Spatial analysis and modelling of depression relative to social vulnerability index across the United States

Submitted: 13 July 2022
Accepted: 9 August 2022
Published: 1 September 2022
Abstract Views: 2527
PDF: 1174
HTML: 213
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


According to the Substance Abuse and Mental Health Services Administration, about 21 million adults in the US experience a major depressive episode. Depression is considered a primary risk factor for suicide. In the US, about 19.5% of adults are reported to be experiencing a depressive disorder, leading to over 45,000 deaths (14.0 deaths per 100,000) due to suicides. To our knowledge, no previous spatial analysis study of depression relative to the social vulnerability index has been performed across the nation. In this study, county-level depression prevalence and indicators were compiled. We analysed the geospatial distribution of depression prevalence based on ordinary least squares, geographically weighted regression, and multiscale geographically weighted regression models. Our findings indicated that the multiscale model could explain over 86% of the local variance of depression prevalence across the US based on per capita income, age 65 and older, belonging to a minority group (predominantly negative impacts), and disability (mainly positive effect). This study can provide valuable insights for public health professionals and policymakers to address depression disparities.



PlumX Metrics


Download data is not yet available.


Allen J, Balfour R, Bell R, Marmot M, 2014. Social determinants of mental health. Int Rev Psychiatry 26:392-407. DOI:
America’s Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, 2022. Available from:
Bailey RK, Mokonogho J, Kumar A, 2019. Racial and ethnic differences in depression: current perspectives. Neuropsychiatr Dis Treat 15:603. DOI:
Brunsdon C, Fotheringham AS, Charlton ME, 1996. Geographically weighted regression: a method for exploring spatial nonstationarity. Geogr Anal 28:281-98. DOI:
Centres for Disease Control and Prevention. CDC’s Social Vulnerability Index (SVI), 2018. Available from:
Centres for Disease Control and Prevention, National Centre for Health Statistics. Underlying Cause of Death 1999-2020 on CDC WONDER Online Database, 2022. Available from:
Cuadros DF, Tomita A, Vandormael A, Slotow R, Burns JK, Tanser F, 2019. Spatial structure of depression in South Africa: A longitudinal panel survey of a nationally representative sample of households. Sci Rep 9:1-10. DOI:
Fotheringham AS, Oshan TM, 2016. Geographically weighted regression and multicollinearity: dispelling the myth. J Geogr Syst 18:303-29. DOI:
Fotheringham AS, Yang W, Kang W, 2017. Multiscale geographically weighted regression (MGWR). Ann Assoc Am Geogr 107:1247-65. DOI:
Frasquilho D, Matos MG, Salonna F, Guerreiro D, Storti CC, Gaspar T, Caldas-de-Almeida JM, 2015. Mental health outcomes in times of economic recession: a systematic literature review. BMC Public Health 16:1-40. DOI:
Goldmann E, Galea S, 2014. Mental health consequences of disasters. Annu Rev Public Health 35:169-83. DOI:
Greenberg PE, Fournier AA, Sisitsky T, Simes M, Berman R, Koenigsberg SH, Kessler RC, 2021. The economic burden of adults with major depressive disorder in the United States (2010 and 2018). Pharmacoeconomics 39:653-65. DOI:
Hames E, Stoler J, Emrich CT, Tewary S, Pandya N, 2017. A GIS approach to identifying socially and medically vulnerable older adult populations in South Florida. Gerontologist 57:1133-41. DOI:
Jung SW, Yoon JH, Lee W, 2021. Predictors for depressive symptoms by four types of disability. Sci Rep 11:1-10. DOI:
Key Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration, 2022. Available from:
Kiani B, Raouf Rahmati A, Bergquist R, Hashtarkhani S, Firouraghi N, Bagheri N, Moghaddas E, Mohammadi A, 2021. Spatio-temporal epidemiology of the tuberculosis incidence rate in Iran 2008 to 2018. BMC Public Health 21:1-20. DOI:
Kok RM, Reynolds CF, 2017. Management of depression in older adults: a review. JAMA 317:2114-22. DOI:
Lin H, Jin M, Liu Q, Du Y, Fu J, Sun C, Ma F, Li W, Liu H, Zhang X, Zhu Y, Chen Y, Sun Z, Wang G, Huang G, Yan J, 2021. Gender-specific prevalence and influencing factors of depression in elderly in rural China: A cross-sectional study. J Affect Disord 288:99-106. DOI:
Lund EM, Nadorff MR, Thomas KB, Galbraith K, 2020. Examining the contributions of disability to suicidality in the context of depression symptoms and other sociodemographic factors. Omega: J Death Dying 81:298-318. DOI:
Mansour S, Al Kindi A, Al-Said A, Al-Said A, Atkinson P, 2021. Sociodemographic determinants of COVID-19 incidence rates in Oman: Geospatial modelling using multiscale geographically weighted regression (MGWR). Sustain Cities Soc 65:102627. DOI:
Mathew S, Pulugurtha SS, Duvvuri S, 2022. Exploring the effect of road network, demographic, and land use characteristics on teen crash frequency using geographically weighted negative binomial regression. Accid Anal Prev 168:106615. DOI:
Mollalo A, Vahedi B, Rivera KM, 2020. GIS-based spatial modeling of COVID-19 incidence rate in the continental United States. Sci Total Environ 728:138884. DOI:
Mollalo A, Mohammadi A, Mavaddati S, Kiani B, 2021. Spatial analysis of COVID-19 vaccination: A scoping review. Int J Environ Res Public Health 18:12024. DOI:
Mollalo A, Tatar M, 2021. Spatial modeling of COVID-19 vaccine hesitancy in the United States. Int J Environ Res Public Health 18:9488. DOI:
National Institute of Mental Health, 2022. Depression. Available from:
Nguyen TN, Ngangue P, Bouhali T, Ryan BL, Stewart M, Fortin M,2019. Social vulnerability in patients with multimorbidity: a cross-sectional analysis. Int J Environ Res Public Health 16:1244. DOI:
Oshan TM, Li Z, Kang W, Wolf LJ, Fotheringham AS, 2019. MGWR: A Python implementation of multiscale geographically weighted regression for investigating process spatial heterogeneity and scale. ISPRS Int J Geo-Inf 8:269. DOI:
Park YS, McMorris BJ, Pruinelli L, Song Y, Kaas MJ, Wyman JF, 2021. Use of geographic information systems to explore associations between neighborhood attributes and mental health outcomes in adults: a systematic review. Int J Environ Res Public Health 18:8597. DOI:
Patel V, Burns JK, Dhingra M, Tarver L, Kohrt BA, Lund C, 2018. Income inequality and depression: a systematic review and meta‐analysis of the association and a scoping review of mechanisms. World Psychiatry 17:76-89. DOI:
Roca M, Del Amo ARL, Riera-Serra P, Pérez-Ara M, Castro A, Roman Juan J, García-Toro M, García-Pazo P, Gili M, 2019. Suicidal risk and executive functions in major depressive disorder: a study protocol. BMC Psychiatry 19:1-6. DOI:
Santini ZI, Jose PE, Cornwell EY, Koyanagi A, Nielsen L, Hinrichsen C, Meilstrup C, Madsen KR, Koushede V, 2020. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. Lancet Public Health 5:e62-e70. DOI:
Shrestha N, 2020. Detecting multicollinearity in regression analysis. Am J Appl Math 8:39-42. DOI:
Shyman L, Sukhorukov R, Barbic D, Mathias S, Chau S, Leon A, Barbic S, 2021. Social determinants of health and depression in adults presenting to the emergency department: Implications for family medicine. Can Fam Physician 67:e337-47. DOI:
Smith R, Meeks S, 2019. Screening older adults for depression: Barriers across clinical discipline training. Innov Aging 3:igz011. DOI:
Smith-East M, Neff DF,2020. Mental health care access using geographic information systems: An integrative review. Issues Ment Health Nurs 41:113-21. DOI:
The Lancet Global Health. Mental health matters, 2020. Lancet Glob Health 8:e1352. DOI:
Trinh NH, Jahan AB, Chen JA, 2021. Moving from cultural competence to cultural humility in psychiatric education. Psychiatr Clin North Am 44:149-57. DOI:
Vahratian A, Blumberg SJ, Terlizzi EP, Schiller JS, 2021. Symptoms of anxiety or depressive disorder and use of mental health care among adults during the COVID-19 pandemic - United States, August 2020-February 2021. MMWR Morb Mortal Wkly Rep 70:490. DOI:
Ward MD, Gleditsch KS, 2018. Spatial regression models (Vol. 155). Sage Publications. DOI:
Wilderman A, Lam M, Yin ZY, 2021. A pilot study exploring the relationship between urban greenspace accessibility and mental health prevalence in the City of San Diego in the context of socioeconomic and demographic factors. Open Health 2:50-70. DOI:
Witteveen D, Velthorst E, 2020. Economic hardship and mental health complaints during COVID-19. Proc Natl Acad Sci U S A 117:27277-84. DOI:
World Health Organization, 2021. Depression. Available from:
Wu C, Zhou M, Liu P, Yang M, 2021. Analyzing COVID‐19 using multisource data: An integrated approach of visualization, spatial regression, and machine learning. GeoHealth 5:e2021GH000439. DOI:

How to Cite

Rivera, K. M., & Mollalo, A. (2022). Spatial analysis and modelling of depression relative to social vulnerability index across the United States. Geospatial Health, 17(2).

List of Cited By :

Crossref logo