About

Briana Mezuk is a Professor of Epidemiology at the University of Michigan School of Public Health and serves as the Director of Masters Studies in Epidemiology. Her research program uses epidemiologic methods to examine the interrelationships between mental and physical health over the lifespan, integrating conceptual and analytical approaches from social science and clinical disciplines to develop a nuanced understanding of health interrelations. Her work aims to inform interventions that adopt an integrative approach to health, with a focus on mental health, aging, chronic disease, diabetes, health equity, and social epidemiology. Dr. Mezuk completed her doctoral training in the Psychiatric Epidemiology Training Program at Johns Hopkins School of Public Health and was a fellow with the Robert Wood Johnson Foundation Health and Society Scholars Program at the University of Michigan. Her research includes projects such as the Mood and Immune Regulation in Twins Study, the Richmond Stress and Sugar Study, and the ATLAS Project, which investigates suicide risk during major life transitions. She has contributed to understanding disparities in health related to race and socioeconomic status, stress reactivity, and the psychosocial care needs of patients with diabetes. Her work emphasizes the importance of interdisciplinary approaches to population health and health disparities.

Research topics

• Medicine
• Psychology
• Family medicine
• Psychiatry
• Biology
• Environmental health
• Nursing
• Medical education
• Immunology
• Genetics

Selected publications

• Work expectations, employment patterns, and psychological distress during the Great Recession among older Americans and South Koreans

  The Gerontologist · 2025-09-10 · 1 citations

  articleSenior author

  BACKGROUND AND OBJECTIVES: Perceived uncertainty about future employment and employment paths during economic crises can negatively affect the mental health of workers. This study examined the association between work expectations and psychological distress among Baby Boomers (born 1948-1965) in the United States and South Korea and explored how employment patterns moderated this association before, during, and after the Great Recession. RESEARCH DESIGN AND METHODS: Data came from 2006 to 2018 waves of the Health and Retirement Study (n = 2,647) and Korean Longitudinal Study of Aging (n = 1,454). Perceived expectations of working in the next 5 years were reported on a probability scale (0%-100%). Psychological distress was assessed by the Center for Epidemiologic Studies Depression Scale. Six mutually exclusive employment patterns during the Recession were constructed: entrance to full-time employment, precarious employment, stable full-time employment, self-employment, exit from the labor force, and consistently out of the labor force. Multivariate mixed-effects logistic regression models were used to assess the association between work expectations, employment patterns, and psychological distress. RESULTS: Higher work expectations were associated with lower odds of psychological distress; this association was most robustly observed during the Recession (ORUS = 0.93 [0.89, 0.98], ORKorea = 0.92 [0.84, 1.01]), and recovery (ORUS = 0.95 [0.92, 0.98], ORKorea = 0.84 [0.80, 0.89]). The relationship between expectations and distress was pronounced among respondents who were self-employed or transitioning into self-employment. Findings were broadly similar comparing two countries. DISCUSSION AND IMPLICATIONS: Expectations regarding, and patterns in, employment impact psychological distress. Findings emphasize the need to support the mental health of older adults nearing retirement during periods of economic crisis.

  PublisherDOI

• Psychological Care Needs and Mental Health Service Use Among Adults with Diabetes: Evidence from the Diabetes, Distress and Disparities (3D) Study

  Preprints.org · 2025-04-18 · 1 citations

  preprintOpen access1st authorCorresponding

  Background/Objectives: Mental disorders and diabetes-related distress (DRD) are under-addressed aspects of person-centered diabetes care. This study examines the burden of depression, anxiety, and DRD among adults with type 1 or 1.5 (T1D/T1.5D), type 2 (T2D), and gestational diabetes (GD), and explores their experiences and barriers in receiving mental health services. Methods: This study uses quantitative data from the 2023/24 Diabetes, Distress, and Disparities (3D) Study, which consists of 573 adults with diabetes (51.3% with T1D/T1.5D, 43.5% with T2D, and 4.4% with current/past GD). Mental health assessments included the Patient Health Questionnaire-9 (depression), Generalized Anxiety Disorder-7 (anxiety), and Problem Areas in Diabetes-11 (DRD). Logistic regression was used to examine the prevalence of mental health concerns and behavioral service use. Results: Overall, 14.5% had clinically-significant depression, 8.0% had anxiety, and 23.6% had elevated DRD. Symptoms of depression, anxiety, and DRD had a positive, non-linear relationship with poor glycemic control. Approximately 30% of those with clinically-significant emotional health concerns did not receive any behavioral health services in the past 12 months. Black adults were less likely to receive behavioral health treatment than non-Hispanic Whites (Odds ratio=0.24, 95% CI: 0.07- 0.77). Common reasons for not receiving behavioral health services included not knowing where to go, cost, and lack of accessible providers. Conclusions: Gaps in addressing emotional health needs of people with diabetes persist. Healthcare systems need to integrate addressing psychosocial factors as part of person-centered diabetes care.

  PublisherOA PDFDOI

• Protocol for the diabetes, distress and disparities (3D) study: an explanatory sequential mixed-methods design

  BMJ Open · 2025-04-01 · 1 citations

  articleOpen accessSenior author

  INTRODUCTION: Psychosocial factors impact diabetes outcomes, yet healthcare systems remain inadequately equipped to address these needs. Research centring on the experiences of people with diabetes (PWD) can inform programme implementation, policies and partnerships to address psychosocial care needs. The goals of the diabetes, distress and disparities (3D) study are to quantify the psychosocial care needs of PWD in a large academic medical centre, generate insights regarding how psychosocial factors shape diabetes outcomes and identify modifiable determinants of psychosocial care. METHODS AND ANALYSIS: The 3D study is recruiting adults with type 1 (T1D), type 2 (T2D), latent autoimmune diabetes in adults (LADA) and gestational diabetes (GD) from the Caswell Diabetes Registry at Michigan Medicine. The 3D study uses an explanatory sequential mixed-methods design with two phases. Phase I (P1: target n=500, began July 2023) consists of an online survey to quantify prevalence and examine correlates of a wide range of psychosocial factors (eg, diabetes-related distress, depression, stigma). This survey was refined through consultation with PWD. Phase II (P2) involves semi-structured telephone interviews with n=40 P1 respondents, recruited using maximum variation sampling informed by demographic characteristics and responses to psychosocial survey measures. P2 will explore a subset of factors (eg, patient-provider communication, social support, barriers/promoters to care). To date, n=573 (5% response rate) have completed P1. In March 2024, we identified a target sample of P1 respondents (n=65) for recruitment into P2. All data collection was completed by September 2024. Analysis will involve quantitative linear and logistic regression to understand correlates of psychosocial outcomes from P1, and qualitative content analysis to clarify potential points of intervention from P2. ETHICS AND DISSEMINATION: This study is approved by the University of Michigan Institutional Review Board (HUM00223735). Protocol materials are available at https://osf.io/yfz6b/. Findings from this study will be disseminated through peer-reviewed publications, presentations at conferences and outreach to key stakeholders, including creating educational materials for patient advocacy groups and interprofessional practice.

  PublisherDOI

• Area socioeconomic inequality and suicide mortality: contrasting common measures using National Violent Death Reporting System and linked administrative data

  American Journal of Epidemiology · 2025-01-25

  articleOpen access

  Area economic inequality may underlie social disparities in suicide mortality (SM). Differences in measuring inequality contribute to variability across empirical evidence. We contrasted common income measures-absolute poverty, Gini inequality index, Index of Concentration at the Extremes (ICE)-and examined their associations with age- and sex-standardized SM across 1381 US counties. We used the 2006-2019 National Violent Death Reporting System linked to 2006-2010 administrative data on socioeconomic factors and a Bayesian spatial multilevel approach. Compared to affluent areas, poorer areas had the highest relative risk (RR) of SM (ICE RR, 1.24; 95% credible interval [CI], 1.17-1.31; absolute poverty RR, 1.33; 95% CI, 1.25-1.41). Gini inequality was not linearly associated with SM. Cross-classifying Gini × ICE showed that the highest-risk areas had concentrated poverty (ICE) but varying Gini inequality. These high-risk, poverty-segregated areas were more often medically underserved, had lower population density, and high unemployment. African American or Indigenous suicide decedents frequently resided in high inequality areas, while older, White decedents with military backgrounds more often resided in lower Gini areas. The choice of inequality measure can lead to varied conclusions about social disparities in SM. A comparative approach offers more nuanced understanding of underlying socioeconomic marginalization.

  PublisherOA PDFDOI

• 115. DEPRESSIVE SYMPTOMS, SOCIAL CONNECTIONS, AND INCIDENT FALLS AMONG ADULTS AGED 65 AND OLDER

  American Journal of Geriatric Psychiatry · 2025-07-15

  article1st authorCorresponding
  PublisherDOI

• Diabetes beliefs, perceived risk and health behaviours: an embedded mixed-methods analysis from the Richmond Stress and Sugar Study

  BMJ Open · 2025-02-01 · 2 citations

  articleOpen accessSenior authorCorresponding

  INTRODUCTION: Efforts to increase engagement with diabetes prevention programmes largely focus on increasing diabetes awareness, with the logic that risk knowledge will motivate behaviour change. However, the salience of perceived risk as it relates to diabetes prevention is contested. The goal of this cross-sectional, embedded mixed-methods study was to examine the relationships between perceived risk, diabetes beliefs and prevention behaviours among adults at elevated risk of type 2 diabetes. METHODS: Data come from the Richmond Stress and Sugar Study (n=125). Diabetes beliefs (ie, internal, chance, powerful others) were assessed using the Multidimensional Health Locus of Control. Preventive behaviours (eg, changing diet, exercise, tobacco, alcohol) were measured by self-report. Perceived risk of developing diabetes was measured using a probability scale (0%-100%). Logistic and Poisson regression models quantified the relationships between beliefs, behaviours and perceived risk. Qualitative themes regarding challenges and facilitators to preventive behaviours were abstracted from open-ended questions and summarised using content analysis. RESULTS: Perceived risk of developing diabetes was low (median: 35% likelihood) and only 10% of participants had ever attended a prevention class. None of the diabetes belief domains were significantly associated with either engagement in preventive behaviours or perceived diabetes risk. Perceived diabetes risk was not associated with engagement in preventive behaviours; however, having a family history of diabetes was strongly related to perceived risk (OR: 3.35, 95% CI: 1.42 to 7.86). Qualitative facilitators and barriers of preventive behaviours reflected psychosocial factors (eg, determination, stress, preferences) and resources (eg, social support, time, overall health). CONCLUSIONS: Perceptions of risk and health beliefs are not correlated with engagement in preventive behaviours among adults at clinically elevated risk of diabetes. Awareness campaigns may benefit from incorporating family health history information. Diabetes prevention programmes should address barriers beyond health beliefs to promote engagement in behaviour change.

  PublisherOA PDFDOI

• 606-P: Addressing Diabetes Distress in Clinical Practice—Provider Feedback and Resource Gaps following Screening Implementation

  Diabetes · 2025-06-13

  article

  Introduction and Objective: While diabetes-related distress is common, healthcare systems may lack resources for adequately addressing this aspect of diabetes care. As part of a quality improvement initiative, we surveyed providers after implementation of annual diabetes distress (DD) screening for persons with Type 1 diabetes (PwT1D) in an academic center with the goal of better understanding how to best address DD in clinical practice. Methods: PwT1D were assigned the Type 1 Diabetes Distress Assessment System (T1DDAS) core scale prior to their adult endocrinology visits with results visible to providers in the electronic medical record during the clinical encounter. Providers were surveyed 1-year after screening implementation. Results: Between December 2023-2024, 2,081 T1DDAS questionnaires were completed by 1,852 unique patients out of 2,452 eligible patients (75.5%). The average score was 1.84±0.88 with 22.9% (n=477) reporting moderate (2.0-2.9) and 12.9% (n=268) reporting high (>3.0) distress. Sixteen of 42 providers responded (38%) to the post-implementation survey. While 15 (94%) agreed that DD is an important to address, only 11 (69%) felt confident in their ability to identify DD, and 3 (19%) were satisfied with the resources currently available to address DD. The most common barriers were limited clinic time (56%), inadequate resources (56%), and insufficient training (31%). Providers identified social work referrals, an embedded psychologist, and handouts with local mental health resources as the most helpful supports for patients with DD. Conclusion: Over one-third of PwT1D in our clinic reported moderate to high diabetes distress (DD), emphasizing the need for strategies to address elevated DD scores. Providers recognize the importance of addressing DD but express dissatisfaction with available resources. These findings will guide future Plan-Do-Check-Act cycles to improve support for PwT1D experiencing DD. Disclosure J.J. Iyengar: None. H. Centola: None. D. Broome: Research Support; Fractyl Health, Inc., Sanofi, T1D Exchange, Rhythm Pharmaceuticals, Inc, Novo Nordisk. K.R. Mizokami-Stout: None. L. Ang: None. J. Lee: None. J. Wyckoff: None. B. Mezuk: None. S. Soleimanpour: Research Support; Ono Pharmaceutical Co., Ltd. J.M. Lee: Advisory Panel; GoodRx. Funding Michigan Nutrition Obesity Research Center (P30DK089503), Michigan Diabetes Research Center (P30DK020572), Michigan Center for Diabetes Translational Research (P30DK092926), the Elizabeth Weiser Caswell Diabetes Institute, and the Breakthrough T1D Center of Excellence at the University of Michigan.

  PublisherDOI

• Expectations regarding transitioning into long-term care, social connectedness, and mental health of older adults

  Social Psychiatry and Psychiatric Epidemiology · 2025-08-18 · 1 citations

  articleOpen accessSenior authorCorresponding

  PURPOSE: This study examined the association between perceived likelihood of moving into a nursing home and depressive and suicidal outcomes among adults aged 65+, and explored variation in those associations by two aspects of social connectedness: individual social networks and neighborhood social cohesion. METHODS: Data comes from the 2018 Health & Retirement Study (N = 7,897). Perceived likelihood of moving into a nursing home in the next five years was assessed using a probability scale (0-100%). Past-year elevated depressive symptoms, major depressive episodes (MDE), and passive suicidal ideation (PSI) were indexed by the Composite International Diagnostic Interview. Social networks (e.g., diversity and frequency of contact with social network, number of close relationships) and neighborhood social cohesion (e.g., living close to good friends, neighborhood social cohesion index) were self-reported. Multivariable logistic regression models were used to examine the association between nursing home expectations and depression outcomes; moderation by social connectedness was examined using interaction terms. RESULTS: The majority of respondents reported low perceived likelihood of moving into a nursing home (median: 5%, IQR: 0-20%). Higher perceived likelihood was positively associated with depressive symptoms (Odds Ratio [OR]: 1.06, 95% CI: 1.01, 1.11), MDE (OR: 1.08, 95% CI: 1.02, 1.15), and PSI (OR: 1.10, 95% CI: 1.04, 1.17). Having a close friend in the neighborhood heightened the association between expectations and mental health; other measures of social connectedness did not moderate this association. CONCLUSION: Older adults anticipating transitioning to long-term care may have unmet emotional support needs, particularly if they are socially-integrated in their neighborhood.

  PublisherOA PDFDOI

• Exploring social, economic, and environmental correlates of suicide in Puerto Rico, 2017–2022: an ecological cross-sectional study

  Injury Epidemiology · 2025-12-01

  articleOpen accessSenior author

  BACKGROUND: Puerto Rico (PR) endures numerous natural and human-caused disasters with significant impacts on community health and infrastructure each year. The Centers for Disease Control's Social Vulnerability Index (CDC-SVI) quantifies a community's capacity to prepare, respond, and recover from disasters. The SVI has been linked to all-cause mortality in the continental US, however, its relevance to suicide mortality, particularly in PR, remains understudied. METHODS: This cross-sectional study analyzed data from 1,471 suicide decedents recorded in the PR site of the National Violent Death Reporting System (NVDRS) from 2017 to 2022. Using Bayesian Poisson hierarchical models, we examined the associations between the county-level CDC-SVI with age- and sex-standardized suicide mortality. We explored whether contributing circumstances (i.e., mental health history, financial loss) varied by measure of SVI among these decedents. RESULTS: During 2017-2022, there were 1,471 suicides (Mean age: 51 years, 84% male, 68% lower education) across PR's 78 municipalities. Overall, there was no association between county CDC-SVI and suicide mortality (Relative Risk: 1.05, 95% CI: 0.88-1.25). The most common contributing circumstances (available for 93% of decedents) were mental health problems (45%), depressed mood (44%), history of mental health treatment (29%), and prior suicide attempt (28%) or suicidal thoughts (26%). Our geospatial analyses revealed a clustering of suicide and vulnerability in central counties and island-municipalities, areas marked by long-standing economic disadvantage and limited access to healthcare. CONCLUSIONS: Social vulnerability was unrelated to suicide mortality, contrasting with prior studies in the continental US. While the CDC-SVI is a useful tool for disaster response planning, its utility for suicide prevention in PR depends on the local validity and relevance of its components. These results suggest that the contextual determinants of suicide in PR operate through different structural pathways, shaped by the island's distinct socioeconomic, demographic and disaster-exposed setting, where most communities already experience high vulnerability.

  PublisherDOI

• Detecting implicit racial bias in provider communication behaviors to reduce disparities in healthcare: Challenges, solutions, and future directions for provider communication training

  UNC Libraries · 2025-07-29

  articleOpen access1st authorCorresponding
  PublisherDOI

Recent grants

• A public health approach to understanding suicide in long-term care

  NIH · $407k · 2017–2020

• Michigan Center for Urban African American Aging Research

  NIH · $2.8M · 1997–2028

• Aging, Major Life Transitions, and Suicide Risk

  NIH · $3.9M · 2022–2026

• NIH Grant K01MH093642

  NIH · $689k · 2017

• Summer Training Program in Integrative Methods for Mental and Physical Health

  NIH · $441k · 2019–2028

Frequent coauthors

• Liming Dong

  59 shared

• Lynda D. Lisabeth

  University of Michigan–Ann Arbor

  53 shared

• Linda S. Williams

  Indiana University – Purdue University Indianapolis

  49 shared

• Viktoryia Kalesnikava

  University of Michigan–Ann Arbor

  46 shared

• Sandro Galea

  Boston University

  40 shared

• Kenneth Tardiff

  Cornell University

  39 shared

• David Vlahov

  Yale University

  39 shared

• Marta R. Prescott

  Boston University

  38 shared