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America's Unhappiest Cities, per Business Week.
Seconded. Any such list lacking Newark is suspect...Syracuse NY, Newark, Camden, or Detroit now those are depressing cities!
So, in Portland, OR, a relatively affluent, very progressive community, insurance companies report a very high occurrence of the "depression" code on their books.
But pick a crumbling, destitute city like oh say Baltimore, MD, and there is not a high rate of "depression" codes on the insurance books.
OBVIOUSLY people in Portland are more depressed!
What a horrible little survey.
Cash
+
access (excellent state-run health plan for the low/low-middle class)
+
a very self-reflective, "enlightened" milieu
+
unremarkable substance dependence rates (less likely to self-medicate rather than seek help)
=
high rate of reporting and detecting depression, NOT necessarily a higher than normal rate of occurrence of depression.
Poverty
+
poor access
+
very low education and a culture where depression is HUGELY stigmatized
+
unreal rates of substance abuse (think self-medicating)
=
very low rates of people seeking medical help for depression and therefore low numbers on MA and insurance books regardless of true rate of depression.
I picked Baltimore because I happen to be familiar with both Portland and Baltimore, but my guess there are plenty of cities like this, where poverty, poor access, and massive cultural stigma falsely deflate depression "rates".
And since this studied weighted depression "rates" the most heavily, I think Portland got a bad rap.