Do Race, Ethnicity, and Psychiatric Diagnoses Matter in the Prevalence of Multiple Chronic Medical Conditions?

• Authors: Leopoldo J. Cabassa, Columbia University; Jennifer Humensky, New York State Psychiat Inst & Hosp; Benjamin Druss, Emory University; Roberto Lewis-Fernandez, New York State Psychiat Inst & Hosp; Arminda P. Gomes, Columbia University; Shuai Wang, New York State Psychiat Inst & Hosp; Carlos Blanco, New York State Psychiat Inst & Hosp
• Journal Title: Medical Care
• Volume: Volume 51, Number 6
• Publisher: Lippincott, Williams & Wilkins | 2013-06-01, Pages 540-547
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1097/MLR.0b013e31828dbb19
• Subjects: Health Sciences, Public Health; Psychology, General; Sociology, Ethnic and Racial Studies
• Keywords: Science & Technology; Life Sciences & Biomedicine; Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health; multiple chronic medical conditions; mental disorders; health disparities; National Epidemiologic Survey on Alcohol and Related Condition; health services research; ALCOHOL-USE-DISORDER; NATIONAL EPIDEMIOLOGIC SURVEY; RANDOMIZED CONTROLLED-TRIAL; INTERVIEW SCHEDULE AUDADIS; SERIOUS MENTAL-ILLNESS; UNITED-STATES; CARDIOVASCULAR-DISEASE; HEALTH-CARE; DIABETES-MELLITUS; RISK-FACTORS

Abstract

Background: The proportion of people in the United States with multiple chronic medical conditions (MCMC) is increasing. Yet, little is known about the relationship that race, ethnicity, and psychiatric disorders have on the prevalence of MCMCs in the general population. Methods: This study used data from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N = 33,107). Multinomial logistic regression models adjusting for sociodemographic variables, body mass index, and quality of life were used to examine differences in the 12-month prevalence of MCMC by race/ ethnicity, psychiatric diagnosis, and the interactions between race/ ethnicity and psychiatric diagnosis. Results: Compared to non-Hispanic Whites, Hispanics reported lower odds of MCMC and African Americans reported higher odds of MCMC after adjusting for covariates. People with psychiatric disorders reported higher odds of MCMC compared with people without psychiatric disorders. There were significant interactions between race and psychiatric diagnosis associated with rates of MCMC. In the presence of certain psychiatric disorders, the odds of MCMC were higher among African Americans with psychiatric disorders compared to non-Hispanic Whites with similar psychiatric disorders. Conclusions: Our study results indicate that race, ethnicity, and psychiatric disorders are associated with the prevalence of MCMC. As the rates of MCMC rise, it is critical to identify which populations are at increased risk and how to best direct services to address their health care needs.