School of Social Work, Columbia University, New York, NY 10027, USA.
Med Care. 2013 Jun;51(6):540-7. doi: 10.1097/MLR.0b013e31828dbb19.
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.
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.
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.
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.
美国患有多种慢性疾病(MCMC)的人群比例正在增加。然而,人们对于种族、民族和精神障碍对一般人群中 MCMC 患病率的影响知之甚少。
本研究使用了来自国家酒精和相关条件流行病学调查(N=33,107)的第 2 波数据。使用调整了社会人口统计学变量、体重指数和生活质量的多项逻辑回归模型,来检验种族/民族、精神科诊断以及种族/民族与精神科诊断之间的相互作用对 MCMC 的 12 个月患病率的差异。
与非西班牙裔白人相比,调整了协变量后,西班牙裔报告 MCMC 的可能性较低,而非洲裔美国人报告 MCMC 的可能性较高。与没有精神科疾病的人相比,患有精神科疾病的人报告 MCMC 的可能性更高。种族和精神科诊断之间存在显著的相互作用,与 MCMC 的发生率有关。在存在某些精神科疾病的情况下,与具有相似精神科疾病的非西班牙裔白人相比,患有精神科疾病的非洲裔美国人发生 MCMC 的可能性更高。
我们的研究结果表明,种族、民族和精神科疾病与 MCMC 的患病率有关。随着 MCMC 发病率的上升,确定哪些人群处于高风险状态以及如何最好地提供服务以满足他们的医疗需求至关重要。