More Than 50% of Americans Are Living With Chronic Conditions

In a new study, researchers from Emory University in Atlanta have found that more than half of US adults are living with at least 1 chronic medical condition, and many more have multiple conditions.

Investigators conducted a secondary data analysis using publicly available data from the National Survey on Drug Use and Health (NSDUH), an annual, nationally representative survey. Pooled data from the 2010-2012 NSDUH surveys included 115,921 adults aged 18 or older. The researchers examined the patterns of co-occurrence of mental illness, substance abuse or dependence, and chronic medical conditions, and the cumulative burden of these conditions and living in poverty on self-rated health.
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Overall, 18.4% of adults had a mental illness in the past year, with 8.6% reporting substance abuse or dependence during that span. Close to 40% had 1 or more chronic medical conditions in their lifetime, and 14.7% indicated they were living in poverty.

The majority of adults studied (52.2%) had at least 1 type of condition, such as mental illness, substance abuse or dependence, or chronic medical conditions, with substantial overlap across the conditions, according to the authors, who pointed out that the odds of reporting worse health also increased as the number of conditions increased among participants. The likelihood of reporting fair or poor health was greatest for people who reported any mental illness (AMI), chronic medical conditions, and poverty, followed by all 3 conditions and poverty.

For each combination of conditions, the addition of poverty increased the likelihood of reporting fair or poor health, the authors noted. "The health of individuals in the U.S.A. is increasingly being defined by complexity and multimorbidity," they wrote.

“[Primary care providers] should be aware that their patients may have co-occurring medical conditions, as well as mental disorders and/or substance use disorders," said study coauthor Elizabeth Reisinger Walker, PhD, MPH, MAT, research assistant professor and assistant director of evidence-based learning at Emory's Rollins School of Public Health.

While multimorbidity has traditionally been defined as 2 or more chronic medical conditions, these findings show that "primary care providers and other physicians should also keep in mind the co-occurrence of mental disorders and substance abuse, as well," Dr Walker added.

"This suggests that continued efforts to provide continuity of care across primary care, mental health care, and substance use treatment are needed," she continued, noting the connection between poverty and poorer health revealed in the study.

Given this association, she said, "Primary care providers may need to go beyond the health care system to fully address their patients' needs."

—Mark McGraw

Reference:
Walker ER, Druss BG. Cumulative burden of comorbid mental disorders, substance use disorders, chronic medical conditions, and poverty on health among adults in the U.S.A [published online September 3, 2016]. Psychol Health Med. doi:10.1080/13548506.2016.1227855.