Undiagnosed depression: A community diagnosis

•Risk factors for undiagnosed depression include psychological stress, drug use, and co-morbid medical conditions.•Based on QALYs lost, the per-resident burden of having undiagnosed depression is $9950 of lost QALYs per resident.•Less advantaged residents bear an even greater economic burden of having undiagnosed depression.•There are both benefits and challenges associated with tackling depression at the community level.

Many large provider networks are investing heavily in preventing disease within the communities that they serve. We explore the potential benefits and challenges associated with tackling depression at the community level using a unique dataset designed for one such provider network. The economic costs of having depression (increased medical care use, lower quality of life, and decreased workplace productivity) are among the highest of any disease. Depression often goes undiagnosed, yet many believe that depression can be treated or prevented altogether. We explore the prevalence, distribution, economic burden, and the psychosocial and economic factors associated with undiagnosed depression in a lower-income neighborhood in northern Manhattan. Even using state-of-the art data to “diagnose” the risk factors within a community, it can be challenging for provider networks to act against such risk factors.