Ashley D. Givens, PhD, MSW, University of Missouri-Columbia, Columbia, MO, USA.
Amy Blank Wilson, PhD, LSW, University of North Carolina at Chapel Hill, NC, USA.
J Am Psychiatr Nurses Assoc. 2021 Jul-Aug;27(4):283-291. doi: 10.1177/10783903211014943. Epub 2021 May 29.
Individuals with severe mental illnesses experience high rates of chronic health conditions; however, the extent to which risk of chronic physical health problems varies by race and gender among these individuals is understudied. This study examines variations in health problems by race and gender among individuals with severe mental illnesses. Administrative data, which included blood pressure, body mass index (BMI), and glycated hemoglobin (HbA1c) values, were obtained from 603 individuals with serious mental illnesses who received integrated health and behavioral health services from a large mental health agency in the Midwest. Bivariate and multivariate statistical models were used to examine variation in physical health problems by race and gender. Compared with men, women with severe mental illnesses were more likely to have BMI levels indicating obesity or morbid obesity ( < .001). Compared with White participants, Black participants were less likely to have high HbA1c levels ( < .001) but were more likely to have high blood pressure ( < .001). Among race and gender groups, Black women were more likely to have high BMI ( < .05), Black men were more likely to have high blood pressure ( < .001), and White men were more likely to have high HbA1c levels ( < .01) when holding constant all other variables. There is evidence that types and severity of physical health problems among individuals with severe mental illnesses varies by race and gender. Replication of these results and more research is needed to ensure that health-related education and integrated health and behavioral health interventions meet the needs of individuals with serious mental illnesses.
患有严重精神疾病的个体慢性病发病率较高；然而，在这些人群中，种族和性别对慢性身体健康问题风险的影响程度研究不足。本研究考察了严重精神疾病个体中种族和性别差异与健康问题的关系。本研究从中西部一家大型心理健康机构接受综合健康和行为健康服务的 603 名严重精神疾病患者中获取了包括血压、体重指数（BMI）和糖化血红蛋白（HbA1c）值在内的行政数据。采用双变量和多变量统计模型来考察种族和性别差异与身体健康问题的关系。与男性相比，患有严重精神疾病的女性更有可能出现 BMI 水平表明肥胖或病态肥胖（<.001）。与白人参与者相比，黑人参与者出现 HbA1c 水平升高的可能性较低（<.001），但出现高血压的可能性较高（<.001）。在种族和性别群体中，黑人女性更有可能出现 BMI 较高（<.05），黑人男性更有可能出现高血压（<.001），而白人男性更有可能出现 HbA1c 水平升高（<.01），在控制所有其他变量的情况下。有证据表明，严重精神疾病个体的身体健康问题的类型和严重程度因种族和性别而异。需要对这些结果进行复制并开展更多的研究，以确保与健康相关的教育和综合健康及行为健康干预措施满足严重精神疾病患者的需求。
