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

项目摘要。患有精神疾病（MI）的人比普通人群平均早死20年 由于共存的慢性健康状况（CHC，即，癌症、心脏病、糖尿病）。西班牙裔/拉丁裔（H/L） 是美国（US）一个特别脆弱的种族群体，占MI和慢性 健康状况比其他少数民族好。具体来说，患有MI的H/L有更高的肥胖率， 其他代谢风险因素使他们患癌症、心脏病和糖尿病的风险增加。然而，在这方面， 尽管这种情况令人担忧，但迄今为止还没有任何研究确定了共存健康的普遍性 在美国与MI一起生活的H/L中的状况。此外，很少有人注意到， 在多个域之间（即，生物、物理环境、社会文化）和影响程度（即， 个体、人际）在美国的H/L与MI之间驱动这些差异。有证据表明 健康的社会决定因素（SDH;即，性别、年龄、歧视）与不良健康结果相关。 然而，目前尚不清楚这些SDH如何导致H/L经历的健康差异负担， MI在美国;这反过来又限制了有效资源的可用性，以改善他们的健康。总目标 这项建议的一个重要目的是评估健康、遗传血统和心理健康等社会决定因素的作用。 H/L中共存慢性疾病的患病率、进展和结局的条件。中央 假设是，精神健康诊断和不良社会背景的H/L历史是共同发生的健康风险 因素和预测因素共存的慢性健康状况。All of Us研究计划数据集提供 一个独特的机会，以更好地了解健康的差异所经历的H/L与MI在美国。目标 目的1：确定共存的慢性健康状况（即，癌症， 心脏病、糖尿病）与无精神疾病诊断史的西班牙裔/拉丁裔相比， 心肌梗死诊断史。目标2：确定健康的社会决定因素在艾滋病毒/艾滋病流行中的作用 同时存在的慢性健康状况H/L与精神疾病诊断史。

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.