Anxiety or Depression Trends by Disability Status and Demographic Intersections in US Adults, 2019-2023

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Importance: Mental health problems, particularly anxiety and depression, remain among the leading causes of disease burden in the US. However, trends in anxiety and depression across disability status and demographics remain understudied. Objective: To examine trends in anxiety and depression prevalence among US adults from 2019 to 2023 by disability status and demographic characteristics. Design, Setting, and Participants: This cross-sectional study used national population-based data from the National Health Interview Surveys from 2019 to 2023. Data were collected from household probability samples of noninstitutionalized US civilian adults aged at least 18 years. Data analyses were performed from December 6, 2024, to November 19, 2025. Exposures: Disability status (measured using Washington Group on Disability Statistics Short Set on Functioning), race and ethnicity, sex, and nativity. Main Outcomes and Measures: The primary outcomes were self-reported anxiety or depression symptoms, assessed using the Washington Group on Disability Statistics Extended Set on Functioning. Joinpoint regression was used to estimate age-standardized prevalence trends and average annual percentage change (AAPC) across disability status, race and ethnicity, sex, and nativity. Results: A total of 150 220 adults were examined (81 525 [51.3%] female; 48 814 individuals [32.3%] aged 45-64 years; 126 051 individuals [81.1%] born in the US), including 16 172 Black individuals (11.9%), 20 427 Hispanic or Latino individuals (17.7%), 12 221 individuals (8.9%) who identified as another race or ethnicity, and 101 400 White individuals (61.4%). There were 15 519 respondents (8.2%) with general disability status and 60 248 respondents (42.3%) with anxiety or depression. From 2019 to 2023, anxiety or depression prevalence increased significantly among individuals without disabilities (AAPC, 3.93; 95% CI, 2.15-5.75). Prevalence increased across all racial and ethnic groups without disabilities, with the highest increases among Black respondents (AAPC, 4.77; 95% CI, 0.61-9.10) and respondents who identified as another race or ethnicity (AAPC, 6.95; 95% CI, 2.56-11.53). Prevalence increased only among females without disabilities (AAPC, 3.50; 95% CI, 2.14-4.87), while increases were observed among males with (AAPC, 3.25; 95% CI, 0.41-6.17) and without (AAPC, 4.62; 95% CI, 1.70-7.63) disabilities. Individuals born outside the US without disabilities experienced higher increases (AAPC, 5.57; 95% CI, 3.10-8.11) than those with disabilities (AAPC, 3.46; 95% CI, 0.06-6.98) and individuals born in the US without disabilities (AAPC, 3.75; 95% CI, 2.14-5.40). Across race and ethnicity, sex, and nativity intersections, Black female individuals born outside the US without disabilities exhibited the highest increase (AAPC, 14.89; 95% CI, 0.48-31.36). Conclusions and Relevance: This cross-sectional study found increasing trends in anxiety or depression prevalence, particularly among individuals without disabilities, individuals born outside the US, and Black individuals and those who did not identify as Black, Hispanic, or White, as well as males and individuals born outside the US with disabilities. These findings emphasize the need for targeted mental health interventions addressing disparities across disability status and demographic intersections.

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