.7) 169 (34.4) 330 (65.6) $ 20,000- $ 34,999 295 (15.2) 132 (47.2) 163 (52.8) $ 35,000- $ 49,999 284 (18.1) 150 (42.9) 134 (57.1) $ 50,000- $ 74,999 324 (18.0) 176 (52.2) 148 (47.8) ≥ $ 75,000 525 (28.9) 324 (59.1) 201 (40.9) Health Insurance 0.048 No 243 (14.6) 103 (38.8) 140 (61.2) Yes 1684 (85.4) 848 (49.9) 836 (50.1) Quality Care 0.005 Excellent/Very Good/Good 1680 (87.2) 857 (50.3) 823 (49.7) Fair/Poor 247 (12.8) 94 (34.1) 153 (65.9) Body Mass Index (BMI) 0.209 < 18.5 (Underweight) 24 (2.6) 11 (35.2) 13 (64.8) 18.5–24.9 (Healthy weight) 455 (25.9) 238 (54.5) 217 (45.5) 25.0-29.9 (Overweight) 683 (34.1) 352 (49.0) 331 (51.0) ≥ 30.0 (Obese) 765 (37.3) 350 (44.1) 415 (55.9) Moderate Physical Activity Intensity 0.003 None 535 (25.6) 213 (38.8) 322 (61.2) At least 1 day per week 1392 (74.4) 738 (51.5) 654 (48.5) Cigarette Smoking Status 0.108 Never 1367 (72.5) 695 (50.3) 672 (49.7) Former smoker 344 (15.2) 178 (46.2) 166 (53.8) Current smoker 216 (12.3) 78 (38.6) 138 (61.4) Table 2 Relative Risk of Anxiety/Depression Symptoms Among Hispanics/Latinos in the US by General Health Status, 2011–2022 General Health Status Fair/Poor (A) n = 515 General Health Status Excellent/Very Good/Good (B) n = 1,412 Absolute Difference A-B Relative Risk A/B Anxiety/Depression Symptoms % (95% CI) % (95% CI) % None 24.7 (19.1–31.4) 56.3 (51.7–60.8) 31.6 0.43 Mild 28.7 (23.1–35.2) 28.6 (25.0 -32.6) 0.1 1.00 Moderate 24.9 (17.7–33.8) 10.4 (7.7–13.8) 14.5 2.39 Severe 21.6 (16.2–28.2) 4.7 (3.2–6.8) 16.9 4.59 Note : Data from 2011, 2012, 2014, 2017, 2018, 2019, and 2022 Health Information National Trends Surveys, HINTS 4 Cycles 1, 2, 4, HINTS 5 Cycles 1, 2, 3, HINTS 6, respectively. Unweighted N = 1,927; Weighted N = 102,482,919. 2013 and 2015 (HINTS Cycle 3, HINTS-FDA) were excluded due to missing anxiety/depression variable (PHQ4), and 2016 was excluded due to the survey not being administered. 2020 data (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 data (HINTS SEER) was excluded due to it not being publicly available. Table 3 Temporal Trend and Annual Average Percentage Change in Anxiety/Depression Symptoms among Hispanics/Latinos in the US 2011–2012 % (95% CI) n = 464 2014 % (95% CI) n = 193 2017–2019 % (95% CI) n = 544 2022 % (95% CI) n = 726 Annual Average Percentage Change Over Time (%) General Health Status Excellent/Very good/good 29.3 (22.8–36.7) 65.3 (53.8–75.3) 58.6 (50.7–66.2) 34.0 (27.8–40.8) 23.5 Fair/Poor 83.3 (72.9–90.2) 65.5 (39.7–84.5) 81.1 (71.7–87.9) 64.6 (53.5–74.2) -6.0 Age 18–25 14.1 (5.4–32.1) 87.3 (55.8–97.4) 66.4 (47.8–81.0) 58.4 (38.9–75.5) 161.1 26–34 41.5 (27.4–57.1) 59.4 (38.8–77.1) 68.6 (52.0-81.5) 53.0 (38.8–66.7) 12.0 35–49 44.1 (34.6–54.0) 72.4 (55.5–84.6) 65.5 (53.9–75.6) 38.9 (28.5–50.4) 4.7 50–64 48.7 (37.9–59.7) 55.4 (29.8–78.4) 63.2 (52.2–73.0) 27.3 (20.0-36.1) -9.7 ≥ 65 57.2 (42.7–70.6) 55.7 (32.0–77.0) 58.4 (46.8–69.2) 28.4 (18.3–41.4) -16.4 Sex Male 32.7 (22.5–45.0) 67.0 (47.0-82.3) 63.3 (52.7–72.7) 37.3 (28.1–47.6) 19.4 Female 47.1 (38.7–55.7) 63.9 (51.0-75.1) 66.7 (58.7–73.9) 44.3 (37.3–51.6) 2.2 Marital Status Single/Never Married 26.0 (16.2–39.1) 72.3 (41.7–90.5) 73.6 (61.8–82.8) 62.6 (50.1–73.7) 55.0 Married/Living as Married 41.9 (34.1–50.2) 63.9 (50.1–75.7) 58.4 (49.7–66.7) 29.9 (23.5–37.3) -7.2 Divorced/Separated 63.9 (47.9–77.4) 52.7 (31.9–72.5) 60.9 (46.7–73.5) 31.8 (21.8–43.8) -16.6 Widowed 61.3 (34.6–82.6) 73.1 (45.4–89.9) 84.9 (69.9–93.1) 33.4 (16.0-56.9) -8.4 US Census Region Northeast 38.9 (25.2–54.7) 57.7 (35.4–77.3) 52.4 (35.1–69.1) 34.8 (22.4–49.6) 1.9 Midwest 24.6 (11.2–45.7) 46.4 (11.8–84.9) 60.3 (39.3–78.0) 42.9 (23.2–65.2) 29.9 South 45.5 (32.4–59.3) 63.4 (45.7–78.1) 69.2 (58.5–78.1) 41.1 (32.2–50.5) 2.6 West 39.0 (27.9–51.3) 76.1 (59.7–87.3) 66.8 (56.1–76.1) 43.2 (33.7–53.3) 15.9 Level of Education Completed <High school 36.8 (21.8–54.8) 55.5 (26.8–80.9) 76.3 (61.0–87.0) 38.6 (23.5–56.2) 13.0 High school graduate 41.9 (26.8–58.6) 75.5 (53.2–89.3) 68.9 (54.0-80.8) 47.3 (34.0-60.9) 13.4 Some college or post high school training 40.8 (29.0-53.6) 72.3 (57.1–83.6) 66.3 (56.1–75.2) 39.6 (30.0–50.0) 9.5 ≥College graduate 40.8 (30.0-52.4) 59.5 (40.8–75.8) 55.9 (43.2–67.8) 38.1 (30.4–46.5) 2.5 Total Annual Family Income < $ 20,000 65.0 (52.0-76.2) 66.8 (40.0-85.9) 71.2 (58.6–81.2) 56.6 (43.8–68.6) -3.7 $ 20,000- $ 34,999 46.2 (262 − 67.6) 60.5 (31.9–83.3) 68.4 (51.0-81.9) 45.5 (32.0-59.8) 3.5 $ 35,000- $ 49,999 31.1 (17.1–49.7) 75.1 (58.9–86.4) 67.9 (50.7–81.3) 60.8 (46.4–73.5) 40.5 $ 50,000- $ 74,999 32.2 (19.2–48.7) 54.6 (31.6–75.8) 62.7 (48.6–75.0) 36.3 (21.6–54.1) 14.1 ≥ $ 75,000 23.5 (14.1–36.4) 60.7 (39.4–78.7) 60.3 (47.6–71.8) 28.0 (20.2–37.2) 34.69 Health Insurance No 56.4 (39.4–72.0) 75.7 (51.1–90.3) 77.1 (53.6–90.8) 47.4 (33.3–61.9) -0.81 Yes 36.0 (28.5–44.2) 63.2 (49.5–75.0) 64.0 (57.3–70.2) 40.1 (33.9–46.7) 13.2 Quality Care Excellent/Very Good/Good 37.1 (29.8–45.0) 62.1 (49.7–73.1) 63.7 (56.6–70.3) 38.2 (32.2–44.6) 10.0 Fair/Poor 54.5 (36.5–71.4) 84.6 (57.1–95.8) 81.1 (66.1–90.5) 59.4 (41.8–74.9) 8.1 Body Mass Index (BMI) 18.5–24.9 (Healthy weight) 28.3 (16.6–43.9) 62.2 (39.4–80.7) 62.6 (48.9–74.5) 37.9 (25.8–51.6) 27.0 25.0-29.9 (Overweight) 40.9 (31.2–51.3) 73.2 (57.4–84.7) 59.5 (49.0-69.3) 37.0 (27.2–48.0) 7.5 ≥ 30.0 (Obese) 48.5 (37.6–59.5) 55.3 (37.6–71.8) 69.0 (59.6–77.0) 47.1 (38.0-56.5) 2.4 Moderate Physical Activity Intensity None 53.9 (40.9–66.4) 73.6 (56.1–86.0) 70.4 (59.7–79.2) 48.0 (37.4–58.7) 0.1 At least 1 day per week 35.3 (27.3–44.1) 62.4 (49.3–73.8) 63.2 (55.0-70.6) 39.3 (32.6–46.4) 13.4 Cigarette Smoking Status Never 33.6 (26.1–42.1) 67.1 (54.6–77.6) 65.7 (58.0-72.6) 40.1 (33.6–46.9) 19.5 Former smoker 50.6 (35.9–65.3) 67.1 (47.2–82.3) 59.2 (44.5–73.4) 43.8 (28.9–59.8) -1.7 Current smoker 59.7 (41.9–75.2) 56.6 (23.2–84.9) 69.4 (53.5–81.7) 49.5 (27.7–71.4) -2.9 Note : Data from 2011, 2012, 2014, 2017, 2018, 2019, and 2022 Health Information National Trends Surveys, HINTS 4 Cycles 1, 2, 4 and HINTS 5 Cycles 1, 2, 3, and HINTS 6, respectively. Unweighted N = 1,927; Weighted N = 102,482,919. 2013, 2015 (HINTS Cycle 3, HINTS-FDA) excluded due to missing anxiety/depression variable. 2013 and 2015 data (HINTS Cycle 3, HINTS-FDA) were excluded due to missing depression variable (PHQ4), and 2016 was excluded due to the survey not being administered. 2020 data (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 data (HINTS SEER) was excluded due to it not being publicly available. Table 4 Multivariable Logistic Regression Analysis of the Odds of Anxiety/Depression Symptoms among Hispanics/Latinos in the US, 2011–2012, 2014, 2017–2019 Sociodemographic-Adjusted AOR (95% CI) Socioeconomic-Adjusted AOR (95% CI) Health Behavior- Adjusted AOR (95% CI) Full adjusted AOR (95% CI) General Health Status Excellent/very good/good [ref] - - - - Fair/Poor 3.95*** (2.76–5.64) 3.56*** (2.46–5.15) 3.66*** (2.47–5.44) 3.30 *** (2.29–4.74) Sociodemographic Factors Age 0.104 0.168 18–25 0.59 (0.31–1.10) 0.63 (0.35–1.14) 26–34 0.86 (0.55–1.35) 0.83 (0.53–1.28) 35–49 [ref] - - 50–64 0.72 (0.47–1.09) 0.70 (0.47–1.05) ≥ 65 0.57 (0.37–0.89) 0.58 (0.36–0.93) Sex 0.137 0.191 Male [ref] - - Female 1.30 (0.92–1.84) 1.25 (0.90–1.73) Marital Status 0.005 0.007 Single/Never Married [ref] - - Married/Living as Married 0.53 (0.35–0.80) 0.56 (0.38–0.83) Divorced/Separated 0.66 (0.39–1.13) 0.61 (0.36–1.02) Widowed 1.07 (0.52–2.19) 1.10 (0.54–2.22) US Census Region 0.087 0.035 Northeast [ref] - - Midwest 0.81 (0.42–1.60) 0.77 (0.38–1.56) South 1.56* (0.99–2.46) 1.58* (1.02–2.46) West 1.39 (0.89–2.19) 1.52 (0.97–2.37) Socioeconomic Factors Level of Education Completed 0.041 0.103 <High school [ref] - - High school graduate 2.22* (1.24–3.98) 2.04* (1.13–3.70) Some college or post high school training 1.91* (1.11–3.29) 1.68 (0.96–2.93) ≥College graduate 2.07* (1.17–3.66) 1.88* (1.05–3.37) Total Annual Family Income 0.041 0.065 < $ 20,000 1.79* (1.06–3.04) 1.87* (1.10–3.17) $ 20,000- $ 34,999 1.28 (0.75–2.17) 1.36 (0.81–2.30) $ 35,000- $ 49,999 1.47 (0.86–2.51) 1.53 (0.89–2.61) $ 50,000- $ 74,999 [ref] - - ≥ $ 75,000 0.83 (0.51–1.33) 0.93 (0.57–1.50) Health Insurance 0.201 0.276 No 1.38 (0.84–2.27) 1.32 (0.80–2.16) Yes [ref] - - Quality Care 0.243 0.185 Excellent/Very Good/Good [ref] - - Fair Poor 1.32 (0.83–2.10) 1.37 (0.86–2.20) Health Behavior Factors Body Mass Index (BMI) 0.624 0.561 18.5–24.9 [ref] (Health weight) - - 25.0-29.9 (Overweight) 1.24 (0.81–1.91) 1.26 (0.84–1.89) ≥ 30.0 (Obese) 1.16 (0.76–1.76) 1.20 (0.81–1.78) Moderate Physical Activity Intensity 0.221 0.087 None 1.24 (0.88–1.74) 1.34 (0.96–1.87) At least 1 day per week [ref] - - Cigarette Smoking Status 0.470 0.440 Never [ref] - - Former smoker 1.08 (0.74–1.563) 1.20 (0.81–1.78) Current smoker 1.38 (0.81–2.37) 1.29 (0.77–2.16) Note : Data from 2011, 2012, 2014, 2017, 2018, 2019, and 2022 Health Information National Trends Surveys, HINTS 4 Cycles 1, 2, 4 and HINTS 5 Cycles 1, 2, 3, and HINTS 6, respectively. Unweighted N = 1927; Weighted N = 102,482,919. 2013 and 2015 (HINTS Cycle 3, HINTS-FDA) were excluded due to missing anxiety/depression variable (PHQ4), and 2016 was excluded due to the survey not being administered. 2020 data (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 data (HINTS SEER) was excluded due to it not being publicly available. BMI < 18.5 was excluded from the table due to the small sample size. Statistical significance: Bold (*p ≤ 0.05, **p ≤ 0.01, ***p ≤ 0.001). 3. Results 3.0 Prevalence of Anxiety/Depression Symptoms Among Hispanic/Latinos Table 1 examines the estimated weighted prevalence of anxiety/depression symptoms among Hispanics/Latinos. The 2018 survey year reported the highest prevalence of anxiety/depression symptoms among Hispanics/Latinos (73.4%). We observed a higher prevalence of anxiety/depression symptoms among Hispanics/Latinos with fair/poor general health than those with excellent/very good/good general health (75.3% vs 43.7%, p < 0.001). Among the sociodemographic factors, the highest prevalence was among Hispanics/Latinos aged 35–49 (54.5%), females (55.2%), widowed (64.7%), and individuals from the South US census region (54.3%). Among the socioeconomic factors, the highest prevalence of anxiety/depression symptoms was among Hispanic/Latino who graduated high school (56.5%), those who earned < $ 20,000 (65.6%), those with no health insurance (61.2%), and those with fair/poor quality care (65.9%). Among the health behaviors or lifestyle risk factors considered in this study, the highest prevalence was among Hispanics/Latinos with a BMI < 18.5 (64.8%), no moderate physical activity (61.2%), and current smokers (61.4%). There was a statistically significant difference in anxiety/depression symptoms among Hispanics/Latinos by survey year (p = < 0.001), general health (p = < 0.001), marital status (p = 0.012), total annual family income (p = 0.001), health insurance (p = 0.048), quality of care (p = 0.005), and moderate physical activity intensity (p = 0.003). [ Insert Table 1 ] 3.1 Relative Risk of Anxiety/Depression Symptoms by General Health Among Hispanics/Latinos Table 2 presents the relative risk of anxiety/depression symptoms between Hispanics/Latinos with fair/poor and excellent/very good/good general health. Hispanics/Latinos with fair/poor health were relatively 0.43 times less likely to experience no anxiety/depression than those with excellent/very good/good general health. On the other hand, Hispanics/Latinos with fair/poor general health were relatively 2.39 and 4.59 times more likely to be at risk of moderate and severe anxiety/depression compared to those with excellent/very good/good general health. Additionally, the severity of the risk of anxiety/depression increases for Hispanics/Latinos with fair/poor compared to those with excellent/very good/good general health. [ Insert Table 2 ] 3.2 Annual Average Percentage Change in Anxiety/Depression Symptoms among Hispanics/Latinos Table 3 shows the annual average percentage change (AAPC) over the survey years from 2011–2012, 2014, 2017–2019, and 2022. Hispanics/Latinos with excellent/very good/good general health experienced a substantial 23.5% increase in AAPC of anxiety/depression symptoms. Meanwhile, those with fair/poor general health had a slight 6.0% decrease in AAPC of anxiety/depression symptoms over the survey years. For the sociodemographic factors, the Hispanics/Latinos with the highest increase in AAPC include those aged 18–25 (161.1%), males (19.4%), single/never married (55.0%), and those who reside in the Midwest (29.9%). For the socioeconomic factors, the Hispanics/Latinos with the highest increase in AAPC include those who graduated high school (13.4%), earned an annual family income of $ 35,000- $ 49,999 (40.5%), had health insurance (13.2%), and had excellent/very good/good quality of care (10.0%). Behavioral health factors with the highest increase in AAPC were Hispanics/Latinos with a healthy BMI (27.0%), at least 1 day or more moderate physical activity (13.4%), and those who never smoked cigarettes (19.5%). [ Insert Table 3 ] 3.3 Trend in Prevalence of Anxiety/Depression Symptoms among Hispanics/Latinos In Fig. 1 , we assessed the trend in the weighted prevalence of anxiety/depression by general health among Hispanics/Latinos over the survey years. Overall, Hispanics/Latinos with poor general health continuously had the highest prevalence of anxiety/depression across survey years, except in 2017 and 2018. Those with fair general health had a decline in anxiety/depression prevalence in 2014 but recorded the highest prevalence in 2018. Hispanics/Latinos with excellent general health reported a higher prevalence of anxiety/depression than those with fair and very good general health in 2014. Generally, Hispanics/Latinos with excellent, very good, or good general health experienced an increase in the prevalence of anxiety/depression up to 2018 and continued to fall from 2019. Meanwhile, those with poor general health remained the highest with fairly steady prevalence. [ Insert Fig. 1 ] Figure 2 depicts the trend in the prevalence of anxiety/depression by age group among Hispanics/Latinos. Hispanics/Latinos aged 18–25 experienced an increased prevalence of anxiety/depression, having the lowest prevalence of anxiety/depression among all age groups in 2011–2012 and the highest in 2014, 2019, and 2022. Those aged 65 years and above had the highest prevalence of anxiety/depression in 2012 and the lowest in 2017. Overall, the prevalence of anxiety/depression among Hispanics/Latinos aged 18–25, 26–34, and 35–49 fairly increased over the survey years. Meanwhile, among those aged 50–64 and 65 and older, the prevalence of anxiety/depression generally decreased slightly over survey years. [ Insert Fig. 2 ] Figure 3 shows the prevalence trend of anxiety/depression by gender among Hispanics/Latinos. Hispanic/Latino females generally had a higher prevalence trend of anxiety/depression than their male counterparts. Additionally, both sexes experienced an increasing prevalence trend of anxiety/depression over the survey years, with males having a more significant increase than females. Prevalence trend of anxiety/depression then declined over the rest of the survey years, 2019 and 2022. [ Insert Fig. 3 ] 3.4 Adjusted Odds of Anxiety/Depression Symptoms among Hispanics/Latinos Table 4 presents the results of the likelihood/odds of general health associated with anxiety/depression symptoms adjusted for sociodemographic, socioeconomic, and behavioral health factors, and all covariates (fully adjusted), respectively. In the fully adjusted model, Hispanics/Latinos with fair/poor general health were more likely to report/experience anxiety/depression compared to those with excellent/very good/good general health (AOR = 3.30, 95% CI = 2.29–4.74). When adjusting for the sociodemographic, socioeconomic, and behavioral health factors, Hispanics/Latinos with fair/poor general health were 3.95 (AOR = 3.95, 95% CI = 2.76–5.64), 3.56 (AOR = 3.56, 95% CI = 2.46–5.15), and 3.66 (AOR = 3.66, 95% CI = 2.47–5.44) times more likely to report anxiety/depression compared to those with excellent/very good/good general health, respectively. Among the covariates in the fully adjusted model, marital status (p = 0.007) and the US census region (p = 0.035) were also statistically significantly associated with anxiety/depression. Hispanics/Latinos who reside in the South (AOR = 1.58, 95% CI = 1.02–2.46) had higher odds of anxiety/depression compared to those who reside in the Northeast. Also, Hispanic/Latinos with high school education and college graduate or more had a higher likelihood of reporting anxiety/depression compared to those with less than a high school education [high school (AOR = 2.04, 95% CI = 1.13–3.70), and college education or more (AOR = 1.88, 95% CI = 1.05–3.37)]. Additionally, Hispanics/Latinos with a total annual family income of less than $ 20,000 had higher odds of having anxiety/depression than those who had a total annual family income of $ 50,000- $ 74,999 (AOR = 1.87, 95% CI = 1.10–3.17). [ Insert Table 4 ] 4. Discussion This study assessed the link between general health and anxiety/depression symptoms among Hispanics/Latinos in the US using nationally representative data. We found that Hispanics/Latinos with fair/poor general health were at higher risk of moderate or severe anxiety/depression than those with excellent/very good/good general health. However, anxiety/depression decreased among Hispanics/Latinos with fair/poor general health over the survey time. In addition, the results showed that fair/poor general health was associated with higher odds of anxiety/depression compared to excellent/very good/good general health. These findings emphasize the importance of disaggregating data to better understand mental health disparities within population subgroups, to harmonize data and facilitate targeted mental health interventions 28 – 32 . A study assessing depression by race and ethnicity found that more Hispanics reported severe depression than mild depression (41% vs 21%) 33 . While there are limited studies assessing the association between general health and depression among Hispanics/Latinos, there have been studies that found an inverse relationship between general health and the severity of anxiety and depression among different populations 34 , 35 . Hispanics/Latinos with fair/poor general health status may have a higher risk for more severe forms of depression due to their disease status 36 . Hispanics/Latinos have been shown to be more likely to be depressed if they have health ailments such as heart disease, hypertension, and high cholesterol 36 . Other studies have indicated that chronic diseases such as rheumatoid arthritis, cancer, diabetes, and heart disease influenced general health outcomes 37 , 38 . Another study focusing on people at risk for diseases like diabetes and cardiovascular disease determined that those who self-reported their health to be fair or poor were associated with having depressive symptoms 11 . This implies that Hispanics/Latinos are more likely to be depressed because of what they believe their general health to be due to health ailments. Severe anxiety/depression can result in alcohol dependencies, insomnia, loss of concentration, memory problems, and suicide 39 – 44 . For instance, Katelyn et al. found that Hispanic groups, including Puerto Ricans and Mexican Americans with major depressive disorder (MDD), had the highest prevalence of alcohol dependence and consumption, and the odds of alcohol dependence were four times higher among those with MDD 39 . It is important to address and develop culturally appropriate interventions for Hispanics/Latinos with fair/poor general health, as they are at higher risk for more severe anxiety/depression outcomes. This study has demonstrated that there is a link between general health and anxiety/depression. Therefore, interventions to improve general health are necessary to mitigate the risk of severe anxiety/depression outcomes. Further, Hispanics/Latinos with excellent/very good/good general health experienced a significant increase in AAPC anxiety/depression than those with fair/poor general health over the observed survey years. Although the temporal trend in anxiety/depression showed that Hispanics/Latinos with fair/poor general health continuously experienced a higher prevalence of anxiety/depression, it is imperative to critically look deeper into the spike in anxiety/depression among those with excellent/very good/good general health. A study has found that major depression has significantly increased over time, generally among Hispanic adolescents from 2009 to 2019 16 . There are limited studies researching reasons for the dramatic increasing trend in anxiety/depression among Hispanic populations. Leung et al. suggested this could be due to concerns over being discriminated against, concerns about access to healthcare, and sudden loss of income 45 . There have been numerous studies that have found that discrimination results in a high risk of negative mental health outcomes, including depression 46 , 47 . Our findings indicate that the odds of anxiety/depression among Hispanics/Latinos with fair/poor general health increased, after adjusting for socioeconomic factors (i.e., education, income, and insurance). Therefore, it is important to develop policy interventions to improve the socioeconomic status of Hispanic/Latino populations. This can help improve their general health, hence reducing the growing mental health problems among Hispanic/Latino populations. Additionally, there was a slight decrease in AAPC anxiety/depression among Hispanics/Latinos with fair/poor general health over the observed survey years. Studies have found that Hispanics/Latinos have higher familism than other races and cultures 48 , 49 . Studies on Hispanics/Latinos reveal that strong social bonds and familism may be protective factors for mental health outcomes 50 – 52 . For instance, Perez et al. uncovered that Hispanics/Latinos with health ailments are likely to change their health behaviors or seek treatment options when they have familism 53 . As such, education and awareness to encourage and promote familism and social bonds among Hispanics/Latinos is necessary as a potential intervention to improve their mental health problems. When adjusting for sociodemographic factors, Hispanics/Latinos with fair/poor general health had increased odds of moderate-severe anxiety/depression. It is unclear how sociodemographic factors impact general health to influence anxiety/depression outcomes among Hispanics/Latinos. Sociodemographic factors were found to be associated with anxiety/depression among Hispanics/Latinos when assessing prevalence trends and AAPC over time. Young adult Hispanics/Latinos aged 18–25 had the highest annual average percent increase in anxiety/depression of 161.1% over the observed survey years. This corroborated the findings by Daley (2022), who found that young Hispanics had a substantial increase in major depression from 2009 to 2019 (119.8%) 16 . The increase in depression symptoms among young adults aged 18–25 has been shown in another study assessing depression trends by different age groups among the general US population from 2005 to 2015, using data from the National Survey on Drug and Health 21 . Additionally, an increased prevalence of anxiety was observed among Hispanic/Latino adolescents, increasing from 32% in 2012 to 46% in 2018 in a study conducted in Dane County, Wisconsin 15 . A systematic review assessing the effectiveness of different kinds of early intervention for mental health among youths indicated that evidence supports cognitive remediation, supportive education, and family psychoeducation as effective methods for interventions 54 . Therefore, adopting such interventions tailored toward Hispanic/Latino young adults can help address the growing mental health problems. In addition, Hispanic/Latino males and females were found to have an increase in AAPC in anxiety/depression symptoms, although males had a higher increase in AAPC than females (19.4% vs 2.2%). Compton et al. (2006) indicated that from 1991–1992 and 2001–2002, Hispanic males experienced an increasing rate of major depression 22 . Also, anxiety was reported to increase significantly among both men and women in the general US population from 2008 to 2018 55 . To our knowledge, no studies have uncovered why Hispanic/Latino males are experiencing an increasing trend of anxiety/depression over time. This warrants further research to understand why Hispanic/Latino males are experiencing such a staggering increase in anxiety/depression over time, to develop effective policy interventions. On the other hand, Hispanic/Latino females reported a higher overall prevalence of anxiety/depression symptoms than males (55.2% vs 47.8%). This finding is consistent with studies that found Hispanic/Latino females generally have a higher prevalence of depression than males 21 , 56 – 58 . A more recent study has also found that females exhibited an increase in depression prevalence 21 . Hispanic/Latino females may have a higher prevalence of depression due to stresses related to acculturation 59 . Acculturation, or the process of becoming accustomed to the US culture, can be stressful for Hispanic/Latino females, with studies finding that higher levels of stress related to acculturation may affect general health and result in higher severity of depression 47 , 60 . Therefore, addressing acculturation-related problems among Hispanics/Latinos can help improve their general and mental health. Also, Hispanics/Latinos with fair/poor general health had a higher likelihood of anxiety/depression symptoms when adjusting for health behaviors or lifestyle risk factors. Health behaviors like BMI, in particular obesity, can affect general health, as shown in a study by Okosun et al., who found that Hispanics have significantly increased odds of a reduction in self-rated health if they have obesity in comparison to non-Hispanic Whites 61 . We found a nonsignificant increased association of overweight and obesity with anxiety/depression symptoms among Hispanics/Latinos. There are limited studies on how health behaviors or lifestyle factors like BMI, smoking status, or exercise affect general health. However, our findings show that the association between general health and anxiety/depression symptoms among Hispanics/Latinos may be influenced by their health behaviors. As such, targeted interventions towards Hispanics/Latinos who are obese are recommended to improve the outcome of general health and anxiety/depression. Such interventions could include dieting, physical activity, weight loss drugs, and bariatric surgery, which have been studied extensively 62 . The influence of general health on anxiety/depression symptoms among Hispanics/Latinos underscores the need for additional research to investigate the causal relationship between general health and mental health outcomes and interventions to improve the general health outcomes of Hispanics/Latinos. Additionally, culturally tailored mental health screening tools for Hispanics/Latinos can be useful in effectively screening for mental health symptoms to enhance the effective implementation of interventions. 5. Limitations This study has some limitations. It is a cross-sectional study, hence limiting the ability to establish a causal relationship between general health and anxiety/depression symptoms. The HINTS data were self-reported and could be affected by recall and social desirability biases. Additionally, we were unable to obtain restricted data for 2013, 2015, 2016, and 2021; therefore, they were not assessed, which could affect the estimated prevalence and temporal trends of anxiety/depression in this study. This study, however, provided tremendously important findings that can aid the development of health policy interventions tailored to improve the general health and mental health of Hispanics/Latinos. 6. Conclusion This study contributed to the limited literature on the link between general health and anxiety/depression symptoms among the Hispanic/Latino population in the US. Overall, our findings showed that Hispanics/Latinos with fair/poor general health have a higher risk of experiencing anxiety/depression than those with excellent/very good/good general health. Thus, fair/poor general health may be a potential predictor of the growing trend of anxiety/depression symptoms among Hispanic/Latino populations in the US. Developing health policies and interventions that target improving the general health of Hispanics/Latinos may help prevent or reduce mental health disorders and improve their quality of life. In addition, higher prevalence trends and odds of anxiety/depression among Hispanics/Latinos were noted among young adults aged 18–25 years and females. Further research is needed to understand the reasons for the increasing prevalence of anxiety/depression among these populations, especially among young adult Hispanics/Latinos, and to better delineate the heterogeneity of this relationship among Hispanics/Latinos. Declarations Data Availability Statement The current study used publicly available, de-identified data from the Health Information National Survey (HINTS) by the United States National Institutes of Health (NIH), under the National Cancer Institute (NCI) program (https://hints.cancer.gov/). Clinical trial number Not applicable Acknowledgement The authors present deep gratitude to Dr. Faustine Williams and Dr. David Adzrago of the Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health (ZIA MD000015) for their voluntary contributions that facilitated the conduct of this study. Authorship contribution statement L.M. contributed to the Conceptualization, Methodology, Data Curation, Formal Analysis, Visualization, Validation, Software, Writing – Original Draft Preparation, Writing − Review & Editing, Project Administration, and Supervision. J.L.R. contributed the Conceptualization, Methodology, Data Curation, Formal Analysis, Visualization, Software, Writing – Original Draft Preparation, Writing − Review & Editing. E.T-B. contributed to the Methodology, Visualization, Validation, Writing − Review & Editing. J.Y. contributed to the Visualization, Validation, Writing − Review & Editing. J.D.F. contributed to the Conceptualization, Visualization, Validation, Writing − Review & Editing. P.H.A. contributed to the Methodology, Visualization, Validation, Writing – Review & Editing. Corresponding author: Lohuwa Mamudu, [email protected] Statements & Declarations Human Ethics and Consent to Participate declarations Not applicable Funding Declaration No funding was received for this work. Consent to Publish The authors consent to the publication of this manuscript and related data in scientific journals. Competing Interests The authors declare no competing interests. References United States Census Bureau. 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Depression and chronic health conditions among latinos: The role of social networks. J Immigr Minor Health. 2016;18:1292–300. Chandola T, Jenkinson C. Validating self-rated health in different ethnic groups. Ethn Health. 2000;5(2):151–9. Molarius A, Janson S. Self-rated health, chronic diseases, and symptoms among middle-aged and elderly men and women. J Clin Epidemiol. 2002;55(4):364–70. Jetelina KK, Reingle Gonzalez JM, Vaeth PA, Mills BA, Caetano R. An investigation of the relationship between alcohol use and major depressive disorder across Hispanic national groups. Alcoholism: Clin experimental Res. 2016;40(3):536–42. Park S-C, Kim J-M, Jun T-Y, et al. Prevalence and clinical correlates of insomnia in depressive disorders: the CRESCEND study. Psychiatry Invest. 2013;10(4):373. Boldrini M, Mann JJ. Depression and suicide. Neurobiol brain disorders. 2023:861–83. Chang Y-C, Lee Y-H, Chiang T, Liu C-T. Associations of Smoking and Alcohol Consumption with loneliness, Depression, and loss of interest among chinese older males and females. Int J Mental Health Addict. 2022:1–16. Fekadu N, Shibeshi W, Engidawork E. Major depressive disorder: pathophysiology and clinical management. J Depress Anxiety. 2017;6(1):255–7. Dillon DG, Pizzagalli DA. Mechanisms of memory disruption in depression. Trends Neurosci. 2018;41(3):137–49. Leung P, LaChapelle AR, Scinta A, Olvera N. Factors contributing to depressive symptoms among Mexican Americans and Latinos. Soc Work. 2014;59(1):42–51. Vines AI, Ward JB, Cordoba E, Black KZ. Perceived racial/ethnic discrimination and mental health: A review and future directions for social epidemiology. Curr Epidemiol Rep. 2017;4:156–65. Finch BK, Kolody B, Vega WA. Perceived discrimination and depression among Mexican-origin adults in California. J Health Soc Behav. 2000:295–313. Campos B, Ullman JB, Aguilera A, Dunkel Schetter C. Familism and psychological health: the intervening role of closeness and social support. Cult Divers Ethn Minor Psychol. 2014;20(2):191. Ackert E, Wikle JS. Familism among Latino/a adolescents: Evidence from time-use data. J Marriage Family. 2022;84(3):879–99. Roberts NA, Burleson MH. Processes linking cultural ingroup bonds and mental health: the roles of social connection and emotion regulation. Front Psychol. 2013;4:52. Smokowski PR, Bacallao ML. Acculturation, internalizing mental health symptoms, and self-esteem: Cultural experiences of Latino adolescents in North Carolina. Child Psychiatry Hum Dev. 2007;37:273–92. Keeler AR, Siegel JT, Alvaro EM. Depression and help seeking among Mexican–Americans: The mediating role of familism. J Immigr Minor Health. 2014;16:1225–31. Katiria Perez G, Cruess D. The impact of familism on physical and mental health among Hispanics in the United States. Health Psychol Rev. 2014;8(1):95–127. Read H, Roush S, Downing D. Early intervention in mental health for adolescents and young adults: A systematic review. Am J Occup Therapy. 2018;72(5):p72051900401–8. Goodwin RD, Weinberger AH, Kim JH, Wu M, Galea S. Trends in anxiety among adults in the United States, 2008–2018: Rapid increases among young adults. J Psychiatr Res. 2020;130:441–6. Romero LJ, Ortiz IE, Finley MR, Wayne S, Lindeman RD. Prevalence of depressive symptoms in New Mexico Hispanic and non-Hispanic white elderly. Ethn Dis. 2005;15(4):691–7. Cuellar I, Roberts RE. Relations of depression, acculturation, and socioeconomic status in a Latino sample. Hispanic J Behav Sci. 1997;19(2):230–8. Akhtar-Danesh N, Landeen J. Relation between depression and sociodemographic factors. Int J mental health Syst. 2007;1:1–9. Shattell MM, Smith KM, Quinlan-Colwell A, Villalba JA. Factors contributing to depression in Latinas of Mexican origin residing in the United States: Implications for nurses. J Am Psychiatr Nurses Assoc. 2008;14(3):193–204. Crockett LJ, Iturbide MI, Torres Stone RA, McGinley M, Raffaelli M, Carlo G. Acculturative stress, social support, and coping: relations to psychological adjustment among Mexican American college students. Cult Divers Ethnic Minor Psychol. 2007;13(4):347. Okosun IS, Choi S, Matamoros T, Dever GA. Obesity is associated with reduced self-rated general health status: evidence from a representative sample of white, black, and Hispanic Americans. Prev Med. 2001;32(5):429–36. Zhang Y, Liu J, Yao J, et al. Obesity: pathophysiology and intervention. Nutrients. 2014;6(11):5153–83. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Rodriguez","email":"","orcid":"","institution":"California State University, Fullerton","correspondingAuthor":false,"prefix":"","firstName":"Jorge","middleName":"L.","lastName":"Rodriguez","suffix":""},{"id":586573030,"identity":"7d7fd684-9c46-4ffb-8c0e-29bb2cae59f7","order_by":2,"name":"Erasmus Tetteh-Bator","email":"","orcid":"","institution":"Jackson State University","correspondingAuthor":false,"prefix":"","firstName":"Erasmus","middleName":"","lastName":"Tetteh-Bator","suffix":""},{"id":586573031,"identity":"aa76a42e-51a8-4e7b-b6cc-e955b36daccf","order_by":3,"name":"Joshua Yang","email":"","orcid":"","institution":"California State University, Fullerton","correspondingAuthor":false,"prefix":"","firstName":"Joshua","middleName":"","lastName":"Yang","suffix":""},{"id":586573033,"identity":"09b1e368-98d0-4f31-995b-14480a196ba4","order_by":4,"name":"James D. Fortenberry","email":"","orcid":"","institution":"Indiana University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"James","middleName":"D.","lastName":"Fortenberry","suffix":""},{"id":586573034,"identity":"ec22d16e-2c43-4f24-9e94-aa4500ffce38","order_by":5,"name":"Paul H. Atandoh","email":"","orcid":"","institution":"Mercer University","correspondingAuthor":false,"prefix":"","firstName":"Paul","middleName":"H.","lastName":"Atandoh","suffix":""}],"badges":[],"createdAt":"2026-01-19 09:53:39","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8637874/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8637874/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102209705,"identity":"f760a84f-f9ea-433e-a25a-a65aef04365f","added_by":"auto","created_at":"2026-02-09 12:13:53","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":165828,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eThe trend in weighted prevalence of anxiety/depression by general health among the Hispanic/Latino population in the US. Health Information National Trends Survey HINTS 4 Cycle 1, 2, 4, HINTS 5 Cycle 1, 2, 3, and HINTS 6; 2011, 2012, 2014, 2017, 2018, 2019, and 2022 data, respectively; Unweighted sample (N=1,927).\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8637874/v1/6ac0ce230c88374d23c562be.jpg"},{"id":102209709,"identity":"8e77995d-e8f9-4839-b922-6dd84d55b707","added_by":"auto","created_at":"2026-02-09 12:13:57","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":156181,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eThe trend in weighted prevalence of anxiety/depression by age group among Hispanics/Latinos. Health Information National Trends Survey, HINTS 4 Cycle 1, 2, 4, HINTS 5 Cycle 1, 2, 3, and HINTS 6; 2011, 2012, 2014, 2017, 2018, 2019, and 2022 data, respectively; Unweighted sample (N= 1,927).\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Picture2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8637874/v1/7a42060f78667b09710a01c2.jpg"},{"id":102209706,"identity":"25863311-f03e-4727-ac86-6feca2fdd1b4","added_by":"auto","created_at":"2026-02-09 12:13:54","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":124425,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eThe trend in weighted prevalence of anxiety/depression by gender among the Hispanic/Latino population in the US. Health Information National Trends Survey, HINTS 4 Cycle 1, 2, 4, HINTS 5 Cycle 1, 2, 3, and HINTS 6; 2011, 2012, 2014, 2017, 2018, 2019, and 2022 data, respectively; Unweighted sample (N= 1,927).\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Picture3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8637874/v1/e4b962fbf9dc118108ea0d94.jpg"},{"id":107754947,"identity":"815fda27-bf92-402d-9e52-758bfa18cabd","added_by":"auto","created_at":"2026-04-24 18:39:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1341930,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8637874/v1/a3156d64-cffa-44ed-ab33-942ad4c04961.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Temporal Differences and Trends in General Health Associated with Anxiety/Depression Symptoms among Hispanics/Latinos","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eDespite the Hispanic/Latino population expanding at a substantially faster rate in the United States (US), their mental health and its risk factors are not well understood\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. The Hispanic/Latino population was 63.7\u0026nbsp;million individuals in 2022, making up around 19% of the total US population\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e. The total population of Hispanics/Latinos in the US is projected to be 110\u0026nbsp;million by 2060, accounting for 28% of the total US population\u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. As of 2021, 20.7% of the Hispanic population was reported to have some kind of mental illness\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e. About 6.8% of Hispanics in the US reported experiencing a major depressive episode in 2019, representing an estimated prevalence rate of 4.1\u0026nbsp;million Hispanics suffering from mental illness annually\u003csup\u003e\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. In the same year, 14.5% of Hispanics were reported to experience mild to severe anxiety symptoms by the National Center for Health Statistics, compared to non-Hispanic White (16.5%) and Asian (8.5%) adults\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e. Thus, it is important to identify potential risk factors for mental illness, including anxiety/depression symptoms, to support mental health prevention and intervention efforts in Hispanic/Latino communities.\u003c/p\u003e \u003cp\u003eThe perceived general health of individuals can influence their mental health status, such as depression\u003csup\u003e\u003cspan additionalcitationids=\"CR8 CR9 CR10\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. Hispanics have been reported to have higher odds of fair/poor health and serious depression in a study that assessed monthly trends and disparities by race, ethnicity, and socioeconomic status during the COVID-19 pandemic\u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. Studies, including meta-analysis, reported a strong association between depressive symptoms and poor general health status\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. A national study among US adults aged 50 and older reported a strong association between poor perceived mental health and poor/fair health status\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Additionally, a study among Mexican American adults reported that poorer general health status was associated with depression\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. However, none of these studies evaluated these associations in a nationally representative sample of Hispanic/Latino population in the US. Also, although there are studies on the trends and disparities in anxiety and depression across multiple racial groups, no study has specifically focused on Hispanics/Latinos. For instance, studies have reported an increase and disparities in the prevalence trend of anxiety\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e and depression\u003csup\u003e\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e among all races and sexes.\u003c/p\u003e \u003cp\u003eOther factors, including sociodemographic and socioeconomic characteristics, and health behaviors, have also been associated with depression/anxiety. A study investigating the distributions of depressive symptoms by gender reported that females have higher depressive symptoms than males\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e. Younger adults and those with low income and educational levels were more at risk for depression symptoms\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. Health behavior factors such as body mass index (BMI), in particular obesity, was reported to have a significant association with depression and anxiety\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. Moreover, the prevalence of depression has been reported to be increasing with widening disparities in the US\u003csup\u003e21,22\u003c/sup\u003e. It is imperative to also assess within-race-specific prevalence trends of anxiety/depression symptoms for improved mental health interventions.\u003c/p\u003e \u003cp\u003eAlthough previous studies have assessed general health influence on mental health, the link between general health and anxiety/depression symptoms among the US Hispanic/Latino populations is understudied and less understood. The present study aims to assess the temporal trends and associations between general health and anxiety/depression symptoms among Hispanics/Latinos in the US. Specifically, this study aims to: (1) estimate the relative risk of anxiety/depression symptoms by general health status among the Hispanic/Latino populations, (2) assess the prevalence and difference in anxiety/depression symptoms by general health status in the Hispanic/Latino population, adjusting for sociodemographic and socioeconomic characteristics, and health behaviors, (3) examine the temporal trend and annual average percent change of anxiety/depression symptoms over time among Hispanic/Latino population based on general health status, adjusting for sociodemographic and socioeconomic characteristics, and health behaviors, and (4) evaluate the odds of anxiety/depression symptoms among the Hispanic/Latino populations. We hypothesize that Hispanics/Latinos will experience an increasing prevalence of anxiety/depression symptoms, and those who reported having fair/poor general health are more likely to experience anxiety/depression symptoms. This study provides a better understanding of the complexities between general health status and anxiety/depression symptoms among the Hispanic/Latino population, which is essential for tailored and effective interventions toward mitigating the impact of mental health disorders, hence, improving the health and quality of life of the Hispanic/Latino populations.\u003c/p\u003e"},{"header":"2. Methodology","content":" \u003cp\u003e \u003cb\u003e2.0 Study Design and Data Source\u003c/b\u003e \u003c/p\u003e \u003c/li\u003e \u003c/span\u003e \u003c/ol\u003e \u003c/p\u003e \u003cp\u003eThis study utilized publicly available de-identified, nationally representative, population-based retrospective cross-sectional data from the Health Information National Survey (HINTS) of US adults aged 18 years and older. As such, an Institutional Review Board approval was not required to access the data for this study. The survey measures health-related determinants and outcomes, including sociodemographic, socioeconomic, behavioral health, and mental health factors. We aggregated and utilized seven HINTS datasets in this study: 2011\u0026ndash;2012 and 2014 (from HINTS 4 Cycles 1\u0026ndash;2, 4), 2017\u0026ndash;2019 (from HINTS 5 Cycles 1\u0026ndash;3), and 2022 (from HINTS 6). Datasets from 2013 (HINTS 4 Cycle 3), 2015 (HINTS FDA), and 2017 (HINTS FDA Cycle 2) were excluded due to missing anxiety/depression variable, 2020 (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 (HINTS SEER) was excluded in this study as it is not publicly available.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Sampling Study Participants\u003c/h2\u003e \u003cp\u003eThe total participants included 17,923 adults who completed any of the seven surveys (HINTS 4 Cycle 1, October 2011 through February 2012 [n\u0026thinsp;=\u0026thinsp;2,591]; Cycle 2, October 2012 through January 2013 [n\u0026thinsp;=\u0026thinsp;2,233]; Cycle 4, August 2014 through November 2014 [n\u0026thinsp;=\u0026thinsp;2,287]; HINTS 5 Cycle 1, January 2017 through May 2017 [n\u0026thinsp;=\u0026thinsp;2,162]; Cycle 2, January 2018 through May 2018 [n\u0026thinsp;=\u0026thinsp;2,283]; Cycle 3, January 2019 through April 2019 [n\u0026thinsp;=\u0026thinsp;3,771]; HINTS 6, March 2022 through November 2022 [n\u0026thinsp;=\u0026thinsp;2,596]). Participants in this study are individuals who self-reported or identified as Hispanic/Latino. The total sample included 1,927 Hispanic/Latino adults in the six surveys (HINTS4 Cycle 1 [n\u0026thinsp;=\u0026thinsp;267, 17.8%], Cycle 2 [n\u0026thinsp;=\u0026thinsp;197, 11.2%], Cycle 4 [n\u0026thinsp;=\u0026thinsp;193, 11.9%]; HINTS5 Cycle 1 [n\u0026thinsp;=\u0026thinsp;132, 10.8%], Cycle 2 [n\u0026thinsp;=\u0026thinsp;137, 9.0%], Cycle 3 [n\u0026thinsp;=\u0026thinsp;275, 13.7%]; HINTS 6 [n\u0026thinsp;=\u0026thinsp;726, 25.4%]).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Measures\u003c/h2\u003e \u003cp\u003e \u003cb\u003e2.2.0 Outcome/Dependent Variable: Anxiety/Depression Symptoms\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe dependent variable in this study is anxiety/depression symptoms measured using the Patient Health Questionnaire-4 (PHQ4). The PHQ4 has been used as a screening tool for anxiety/depression symptoms. It is comprised of a screening tool for depression (PHQ-2) and generalized anxiety disorder (GAD-2). The first two questions measure the level of anxiety (GAD-2), and the last two measure the depression level (PHQ-2). Having a GAD-2 score\u0026thinsp;\u0026ge;\u0026thinsp;3 suggests anxiety, and a PHQ-2 score\u0026thinsp;\u0026ge;\u0026thinsp;3 suggests depression. Participants were asked the following four questions based on the PHQ4: \u0026ldquo;Over the past 2 weeks, how often have you been bothered by\u0026rdquo; little interest, hopeless, nervous, and worrying. Overall, the PHQ4 score ranges from 0\u0026ndash;12, often categorized as none (0\u0026ndash;2), mild (3\u0026ndash;5), moderate (6\u0026ndash;8), and severe (9\u0026ndash;12) anxiety/depression symptoms\u003csup\u003e\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u003c/sup\u003e. We recategorized the PHQ-4 scores as no anxiety/depression symptoms (none) with scores\u0026thinsp;\u0026le;\u0026thinsp;2 and anxiety/depression symptoms (mild, moderate, and severe) with scores\u0026thinsp;\u0026gt;\u0026thinsp;2\u003csup\u003e23\u003c/sup\u003e.\u003c/p\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003e2.2.1 Independent Variable: General Health\u003c/h2\u003e \u003cp\u003eThe primary independent variable of interest in this study is general health. HINTS survey asked participants: \u0026ldquo;In general, would you say your health is?\u0026rdquo; and provided the answer choices of excellent, very good, good, fair, and poor. General health was dichotomized as excellent/very good/good and fair/poor\u003csup\u003e26\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e2.2.2 Covariate\u003c/h2\u003e \u003cp\u003eOther variables/covariates included sociodemographic, socioeconomic, and behavioral health factors. The sociodemographic factors included sex at birth (male or female), age (18\u0026ndash;25, 26\u0026ndash;34, 35\u0026ndash;49, 50\u0026ndash;64, or 65+), marital status (married/living as married, divorced, widowed, separated, or single/never married), and census region (Northeast, Midwest, South, or West). Socioeconomic factors included annual family income (\u0026lt;\u003cspan\u003e$\u003c/span\u003e20,000, \u003cspan\u003e$\u003c/span\u003e20,000-\u003cspan\u003e$\u003c/span\u003e34,999, \u003cspan\u003e$\u003c/span\u003e35,000-\u003cspan\u003e$\u003c/span\u003e49,999, \u003cspan\u003e$\u003c/span\u003e50,000-\u003cspan\u003e$\u003c/span\u003e74,999, or \u0026ge;\u003cspan\u003e$\u003c/span\u003e75,000), healthcare coverage (yes or no), self-perceived quality healthcare (excellent, very good, good, fair, or poor; recategorized as excellent/very good/good or fair/poor), and education (less than high school, 12 years or completed high school, some college or post high school training other than college, or college graduate or greater). Health behavior factors included the number of times moderately exercised (recategorized as none, at least 1 per day), BMI calculated by the given height and weight, provided by the survey respondents (recategorized as underweight [\u0026lt;\u0026thinsp;18.5], normal weight [18.5\u0026ndash;24.9], overweight [25.0-29.9], obese [\u0026ge;\u0026thinsp;30]), and smoking status (current smoker, former smoker, or never smoked).\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Statistical Analysis\u003c/h2\u003e \u003cp\u003eStatistical analyses conducted in this study included temporal trends, differences in prevalence, bivariate, and multivariate analyses. To achieve nationally representative estimates, our samples were weighted with the survey weight to account for the complex survey design from the primary sample unit, the sample strata, and the sample weight. In Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, population characteristics of Hispanics/Latinos were obtained from frequency and percentages. Bivariate Chi-square tests were conducted to examine the differences in anxiety/depression symptoms among the levels of individual general health and covariates. In Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, we estimated the relative risk of anxiety/depression symptoms for general health among Hispanics/Latinos, calculating the absolute percentage difference and relative risk/odds ratio. In Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, prevalence measures of the temporal trend for anxiety/depression symptoms and annual average percentage change (AAPC) over the survey period were estimated from 2011\u0026ndash;2012, 2014, 2017\u0026ndash;2019, and 2022. The AAPC was calculated using the semi-elasticity index approach by the US Bureau of Labor Statistics \u003csup\u003e\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. In Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, adjusted multivariable logistic regression analysis models were conducted to obtain adjusted odds of anxiety/depression among Hispanics/Latinos. Four logistic regression models were examined: (1) general health adjusted for sociodemographic factors, (2) general health adjusted for socioeconomic factors, (3) general health adjusted for health behavior factors, and (4) fully adjusted (general health adjusted for all covariates) models. The summary of our analyses was reported using percentages, adjusted odds ratio (AOR), 95% confidence interval (95% CI), and p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 for statistical significance. Our analyses were conducted using IBM SPSS Statistics Software (Version 29.0.0.0).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample Characteristics, Prevalence, and Bivariate Analysis of Anxiety/Depression Symptoms Status among Hispanic/Latinos in the US, 2011\u0026ndash;2022\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOverall\u003c/p\u003e \u003cp\u003e[N\u0026thinsp;=\u0026thinsp;1927, 100%]\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Anxiety/Depression Symptoms [n\u0026thinsp;=\u0026thinsp;951, 48.2%]\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAnxiety/Depression Symptoms\u003c/p\u003e \u003cp\u003e[n\u0026thinsp;=\u0026thinsp;976, 51.8%]\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eChi-square; p-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYear\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2011\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e267 (17.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e161 (69.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e106 (30.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e197 (11.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67 (45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e130 (54.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e193 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e66 (34.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e127 (65.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2017\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e132 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61 (33.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e71 (66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2018\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e137 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e46 (26.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91 (73.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e275 (13.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e106 (41.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e169 (58.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e726 (25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e444 (58.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e282 (41.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGeneral Health Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcellent/Very good/Good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1412 (74.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e798 (56.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e614 (43.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair/Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e515 (25.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e153 (24.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e362 (75.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.654\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e138 (16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56 (51.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e82 (48.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e(20.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e135 (45.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e172 (54.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e553 (32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e268 (45.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e285 (54.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e555 (21.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e284 (50.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e271 (49.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e374 (9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e208 (52.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e166 (47.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e704 (46.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e383 (52.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e321 (47.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1223 (53.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e568 (44.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e655 (55.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.012\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle/Never Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e383 (34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e140 (41.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e243 (58.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried/Living as Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1036 (53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e569 (53.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e467 (46.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced/Separated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e385 (9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e191 (46.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e194 (53.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e72 (64.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUS Census Region\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.171\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNortheast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e274 (15.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e136 (55.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e138 (44.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMidwest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e123 (9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e61 (57.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62 (42.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e800 (35.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e399 (45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e401 (54.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e730 (40.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e355 (45.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e375 (54.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of Education Completed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.546\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;High school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e284 (16.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115 (51.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e169 (48.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e349 (22.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e170 (43.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e179 (56.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSome college or post high school training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e635 (37.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e298 (47.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e337 (52.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;College graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e659 (23.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e368 (51.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e291 (48.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Annual Family Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u003cspan\u003e$\u003c/span\u003e20,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e499 (19.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e169 (34.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e330 (65.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e20,000-\u003cspan\u003e$\u003c/span\u003e34,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e295 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e132 (47.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e163 (52.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e35,000-\u003cspan\u003e$\u003c/span\u003e49,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e284 (18.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e150 (42.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e134 (57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e50,000-\u003cspan\u003e$\u003c/span\u003e74,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e324 (18.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e176 (52.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e148 (47.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u003cspan\u003e$\u003c/span\u003e75,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e525 (28.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e324 (59.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e201 (40.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth Insurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.048\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e243 (14.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e103 (38.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e140 (61.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1684 (85.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e848 (49.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e836 (50.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQuality Care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcellent/Very Good/Good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1680 (87.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e857 (50.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e823 (49.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair/Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e247 (12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e94 (34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e153 (65.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBody Mass Index (BMI)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.209\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;18.5 (Underweight)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24 (2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11 (35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13 (64.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18.5\u0026ndash;24.9 (Healthy weight)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e455 (25.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e238 (54.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e217 (45.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25.0-29.9 (Overweight)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e683 (34.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e352 (49.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e331 (51.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30.0 (Obese)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e765 (37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e350 (44.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e415 (55.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eModerate Physical Activity Intensity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.003\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e535 (25.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e213 (38.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e322 (61.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt least 1 day per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1392 (74.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e738 (51.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e654 (48.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCigarette Smoking Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.108\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1367 (72.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e695 (50.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e672 (49.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormer smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e344 (15.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e178 (46.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e166 (53.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCurrent smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e216 (12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e78 (38.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e138 (61.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRelative Risk of Anxiety/Depression Symptoms Among Hispanics/Latinos in the US by General Health Status, 2011\u0026ndash;2022\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGeneral Health Status\u003c/p\u003e \u003cp\u003eFair/Poor (A)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;515\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eGeneral Health Status\u003c/p\u003e \u003cp\u003eExcellent/Very Good/Good (B)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;1,412\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAbsolute Difference\u003c/p\u003e \u003cp\u003eA-B\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eRelative Risk\u003c/p\u003e \u003cp\u003eA/B\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety/Depression Symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e% (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e% (95% CI)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.7 (19.1\u0026ndash;31.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.3 (51.7\u0026ndash;60.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e28.7 (23.1\u0026ndash;35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.6 (25.0 -32.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24.9 (17.7\u0026ndash;33.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.4 (7.7\u0026ndash;13.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.6 (16.2\u0026ndash;28.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.7 (3.2\u0026ndash;6.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.59\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003eNote\u003c/b\u003e: \u003cem\u003eData from 2011, 2012, 2014, 2017, 2018, 2019, and 2022 Health Information National Trends Surveys, HINTS 4 Cycles 1, 2, 4, HINTS 5 Cycles 1, 2, 3, HINTS 6, respectively. Unweighted N\u0026thinsp;=\u0026thinsp;1,927; Weighted N\u0026thinsp;=\u0026thinsp;102,482,919. 2013 and 2015 (HINTS Cycle 3, HINTS-FDA) were excluded due to missing anxiety/depression variable (PHQ4), and 2016 was excluded due to the survey not being administered. 2020 data (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 data (HINTS SEER) was excluded due to it not being publicly available.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eTemporal Trend and Annual Average Percentage Change in Anxiety/Depression Symptoms among Hispanics/Latinos in the US\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2011\u0026ndash;2012\u003c/p\u003e \u003cp\u003e% (95% CI)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;464\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2014\u003c/p\u003e \u003cp\u003e% (95% CI)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;193\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2017\u0026ndash;2019\u003c/p\u003e \u003cp\u003e% (95% CI)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;544\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2022\u003c/p\u003e \u003cp\u003e% (95% CI)\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;726\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eAnnual Average Percentage Change Over Time\u003c/p\u003e \u003cp\u003e(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGeneral Health Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eExcellent/Very good/good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.3 (22.8\u0026ndash;36.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.3 (53.8\u0026ndash;75.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58.6 (50.7\u0026ndash;66.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34.0 (27.8\u0026ndash;40.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFair/Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e83.3 (72.9\u0026ndash;90.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e65.5 (39.7\u0026ndash;84.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e81.1 (71.7\u0026ndash;87.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e64.6 (53.5\u0026ndash;74.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-6.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e18\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.1 (5.4\u0026ndash;32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87.3 (55.8\u0026ndash;97.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.4 (47.8\u0026ndash;81.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e58.4 (38.9\u0026ndash;75.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e161.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e26\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.5 (27.4\u0026ndash;57.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.4 (38.8\u0026ndash;77.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68.6 (52.0-81.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e53.0 (38.8\u0026ndash;66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e35\u0026ndash;49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.1 (34.6\u0026ndash;54.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.4 (55.5\u0026ndash;84.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.5 (53.9\u0026ndash;75.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38.9 (28.5\u0026ndash;50.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e50\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.7 (37.9\u0026ndash;59.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.4 (29.8\u0026ndash;78.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.2 (52.2\u0026ndash;73.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27.3 (20.0-36.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-9.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e57.2 (42.7\u0026ndash;70.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.7 (32.0\u0026ndash;77.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58.4 (46.8\u0026ndash;69.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.4 (18.3\u0026ndash;41.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-16.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.7 (22.5\u0026ndash;45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.0 (47.0-82.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.3 (52.7\u0026ndash;72.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.3 (28.1\u0026ndash;47.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.1 (38.7\u0026ndash;55.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.9 (51.0-75.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.7 (58.7\u0026ndash;73.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e44.3 (37.3\u0026ndash;51.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSingle/Never Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.0 (16.2\u0026ndash;39.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.3 (41.7\u0026ndash;90.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73.6 (61.8\u0026ndash;82.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62.6 (50.1\u0026ndash;73.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e55.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMarried/Living as Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.9 (34.1\u0026ndash;50.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.9 (50.1\u0026ndash;75.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e58.4 (49.7\u0026ndash;66.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29.9 (23.5\u0026ndash;37.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-7.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDivorced/Separated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.9 (47.9\u0026ndash;77.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e52.7 (31.9\u0026ndash;72.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.9 (46.7\u0026ndash;73.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31.8 (21.8\u0026ndash;43.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-16.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.3 (34.6\u0026ndash;82.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.1 (45.4\u0026ndash;89.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e84.9 (69.9\u0026ndash;93.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e33.4 (16.0-56.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-8.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUS Census Region\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNortheast\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.9 (25.2\u0026ndash;54.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.7 (35.4\u0026ndash;77.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52.4 (35.1\u0026ndash;69.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34.8 (22.4\u0026ndash;49.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMidwest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.6 (11.2\u0026ndash;45.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.4 (11.8\u0026ndash;84.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.3 (39.3\u0026ndash;78.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42.9 (23.2\u0026ndash;65.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e29.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSouth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45.5 (32.4\u0026ndash;59.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.4 (45.7\u0026ndash;78.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.2 (58.5\u0026ndash;78.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e41.1 (32.2\u0026ndash;50.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eWest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.0 (27.9\u0026ndash;51.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.1 (59.7\u0026ndash;87.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.8 (56.1\u0026ndash;76.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43.2 (33.7\u0026ndash;53.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of Education Completed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u0026lt;High school\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.8 (21.8\u0026ndash;54.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.5 (26.8\u0026ndash;80.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76.3 (61.0\u0026ndash;87.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38.6 (23.5\u0026ndash;56.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eHigh school graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.9 (26.8\u0026ndash;58.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.5 (53.2\u0026ndash;89.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68.9 (54.0-80.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47.3 (34.0-60.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSome college or post high school training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.8 (29.0-53.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.3 (57.1\u0026ndash;83.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66.3 (56.1\u0026ndash;75.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39.6 (30.0\u0026ndash;50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u0026ge;College graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.8 (30.0-52.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e59.5 (40.8\u0026ndash;75.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55.9 (43.2\u0026ndash;67.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38.1 (30.4\u0026ndash;46.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Annual Family Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u0026lt;\u003cspan\u003e$\u003c/span\u003e20,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e65.0 (52.0-76.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.8 (40.0-85.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71.2 (58.6\u0026ndash;81.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e56.6 (43.8\u0026ndash;68.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-3.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e20,000-\u003cspan\u003e$\u003c/span\u003e34,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46.2 (262\u0026thinsp;\u0026minus;\u0026thinsp;67.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.5 (31.9\u0026ndash;83.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e68.4 (51.0-81.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e45.5 (32.0-59.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e35,000-\u003cspan\u003e$\u003c/span\u003e49,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.1 (17.1\u0026ndash;49.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.1 (58.9\u0026ndash;86.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e67.9 (50.7\u0026ndash;81.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.8 (46.4\u0026ndash;73.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e50,000-\u003cspan\u003e$\u003c/span\u003e74,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.2 (19.2\u0026ndash;48.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54.6 (31.6\u0026ndash;75.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.7 (48.6\u0026ndash;75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e36.3 (21.6\u0026ndash;54.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u0026ge;\u003cspan\u003e$\u003c/span\u003e75,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.5 (14.1\u0026ndash;36.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.7 (39.4\u0026ndash;78.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60.3 (47.6\u0026ndash;71.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.0 (20.2\u0026ndash;37.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e34.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth Insurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e56.4 (39.4\u0026ndash;72.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75.7 (51.1\u0026ndash;90.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77.1 (53.6\u0026ndash;90.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47.4 (33.3\u0026ndash;61.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-0.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.0 (28.5\u0026ndash;44.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.2 (49.5\u0026ndash;75.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e64.0 (57.3\u0026ndash;70.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.1 (33.9\u0026ndash;46.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQuality Care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eExcellent/Very Good/Good\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.1 (29.8\u0026ndash;45.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.1 (49.7\u0026ndash;73.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.7 (56.6\u0026ndash;70.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38.2 (32.2\u0026ndash;44.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFair/Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e54.5 (36.5\u0026ndash;71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e84.6 (57.1\u0026ndash;95.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e81.1 (66.1\u0026ndash;90.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59.4 (41.8\u0026ndash;74.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBody Mass Index (BMI)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e18.5\u0026ndash;24.9 (Healthy weight)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.3 (16.6\u0026ndash;43.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.2 (39.4\u0026ndash;80.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62.6 (48.9\u0026ndash;74.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.9 (25.8\u0026ndash;51.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e25.0-29.9 (Overweight)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.9 (31.2\u0026ndash;51.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.2 (57.4\u0026ndash;84.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59.5 (49.0-69.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.0 (27.2\u0026ndash;48.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30.0 (Obese)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.5 (37.6\u0026ndash;59.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55.3 (37.6\u0026ndash;71.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.0 (59.6\u0026ndash;77.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e47.1 (38.0-56.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eModerate Physical Activity Intensity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.9 (40.9\u0026ndash;66.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73.6 (56.1\u0026ndash;86.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e70.4 (59.7\u0026ndash;79.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48.0 (37.4\u0026ndash;58.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAt least 1 day per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.3 (27.3\u0026ndash;44.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.4 (49.3\u0026ndash;73.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.2 (55.0-70.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39.3 (32.6\u0026ndash;46.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCigarette Smoking Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.6 (26.1\u0026ndash;42.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.1 (54.6\u0026ndash;77.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e65.7 (58.0-72.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.1 (33.6\u0026ndash;46.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFormer smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.6 (35.9\u0026ndash;65.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.1 (47.2\u0026ndash;82.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59.2 (44.5\u0026ndash;73.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e43.8 (28.9\u0026ndash;59.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-1.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCurrent smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59.7 (41.9\u0026ndash;75.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e56.6 (23.2\u0026ndash;84.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.4 (53.5\u0026ndash;81.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49.5 (27.7\u0026ndash;71.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e\u003cb\u003eNote\u003c/b\u003e: \u003cem\u003eData from 2011, 2012, 2014, 2017, 2018, 2019, and 2022 Health Information National Trends Surveys, HINTS 4 Cycles 1, 2, 4 and HINTS 5 Cycles 1, 2, 3, and HINTS 6, respectively. Unweighted N\u0026thinsp;=\u0026thinsp;1,927; Weighted N\u0026thinsp;=\u0026thinsp;102,482,919. 2013, 2015 (HINTS Cycle 3, HINTS-FDA) excluded due to missing anxiety/depression variable. 2013 and 2015 data (HINTS Cycle 3, HINTS-FDA) were excluded due to missing depression variable (PHQ4), and 2016 was excluded due to the survey not being administered. 2020 data (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 data (HINTS SEER) was excluded due to it not being publicly available.\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultivariable Logistic Regression Analysis of the Odds of Anxiety/Depression Symptoms among Hispanics/Latinos in the US, 2011\u0026ndash;2012, 2014, 2017\u0026ndash;2019\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSociodemographic-Adjusted\u003c/p\u003e \u003cp\u003eAOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSocioeconomic-Adjusted\u003c/p\u003e \u003cp\u003eAOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHealth Behavior- Adjusted\u003c/p\u003e \u003cp\u003eAOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFull adjusted\u003c/p\u003e \u003cp\u003eAOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeneral Health Status\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcellent/very good/good \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair/Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e3.95***\u003c/b\u003e (2.76\u0026ndash;5.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e3.56***\u003c/b\u003e (2.46\u0026ndash;5.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003e3.66***\u003c/b\u003e (2.47\u0026ndash;5.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e3.30 ***\u003c/b\u003e (2.29\u0026ndash;4.74)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSociodemographic Factors\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.168\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.59 (0.31\u0026ndash;1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63 (0.35\u0026ndash;1.14)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e26\u0026ndash;34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.86 (0.55\u0026ndash;1.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.83 (0.53\u0026ndash;1.28)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e35\u0026ndash;49 \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e50\u0026ndash;64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.72 (0.47\u0026ndash;1.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.70 (0.47\u0026ndash;1.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.57 (0.37\u0026ndash;0.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.58 (0.36\u0026ndash;0.93)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSex\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.137\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.191\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.30 (0.92\u0026ndash;1.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.25 (0.90\u0026ndash;1.73)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e0.005\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.007\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle/Never Married \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried/Living as Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.53 (0.35\u0026ndash;0.80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.56 (0.38\u0026ndash;0.83)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced/Separated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.66 (0.39\u0026ndash;1.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.61 (0.36\u0026ndash;1.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.07 (0.52\u0026ndash;2.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.10 (0.54\u0026ndash;2.22)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eUS Census Region\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e0.035\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNortheast \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMidwest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.81 (0.42\u0026ndash;1.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.77 (0.38\u0026ndash;1.56)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSouth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003e1.56*\u003c/b\u003e (0.99\u0026ndash;2.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.58*\u003c/b\u003e (1.02\u0026ndash;2.46)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWest\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.39 (0.89\u0026ndash;2.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.52 (0.97\u0026ndash;2.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocioeconomic Factors\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLevel of Education Completed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.041\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;High school \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh school graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.22*\u003c/b\u003e (1.24\u0026ndash;3.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e2.04*\u003c/b\u003e (1.13\u0026ndash;3.70)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSome college or post high school training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.91*\u003c/b\u003e (1.11\u0026ndash;3.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.68 (0.96\u0026ndash;2.93)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;College graduate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e2.07*\u003c/b\u003e (1.17\u0026ndash;3.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.88*\u003c/b\u003e (1.05\u0026ndash;3.37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal Annual Family Income\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e0.041\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.065\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u003cspan\u003e$\u003c/span\u003e20,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003e1.79*\u003c/b\u003e (1.06\u0026ndash;3.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1.87*\u003c/b\u003e (1.10\u0026ndash;3.17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e20,000-\u003cspan\u003e$\u003c/span\u003e34,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.28 (0.75\u0026ndash;2.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.36 (0.81\u0026ndash;2.30)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e35,000-\u003cspan\u003e$\u003c/span\u003e49,999\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.47 (0.86\u0026ndash;2.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.53 (0.89\u0026ndash;2.61)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cspan\u003e$\u003c/span\u003e50,000-\u003cspan\u003e$\u003c/span\u003e74,999 \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u003cspan\u003e$\u003c/span\u003e75,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.83 (0.51\u0026ndash;1.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.93 (0.57\u0026ndash;1.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth Insurance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.201\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.276\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.38 (0.84\u0026ndash;2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.32 (0.80\u0026ndash;2.16)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eQuality Care\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.243\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.185\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExcellent/Very Good/Good \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFair Poor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.32 (0.83\u0026ndash;2.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.37 (0.86\u0026ndash;2.20)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHealth Behavior Factors\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBody Mass Index (BMI)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.624\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.561\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18.5\u0026ndash;24.9 \u003cb\u003e[ref]\u003c/b\u003e (Health weight)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e25.0-29.9 (Overweight)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.24 (0.81\u0026ndash;1.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.26 (0.84\u0026ndash;1.89)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;30.0 (Obese)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.16 (0.76\u0026ndash;1.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.20 (0.81\u0026ndash;1.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eModerate Physical Activity Intensity\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.24 (0.88\u0026ndash;1.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.34 (0.96\u0026ndash;1.87)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt least 1 day per week \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCigarette Smoking Status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.470\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.440\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever \u003cb\u003e[ref]\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFormer smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.08 (0.74\u0026ndash;1.563)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.20 (0.81\u0026ndash;1.78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCurrent smoker\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.38 (0.81\u0026ndash;2.37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.29 (0.77\u0026ndash;2.16)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e\u003cb\u003eNote\u003c/b\u003e: \u003cem\u003eData from 2011, 2012, 2014, 2017, 2018, 2019, and 2022 Health Information National Trends Surveys, HINTS 4 Cycles 1, 2, 4 and HINTS 5 Cycles 1, 2, 3, and HINTS 6, respectively. Unweighted N\u0026thinsp;=\u0026thinsp;1927; Weighted N\u0026thinsp;=\u0026thinsp;102,482,919. 2013 and 2015 (HINTS Cycle 3, HINTS-FDA) were excluded due to missing anxiety/depression variable (PHQ4), and 2016 was excluded due to the survey not being administered. 2020 data (HINTS 5 Cycle 4) was excluded due to the COVID-19 pandemic, and 2021 data (HINTS SEER) was excluded due to it not being publicly available. BMI\u0026thinsp;\u0026lt;\u0026thinsp;18.5 was excluded from the table due to the small sample size. Statistical significance: Bold (*p\u0026thinsp;\u0026le;\u0026thinsp;0.05, **p\u0026thinsp;\u0026le;\u0026thinsp;0.01, ***p\u0026thinsp;\u0026le;\u0026thinsp;0.001).\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"3. Results","content":"\u003cp\u003e \u003cb\u003e3.0 Prevalence of Anxiety/Depression Symptoms Among Hispanic/Latinos\u003c/b\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e examines the estimated weighted prevalence of anxiety/depression symptoms among Hispanics/Latinos. The 2018 survey year reported the highest prevalence of anxiety/depression symptoms among Hispanics/Latinos (73.4%). We observed a higher prevalence of anxiety/depression symptoms among Hispanics/Latinos with fair/poor general health than those with excellent/very good/good general health (75.3% vs 43.7%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Among the sociodemographic factors, the highest prevalence was among Hispanics/Latinos aged 35\u0026ndash;49 (54.5%), females (55.2%), widowed (64.7%), and individuals from the South US census region (54.3%). Among the socioeconomic factors, the highest prevalence of anxiety/depression symptoms was among Hispanic/Latino who graduated high school (56.5%), those who earned \u0026lt;\u003cspan\u003e$\u003c/span\u003e20,000 (65.6%), those with no health insurance (61.2%), and those with fair/poor quality care (65.9%). Among the health behaviors or lifestyle risk factors considered in this study, the highest prevalence was among Hispanics/Latinos with a BMI\u0026thinsp;\u0026lt;\u0026thinsp;18.5 (64.8%), no moderate physical activity (61.2%), and current smokers (61.4%). There was a statistically significant difference in anxiety/depression symptoms among Hispanics/Latinos by survey year (p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001), general health (p\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;0.001), marital status (p\u0026thinsp;=\u0026thinsp;0.012), total annual family income (p\u0026thinsp;=\u0026thinsp;0.001), health insurance (p\u0026thinsp;=\u0026thinsp;0.048), quality of care (p\u0026thinsp;=\u0026thinsp;0.005), and moderate physical activity intensity (p\u0026thinsp;=\u0026thinsp;0.003).\u003c/p\u003e \u003cp\u003e[\u003cb\u003eInsert\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Relative Risk of Anxiety/Depression Symptoms by General Health Among Hispanics/Latinos\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the relative risk of anxiety/depression symptoms between Hispanics/Latinos with fair/poor and excellent/very good/good general health. Hispanics/Latinos with fair/poor health were relatively 0.43 times less \u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003elikely\u003c/span\u003e to experience no anxiety/depression than those with excellent/very good/good general health. On the other hand, Hispanics/Latinos with fair/poor general health were relatively 2.39 and 4.59 times more likely to be at risk of moderate and severe anxiety/depression compared to those with excellent/very good/good general health. Additionally, the severity of the risk of anxiety/depression increases for Hispanics/Latinos with fair/poor compared to those with excellent/very good/good general health.\u003c/p\u003e \u003cp\u003e[\u003cb\u003eInsert\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Annual Average Percentage Change in Anxiety/Depression Symptoms among Hispanics/Latinos\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the annual average percentage change (AAPC) over the survey years from 2011\u0026ndash;2012, 2014, 2017\u0026ndash;2019, and 2022. Hispanics/Latinos with excellent/very good/good general health experienced a substantial 23.5% increase in AAPC of anxiety/depression symptoms. Meanwhile, those with fair/poor general health had a slight 6.0% decrease in AAPC of anxiety/depression symptoms over the survey years. For the sociodemographic factors, the Hispanics/Latinos with the highest increase in AAPC include those aged 18\u0026ndash;25 (161.1%), males (19.4%), single/never married (55.0%), and those who reside in the Midwest (29.9%). For the socioeconomic factors, the Hispanics/Latinos with the highest increase in AAPC include those who graduated high school (13.4%), earned an annual family income of \u003cspan\u003e$\u003c/span\u003e35,000-\u003cspan\u003e$\u003c/span\u003e49,999 (40.5%), had health insurance (13.2%), and had excellent/very good/good quality of care (10.0%). Behavioral health factors with the highest increase in AAPC were Hispanics/Latinos with a healthy BMI (27.0%), at least 1 day or more moderate physical activity (13.4%), and those who never smoked cigarettes (19.5%).\u003c/p\u003e \u003cp\u003e[\u003cb\u003eInsert\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Trend in Prevalence of Anxiety/Depression Symptoms among Hispanics/Latinos\u003c/h2\u003e \u003cp\u003eIn Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, we assessed the trend in the weighted prevalence of anxiety/depression by general health among Hispanics/Latinos over the survey years. Overall, Hispanics/Latinos with poor general health continuously had the highest prevalence of anxiety/depression across survey years, except in 2017 and 2018. Those with fair general health had a decline in anxiety/depression prevalence in 2014 but recorded the highest prevalence in 2018. Hispanics/Latinos with excellent general health reported a higher prevalence of anxiety/depression than those with fair and very good general health in 2014. Generally, Hispanics/Latinos with excellent, very good, or good general health experienced an increase in the prevalence of anxiety/depression up to 2018 and continued to fall from 2019. Meanwhile, those with poor general health remained the highest with fairly steady prevalence.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e[\u003cb\u003eInsert\u003c/b\u003e Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e depicts the trend in the prevalence of anxiety/depression by age group among Hispanics/Latinos. Hispanics/Latinos aged 18\u0026ndash;25 experienced an increased prevalence of anxiety/depression, having the lowest prevalence of anxiety/depression among all age groups in 2011\u0026ndash;2012 and the highest in 2014, 2019, and 2022. Those aged 65 years and above had the highest prevalence of anxiety/depression in 2012 and the lowest in 2017. Overall, the prevalence of anxiety/depression among Hispanics/Latinos aged 18\u0026ndash;25, 26\u0026ndash;34, and 35\u0026ndash;49 fairly increased over the survey years. Meanwhile, among those aged 50\u0026ndash;64 and 65 and older, the prevalence of anxiety/depression generally decreased slightly over survey years.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e[\u003cb\u003eInsert\u003c/b\u003e Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the prevalence trend of anxiety/depression by gender among Hispanics/Latinos. Hispanic/Latino females generally had a higher prevalence trend of anxiety/depression than their male counterparts. Additionally, both sexes experienced an increasing prevalence trend of anxiety/depression over the survey years, with males having a more significant increase than females. Prevalence trend of anxiety/depression then declined over the rest of the survey years, 2019 and 2022.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e[\u003cb\u003eInsert\u003c/b\u003e Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003e3.4 Adjusted Odds of Anxiety/Depression Symptoms among Hispanics/Latinos\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e presents the results of the likelihood/odds of general health associated with anxiety/depression symptoms adjusted for sociodemographic, socioeconomic, and behavioral health factors, and all covariates (fully adjusted), respectively. In the fully adjusted model, Hispanics/Latinos with fair/poor general health were more likely to report/experience anxiety/depression compared to those with excellent/very good/good general health (AOR\u0026thinsp;=\u0026thinsp;3.30, 95% CI\u0026thinsp;=\u0026thinsp;2.29\u0026ndash;4.74). When adjusting for the sociodemographic, socioeconomic, and behavioral health factors, Hispanics/Latinos with fair/poor general health were 3.95 (AOR\u0026thinsp;=\u0026thinsp;3.95, 95% CI\u0026thinsp;=\u0026thinsp;2.76\u0026ndash;5.64), 3.56 (AOR\u0026thinsp;=\u0026thinsp;3.56, 95% CI\u0026thinsp;=\u0026thinsp;2.46\u0026ndash;5.15), and 3.66 (AOR\u0026thinsp;=\u0026thinsp;3.66, 95% CI\u0026thinsp;=\u0026thinsp;2.47\u0026ndash;5.44) times more likely to report anxiety/depression compared to those with excellent/very good/good general health, respectively.\u003c/p\u003e \u003cp\u003eAmong the covariates in the fully adjusted model, marital status (p\u0026thinsp;=\u0026thinsp;0.007) and the US census region (p\u0026thinsp;=\u0026thinsp;0.035) were also statistically significantly associated with anxiety/depression. Hispanics/Latinos who reside in the South (AOR\u0026thinsp;=\u0026thinsp;1.58, 95% CI\u0026thinsp;=\u0026thinsp;1.02\u0026ndash;2.46) had higher odds of anxiety/depression compared to those who reside in the Northeast. Also, Hispanic/Latinos with high school education and college graduate or more had a higher likelihood of reporting anxiety/depression compared to those with less than a high school education [high school (AOR\u0026thinsp;=\u0026thinsp;2.04, 95% CI\u0026thinsp;=\u0026thinsp;1.13\u0026ndash;3.70), and college education or more (AOR\u0026thinsp;=\u0026thinsp;1.88, 95% CI\u0026thinsp;=\u0026thinsp;1.05\u0026ndash;3.37)]. Additionally, Hispanics/Latinos with a total annual family income of less than \u003cspan\u003e$\u003c/span\u003e20,000 had higher odds of having anxiety/depression than those who had a total annual family income of \u003cspan\u003e$\u003c/span\u003e50,000-\u003cspan\u003e$\u003c/span\u003e74,999 (AOR\u0026thinsp;=\u0026thinsp;1.87, 95% CI\u0026thinsp;=\u0026thinsp;1.10\u0026ndash;3.17).\u003c/p\u003e \u003cp\u003e[\u003cb\u003eInsert\u003c/b\u003e Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThis study assessed the link between general health and anxiety/depression symptoms among Hispanics/Latinos in the US using nationally representative data. We found that Hispanics/Latinos with fair/poor general health were at higher risk of moderate or severe anxiety/depression than those with excellent/very good/good general health. However, anxiety/depression decreased among Hispanics/Latinos with fair/poor general health over the survey time. In addition, the results showed that fair/poor general health was associated with higher odds of anxiety/depression compared to excellent/very good/good general health. These findings emphasize the importance of disaggregating data to better understand mental health disparities within population subgroups, to harmonize data and facilitate targeted mental health interventions\u003csup\u003e\u003cspan additionalcitationids=\"CR29 CR30 CR31\" citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eA study assessing depression by race and ethnicity found that more Hispanics reported severe depression than mild depression (41% vs 21%)\u003csup\u003e33\u003c/sup\u003e. While there are limited studies assessing the association between general health and depression among Hispanics/Latinos, there have been studies that found an inverse relationship between general health and the severity of anxiety and depression among different populations\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e,\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. Hispanics/Latinos with fair/poor general health status may have a higher risk for more severe forms of depression due to their disease status\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e. Hispanics/Latinos have been shown to be more likely to be depressed if they have health ailments such as heart disease, hypertension, and high cholesterol\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e. Other studies have indicated that chronic diseases such as rheumatoid arthritis, cancer, diabetes, and heart disease influenced general health outcomes\u003csup\u003e\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e,\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e. Another study focusing on people at risk for diseases like diabetes and cardiovascular disease determined that those who self-reported their health to be fair or poor were associated with having depressive symptoms\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. This implies that Hispanics/Latinos are more likely to be depressed because of what they believe their general health to be due to health ailments. Severe anxiety/depression can result in alcohol dependencies, insomnia, loss of concentration, memory problems, and suicide\u003csup\u003e\u003cspan additionalcitationids=\"CR40 CR41 CR42 CR43\" citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e. For instance, Katelyn et al. found that Hispanic groups, including Puerto Ricans and Mexican Americans with major depressive disorder (MDD), had the highest prevalence of alcohol dependence and consumption, and the odds of alcohol dependence were four times higher among those with MDD\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e. It is important to address and develop culturally appropriate interventions for Hispanics/Latinos with fair/poor general health, as they are at higher risk for more severe anxiety/depression outcomes. This study has demonstrated that there is a link between general health and anxiety/depression. Therefore, interventions to improve general health are necessary to mitigate the risk of severe anxiety/depression outcomes.\u003c/p\u003e \u003cp\u003eFurther, Hispanics/Latinos with excellent/very good/good general health experienced a significant increase in AAPC anxiety/depression than those with fair/poor general health over the observed survey years. Although the temporal trend in anxiety/depression showed that Hispanics/Latinos with fair/poor general health continuously experienced a higher prevalence of anxiety/depression, it is imperative to critically look deeper into the spike in anxiety/depression among those with excellent/very good/good general health. A study has found that major depression has significantly increased over time, generally among Hispanic adolescents from 2009 to 2019\u003csup\u003e16\u003c/sup\u003e. There are limited studies researching reasons for the dramatic increasing trend in anxiety/depression among Hispanic populations. Leung et al. suggested this could be due to concerns over being discriminated against, concerns about access to healthcare, and sudden loss of income\u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e. There have been numerous studies that have found that discrimination results in a high risk of negative mental health outcomes, including depression\u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e,\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e. Our findings indicate that the odds of anxiety/depression among Hispanics/Latinos with fair/poor general health increased, after adjusting for socioeconomic factors (i.e., education, income, and insurance). Therefore, it is important to develop policy interventions to improve the socioeconomic status of Hispanic/Latino populations. This can help improve their general health, hence reducing the growing mental health problems among Hispanic/Latino populations.\u003c/p\u003e \u003cp\u003eAdditionally, there was a slight decrease in AAPC anxiety/depression among Hispanics/Latinos with fair/poor general health over the observed survey years. Studies have found that Hispanics/Latinos have higher \u003cem\u003efamilism\u003c/em\u003e than other races and cultures\u003csup\u003e\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e,\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e. Studies on Hispanics/Latinos reveal that strong social bonds and \u003cem\u003efamilism\u003c/em\u003e may be protective factors for mental health outcomes\u003csup\u003e\u003cspan additionalcitationids=\"CR51\" citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e. For instance, Perez et al. uncovered that Hispanics/Latinos with health ailments are likely to change their health behaviors or seek treatment options when they have \u003cem\u003efamilism\u003c/em\u003e\u003csup\u003e\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u003c/sup\u003e. As such, education and awareness to encourage and promote \u003cem\u003efamilism\u003c/em\u003e and social bonds among Hispanics/Latinos is necessary as a potential intervention to improve their mental health problems.\u003c/p\u003e \u003cp\u003eWhen adjusting for sociodemographic factors, Hispanics/Latinos with fair/poor general health had increased odds of moderate-severe anxiety/depression. It is unclear how sociodemographic factors impact general health to influence anxiety/depression outcomes among Hispanics/Latinos. Sociodemographic factors were found to be associated with anxiety/depression among Hispanics/Latinos when assessing prevalence trends and AAPC over time. Young adult Hispanics/Latinos aged 18\u0026ndash;25 had the highest annual average percent increase in anxiety/depression of 161.1% over the observed survey years. This corroborated the findings by Daley (2022), who found that young Hispanics had a substantial increase in major depression from 2009 to 2019 (119.8%)\u003csup\u003e16\u003c/sup\u003e. The increase in depression symptoms among young adults aged 18\u0026ndash;25 has been shown in another study assessing depression trends by different age groups among the general US population from 2005 to 2015, using data from the National Survey on Drug and Health\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. Additionally, an increased prevalence of anxiety was observed among Hispanic/Latino adolescents, increasing from 32% in 2012 to 46% in 2018 in a study conducted in Dane County, Wisconsin\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u003c/sup\u003e. A systematic review assessing the effectiveness of different kinds of early intervention for mental health among youths indicated that evidence supports cognitive remediation, supportive education, and family psychoeducation as effective methods for interventions\u003csup\u003e\u003cspan citationid=\"CR54\" class=\"CitationRef\"\u003e54\u003c/span\u003e\u003c/sup\u003e. Therefore, adopting such interventions tailored toward Hispanic/Latino young adults can help address the growing mental health problems.\u003c/p\u003e \u003cp\u003eIn addition, Hispanic/Latino males and females were found to have an increase in AAPC in anxiety/depression symptoms, although males had a higher increase in AAPC than females (19.4% vs 2.2%). Compton et al. (2006) indicated that from 1991\u0026ndash;1992 and 2001\u0026ndash;2002, Hispanic males experienced an increasing rate of major depression\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Also, anxiety was reported to increase significantly among both men and women in the general US population from 2008 to 2018\u003csup\u003e55\u003c/sup\u003e. To our knowledge, no studies have uncovered why Hispanic/Latino males are experiencing an increasing trend of anxiety/depression over time. This warrants further research to understand why Hispanic/Latino males are experiencing such a staggering increase in anxiety/depression over time, to develop effective policy interventions.\u003c/p\u003e \u003cp\u003eOn the other hand, Hispanic/Latino females reported a higher overall prevalence of anxiety/depression symptoms than males (55.2% vs 47.8%). This finding is consistent with studies that found Hispanic/Latino females generally have a higher prevalence of depression than males\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan additionalcitationids=\"CR57\" citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e\u003c/sup\u003e. A more recent study has also found that females exhibited an increase in depression prevalence\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e. Hispanic/Latino females may have a higher prevalence of depression due to stresses related to acculturation\u003csup\u003e\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e. Acculturation, or the process of becoming accustomed to the US culture, can be stressful for Hispanic/Latino females, with studies finding that higher levels of stress related to acculturation may affect general health and result in higher severity of depression\u003csup\u003e\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e,\u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e60\u003c/span\u003e\u003c/sup\u003e. Therefore, addressing acculturation-related problems among Hispanics/Latinos can help improve their general and mental health.\u003c/p\u003e \u003cp\u003eAlso, Hispanics/Latinos with fair/poor general health had a higher likelihood of anxiety/depression symptoms when adjusting for health behaviors or lifestyle risk factors. Health behaviors like BMI, in particular obesity, can affect general health, as shown in a study by Okosun et al., who found that Hispanics have significantly increased odds of a reduction in self-rated health if they have obesity in comparison to non-Hispanic Whites\u003csup\u003e\u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e61\u003c/span\u003e\u003c/sup\u003e. We found a nonsignificant increased association of overweight and obesity with anxiety/depression symptoms among Hispanics/Latinos. There are limited studies on how health behaviors or lifestyle factors like BMI, smoking status, or exercise affect general health. However, our findings show that the association between general health and anxiety/depression symptoms among Hispanics/Latinos may be influenced by their health behaviors. As such, targeted interventions towards Hispanics/Latinos who are obese are recommended to improve the outcome of general health and anxiety/depression. Such interventions could include dieting, physical activity, weight loss drugs, and bariatric surgery, which have been studied extensively\u003csup\u003e\u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e62\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe influence of general health on anxiety/depression symptoms among Hispanics/Latinos underscores the need for additional research to investigate the causal relationship between general health and mental health outcomes and interventions to improve the general health outcomes of Hispanics/Latinos. Additionally, culturally tailored mental health screening tools for Hispanics/Latinos can be useful in effectively screening for mental health symptoms to enhance the effective implementation of interventions.\u003c/p\u003e"},{"header":"5. Limitations","content":"\u003cp\u003eThis study has some limitations. It is a cross-sectional study, hence limiting the ability to establish a causal relationship between general health and anxiety/depression symptoms. The HINTS data were self-reported and could be affected by recall and social desirability biases. Additionally, we were unable to obtain restricted data for 2013, 2015, 2016, and 2021; therefore, they were not assessed, which could affect the estimated prevalence and temporal trends of anxiety/depression in this study. This study, however, provided tremendously important findings that can aid the development of health policy interventions tailored to improve the general health and mental health of Hispanics/Latinos.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eThis study contributed to the limited literature on the link between general health and anxiety/depression symptoms among the Hispanic/Latino population in the US. Overall, our findings showed that Hispanics/Latinos with fair/poor general health have a higher risk of experiencing anxiety/depression than those with excellent/very good/good general health. Thus, fair/poor general health may be a potential predictor of the growing trend of anxiety/depression symptoms among Hispanic/Latino populations in the US. Developing health policies and interventions that target improving the general health of Hispanics/Latinos may help prevent or reduce mental health disorders and improve their quality of life. In addition, higher prevalence trends and odds of anxiety/depression among Hispanics/Latinos were noted among young adults aged 18\u0026ndash;25 years and females. Further research is needed to understand the reasons for the increasing prevalence of anxiety/depression among these populations, especially among young adult Hispanics/Latinos, and to better delineate the heterogeneity of this relationship among Hispanics/Latinos.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Data Availability Statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe current study used publicly available, de-identified data from the Health Information National Survey (HINTS) by the United States National Institutes of Health (NIH), under the National Cancer Institute (NCI) program (https://hints.cancer.gov/).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors present deep gratitude to Dr. Faustine Williams and Dr. David Adzrago of the Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health (ZIA MD000015) for their voluntary contributions that facilitated the conduct of this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthorship contribution statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eL.M.\u0026nbsp;\u003c/strong\u003econtributed to the Conceptualization, Methodology, Data Curation, Formal Analysis, Visualization, Validation, Software, Writing \u0026ndash; Original Draft Preparation, Writing \u0026minus; Review \u0026amp; Editing, Project Administration, and Supervision. \u003cstrong\u003eJ.L.R.\u0026nbsp;\u003c/strong\u003econtributed the Conceptualization, Methodology, Data Curation, Formal Analysis, Visualization, Software, Writing \u0026ndash; Original Draft Preparation, Writing \u0026minus; Review \u0026amp; Editing. \u003cstrong\u003eE.T-B.\u0026nbsp;\u003c/strong\u003econtributed to the Methodology, Visualization, Validation, Writing \u0026minus; Review \u0026amp; Editing. \u003cstrong\u003eJ.Y.\u0026nbsp;\u003c/strong\u003econtributed to the Visualization, Validation, Writing \u0026minus; Review \u0026amp; Editing. \u003cstrong\u003eJ.D.F.\u0026nbsp;\u003c/strong\u003econtributed to the Conceptualization, Visualization, Validation, Writing \u0026minus; Review \u0026amp; Editing. \u003cstrong\u003eP.H.A.\u0026nbsp;\u003c/strong\u003econtributed to the Methodology, Visualization, Validation, Writing \u0026ndash; Review \u0026amp; Editing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLohuwa Mamudu, [email protected]\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatements \u0026amp; Declarations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eHuman Ethics and Consent to Participate declarations\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors consent to the publication of this manuscript and related data in scientific journals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eUnited States Census Bureau. 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Nutrients. 2014;6(11):5153\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Depression, Anxiety, Hispanics/Latinos, General Health Status, Mental Health","lastPublishedDoi":"10.21203/rs.3.rs-8637874/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8637874/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eGeneral health has been linked with anxiety/depression symptoms in the general population, but there is limited information on Hispanic/Latino populations, who are the fastest-growing ethnic minority group. We investigated the temporal trend, disparities, and the association between general health and anxiety/depression symptoms among Hispanics/Latinos in the US.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eA weighted retrospective cross-sectional national population-based data from the Health Information National Trends Survey (2011\u0026ndash;2012, 2014, 2017\u0026ndash;2019, and 2022) involving 1,927 Hispanics/Latinos aged\u0026thinsp;\u0026ge;\u0026thinsp;18 years was analyzed. Semi-elastic annual average percentage change (AAPC), bivariate Chi-square, and multivariate logistic regression were conducted to examine the prevalence trends, differences, and odds of anxiety/depression symptoms with general health, adjusting for sociodemographic, socioeconomic, and behavioral health factors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAmong Hispanics/Latinos, the overall prevalence of anxiety/depression symptoms was 51.8% and 75.3% among those with fair/poor general health. There was an increasing relative risk of severity of anxiety/depression symptoms among Hispanics/Latinos with fair/poor general health. There was a 23.5% increase and 6.0% decrease in AAPC of anxiety/depression among Hispanics/Latinos with excellent/very good/good and fair/poor general health, respectively, across the survey years. Additionally, Hispanics/Latinos with fair/poor general health had higher odds of anxiety/depression symptoms than those with excellent/very good/good general health, after adjusting for the sociodemographic (AOR\u0026thinsp;=\u0026thinsp;3.95, 95% CI\u0026thinsp;=\u0026thinsp;2.76\u0026ndash;5.64), socioeconomic (AOR\u0026thinsp;=\u0026thinsp;3.56, 95% CI\u0026thinsp;=\u0026thinsp;2.46\u0026ndash;5.15), and behavioral health risk factors (AOR\u0026thinsp;=\u0026thinsp;3.66, 95% CI\u0026thinsp;=\u0026thinsp;2.47\u0026ndash;5.44), respectively.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eOur study shows Hispanics/Latinos with fair/poor general health are at a higher risk of experiencing anxiety/depression symptoms. We recommend additional research to better understand specific disease/health conditions that disproportionately contribute to anxiety/depression symptoms among Hispanics/Latinos.\u003c/p\u003e","manuscriptTitle":"Temporal Differences and Trends in General Health Associated with Anxiety/Depression Symptoms among Hispanics/Latinos","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-09 12:12:56","doi":"10.21203/rs.3.rs-8637874/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1a024562-73d7-42b5-8d44-491894f7f57b","owner":[],"postedDate":"February 9th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-24T18:39:10+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-09 12:12:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8637874","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8637874","identity":"rs-8637874","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}