Ana Quiñones|Anda Botoseneanu|Sheila Markwardt|Corey Nagel|Jason T. Newsom|David A. Dorr|Heather G. Allore
Racial/ethnic differences in multimorbidity development and chronic disease accumulation for middle-aged adults
Oregon Health & Science University|University of Michigan–Dearborn|Michigan United|University of Michigan–Ann Arbor|Oregon Health & Science University|University of Arkansas for Medical Sciences|Portland State University|Oregon Health & Science University|Yale University
multimorbidityhaving two coexisting chronic conditionsis highly prevalent costly disabling older adults questions remain regarding chronic diseases accumulation time whether differs racial ethnic background answering knowledge gap study identifies differences rates chronic disease accumulation multimorbidity development among nonhispanic white nonhispanic black hispanic study participants starting middleage followed 16 yearswe analyzed data health retirement study hrs biennial ongoing publiclyavailable longitudinal nationallyrepresentative study middleaged older adults united states assessed change chronic disease burden among 8872 nonhispanic black nonhispanic white hispanic participants 5155 years age first interview time study period 19982014 subsequent followup observations 2014 multimorbidity defined two seven somatic chronic diseases arthritis cancer heart disease myocardial infarction coronary heart disease angina congestive heart failure heart problems diabetes hypertension lung disease stroke used negative binomial generalized estimating equation models assess trajectories multimorbidity burden time nonhispanic black nonhispanic white hispanic participants covariateadjusted models nonhispanic black respondents initial chronic disease counts 28 higher nonhispanic white respondents irr 1279 95 ci 1201 1361 hispanic respondents initial chronic disease counts 15 lower nonhispanic white respondents irr 0852 95 ci 0775 0938 nonhispanic black respondents rates chronic disease accumulation 11 slower nonhispanic whites irr 0989 95 ci 0981 0998 hispanic respondents rates chronic disease accumulation 15 faster nonhispanic white respondents irr 1015 95 ci 1002 1028 using marginal effects commands translates predicted values chronic disease white respondents begin study period 098 chronic diseases end 28 chronic diseases black respondents begin study period 13 chronic diseases end 33 chronic diseases hispanic respondents begin study period 084 chronic diseases end 27 chronic diseasesmiddleaged nonhispanic black adults start higher level chronic disease burden develop multimorbidity earlier age average nonhispanic white counterparts hispanics hand accumulate chronic disease faster rate relative nonhispanic white adults findings important implications improving primary secondary chronic disease prevention efforts among nonhispanic black hispanic americans stave greater multimorbidityrelated health impacts