The findings in this report are subject to at least five limitations.
First, because BRFSS surveys include only noninstitutionalized adults with
telephones, persons in institutions and in households without telephones (i.e.,
populations that might have worse mental health than others) are excluded.6 Because certain racial/ethnic minorities are disproportionately represented
in these vulnerable populations, their overall FMD prevalence likely is underestimated.
Second, because states commonly use only English- or Spanish-language surveys,
persons who speak another primary language are excluded. Third, because BRFSS
is a cross-sectional survey, whether the characteristics studied (e.g., SES
and marital status) affect FMD or whether FMD affects these characteristics
is uncertain. Fourth, although the characteristics studied explained some
of the variability in FMD among racial/ethnic populations, risk behaviors,
physical and social environment, psychosocial factors, health conditions,
stressful life events, unmeasured socioeconomic factors, and cultural factors
might account for additional FMD differences among racial/ethnic populations.
Finally, the BRFSS mental health measure was not validated for detection of
mental illness with clinical psychiatric examinations.