Describing the population health burden of depression: health-adjusted life expectancy by depression status in Canada
Bibliographic record
Abstract
INTRODUCTION: Few studies have evaluated the impact of depression in terms of losses to both premature mortality and health-related quality of life (HRQOL) on the overall population. Health-adjusted life expectancy (HALE) is a summary measure of population health that combines both morbidity and mortality into a single summary statistic that describes the current health status of a population. METHODS: We estimated HALE for the Canadian adult population according to depression status. National Population Health Survey (NPHS) participants 20 years and older (n = 12 373) were followed for mortality outcomes from 1994 to 2009, based on depression status. Depression was defined as having likely experienced a major depressive episode in the previous year as measured by the Composite International Diagnostic Interview Short Form. Life expectancy was estimated by building period abridged life tables by sex and depression status using the relative risks of mortality from the NPHS and mortality data from the Canadian Chronic Disease Surveillance System (2007-2009). The Canadian Community Health Survey (2009/10) provided estimates of depression prevalence and Health Utilities Index as a measure of HRQOL. Using the combined mortality, depression prevalence and HRQOL estimates, HALE was estimated for the adult population according to depression status and by sex. RESULTS: For the population of women with a recent major depressive episode, HALE at 20 years of age was 42.0 years (95% CI: 40.2-43.8) compared to 57.0 years (95% CI: 56.8-57.2) for women without a recent major depressive episode. For the population of Canadian men, HALE at 20 was 39.0 years (95% CI: 36.5-41.5) for those with a recent major depressive episode compared to 53.8 years (95% CI: 53.6-54.0) for those without. For the 15.0-year difference in HALE between women with and without depression, 12.3 years can be attributed to the HRQOL gap and the remaining 2.7 years to the mortality gap. The 14.8 fewer years of HALE observed for men with depression equated to a 13.0-year HRQOL gap and a 1.8-year mortality gap. CONCLUSION: The population of adult men and women with depression in Canada had substantially lower healthy life expectancy than those without depression. Much of this gap is explained by lower levels of HRQOL, but premature mortality also plays a role.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.009 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".