Hispanic/Latinxs coexisting chronic health conditions, mental illness and social determinants of health

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Project Summary. People with mental illness (MI) die an average of 20 years earlier than the general population due to coexisting chronic health conditions (CHC, i.e., cancer, heart disease, diabetes). Hispanics/Latinxs (H/L) are a particularly vulnerable ethnic group in the United States (US), accounting for higher rates of MI and chronic health conditions than other minority ethnic groups. Specifically, H/L with MI have higher rates of obesity, and other metabolic risk factors placing them at elevated risk for cancer, heart disease, and diabetes. However, despite this alarming scenario, no research to date has established the prevalence of co-existing health conditions among H/L living with MI in the US. Furthermore, limited attention has been paid to how the interplay between multiple domains (i.e., biological, physical environment, sociocultural) and levels of influence (i.e., individual, interpersonal) drive these disparities among H/L with MI in the US. There is some evidence on how social determinants of health (SDH; i.e., gender, age, discrimination) correlate with poor health outcomes. However, it remains unclear how these SDH contribute to the health disparity burden experienced by H/L with MI in the US; which in turn, limits the availability of effective resources to improve their health. The overall goal of this proposal is to assess the contribution of social determinants of health, genetic ancestry and mental conditions in the prevalence, progression, and outcomes of coexisting chronic diseases in H/L. The central hypothesis is that H/L history of mental health diagnosis and adverse social contexts are co-occurring health risk factors and predictor in coexisting chronic health conditions. The All of Us Research Program datasets provide a unique opportunity to better understand the health disparities experienced by H/L with MI in the US. The aims of the proposed study are: Aim 1: Determine the prevalence of coexisting chronic health conditions (i.e., cancer, heart disease, diabetes) among H/L with a history of a mental illness diagnosis versus Hispanic/Latinxs without a history of a MI diagnosis. Aim 2: Determine the role of social determinants of health in the prevalence of coexisting chronic health conditions H/L with a history of a mental illness diagnosis.