TY  - JOUR
AU  - Valenzuela, Steele
AU  - Peak, Katherine D.
AU  - Huguet, Nathalie
AU  - Marino, Miguel
AU  - Schmidt, Teresa D.
AU  - Voss, Robert
AU  - Quinones, Ana R.
AU  - Nagel, Corey
PY  - 2024
TI  - Social Deprivation and Multimorbidity Among Community-Based Health Center Patients in the United States
T2  - Preventing Chronic Disease
JO  - Prev Chronic Dis
SP  - E75
VL  - 21
CY  - Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
N2  - INTRODUCTION  Multimorbidity - having 2 or more chronic diseases - is a national public health concern that entails burdensome and costly care for patients, their families, and public health programs. Adults residing in socially deprived areas often have limited access to social and material resources. They also experience a greater multimorbidity burden. METHODS  We conducted a retrospective cohort analysis of electronic health record (EHR) data from 678 community-based health centers (CHCs) in 27 states from the Accelerating Data Value Across a National Community Health Center (ADVANCE) Network, a clinical research network, from 2012-2019. We used mixed-effects Poisson regression to examine the relationship of area-level social deprivation (eg, educational attainment, household income, unemployment) to chronic disease accumulation among a sample of patients aged 45 years or older (N = 816,921) residing across 9,362 zip code tabulation areas and receiving care in safety-net health organizations. RESULTS  We observed high rates of chronic disease among this national sample. Prevalence of multimorbidity varied considerably by geographic location, both within and between states. People in more socially deprived areas with Social Deprivation Index (SDI) scores in quartiles 2, 3, and 4 had greater initial chronic disease counts - 17.1%, 17.7%, and 18.0%, respectively - but a slower rate of accumulation compared with people in the least-deprived quartile. Our findings were consistent for models of the composite SDI and those evaluating disaggregated measures of area-level educational attainment, household income, and unemployment. CONCLUSION  Social factors play an important role in the development and progression of multimorbidity, which suggests that an assessment and understanding of area-level social deprivation is necessary for developing public health strategies to address multimorbidity.
SN  - 1545-1151
UR  - https://doi.org/10.5888/pcd21.240060
DO  - 10.5888/pcd21.240060
ER  - 
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