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The Alachua County, Florida, Mortality Study

Robert E. Markush, MD; John J. Schwab, MD; Patricia Farris, MA; Paula A. Present, MA; Charles E. Holzer III, PhD

Arch Gen Psychiatry. 1977;34(12):1393-1401.

Abstract
• This study reports the results of a household survey and search of death certificates that show a relationship between depression, anxiety, and subsequent mortality. It is part of an effort to develop practical epidemiologic techniques for continuous assessment of community mental health. Use is made of the population attributable mortality rate, estimated from a comparison of the prevalence of a given factor in life and at death. The study estimated attributable mortality prospectively by following up participants in a mental health survey of Alachua County, Florida, for up to four years. Of eight mental scales examined, five (mood, depression, somatic symptoms of anxiety, the Health Opinion Survey, and selected psychopathologic symptoms) showed significant association of scores with community mortality. The data suggest linkages of mental factors to mortality of an order of magnitude sufficient to warrant consideration of these factors as leading causes of death.

Author Affiliations
From the Community Mental Health Epidemiology Program, Center for Epidemiologic Studies, National Institute of Mental Health, Rockville, Md (Dr Markush and Mrs Present); the Department of Psychiatry, University of Florida, Gainesville (Drs Schwab and Holzer and Mrs Farris). Dr Markush is now with St Elizabeths Hospital, Washington, DC; Dr Schwab is with the Department of Psychiatry and Behavioral Sciences, University of Louisville (Ky); Mrs Farris is now with Florida State University, Tallahassee; and Mrs Present is now with the Consumer Products Safety Commission, Bethesda, Md.

Footnotes
Accepted for publication Sept 14, 1977.

Read before the annual meeting of the American Sociological Association, San Francisco, Aug 29, 1975.

Reprint requests to 1321 Geranium St NW, Washington, DC 20012 (Dr Markush).

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