Discrimination and Multimorbidity among older adults

Abstract

Aim: This study aims to investigate the relationship between racial discrimination and multimorbidity among American older adults, and whether discrimination mediates the relationship between socioeconomic factors and health outcomes. Methods: Participants in this study who were 65 years of age or older were drawn from the 2022 Behavioural Risk Factors Surveillance System (BRFSS) database. This study included 44,029 participants. Multimorbidity was defined as the presence of two or more chronic conditions, including stroke, heart attack, angina, cancer, asthma, arthritis, depression, chronic pulmonary disease, diabetes, and kidney disease. Racial discrimination was measured through self-reported experiences of being treated differently based on race. Socioeconomic factors (income and education level) and behavioural factors (smoking, alcohol consumption, physical activity) were considered. Negative binomial regression models were used to examine the association between racial discrimination and multimorbidity, adjusting for potential confounders. Results: The analysis revealed a significant association between experience of racial discrimination and multimorbidity (Rate Ratio [RR] = 1.13; 95% Confidence Interval [CI]: 1.05- 1.21). Socioeconomic factors such as lower income and education levels were also significantly associated with higher multimorbidity risk, however no evidence of discrimination experience partially mediating the association. Conclusion: Understanding the impact of racial discrimination on multimorbidity highlights the importance of addressing social determinants of health. This study underscores the need for targeted interventions to mitigate health inequalities among older adults, particularly those facing racial discrimination.