Asian Americans are the fastest-growing minority group in the United States, yet little is known about their multimorbidity. This study examined the association of Asian Indians, Chinese and non-Hispanic whites (NHWs) to multimorbidity, defined as the concurrent presence of two or more chronic conditions in the same individual. We used a cross-sectional design with data from the National Health Interview Survey (2012-2017) of Asian Indians, Chinese, and NHWs (N = 132,666). Logistic regressions were used to examine the adjusted association of race/ethnicity to multimorbidity. There were 1.9% Asian Indians, 1.8% Chinese, and 96.3% NHWs. In unadjusted analyses (p < 0.001), 17.1% Asian Indians, 17.9% Chinese, and 39.0% NHWs had multimorbidity. Among the dyads, high cholesterol and hypertension were the most common combination of chronic conditions among Asian Indians (32.4%), Chinese (41.0%), and NHWs (20.6%). Asian Indians (AOR = 0.73, 95% CI = (0.61, 0.89)) and Chinese (AOR = 0.63, 95% CI = (0.53, 0.75)) were less likely to have multimorbidity compared to NHWs, after controlling for age, sex, and other risk factors. However, Asian Indians and Chinese were more likely to have high cholesterol and hypertension, risk factors for diabetes and heart disease.

https://www.mdpi.com/1660-4601/17/9/3336/pdf

Prevalence of Multimorbidity among Asian Indian, Chinese, and Non-Hispanic White Adults in the United States

Over the last century life expectancy has increased dramatically nearly all over the world. This dramatic absolute and relative increase of the old aged people component of the population has influenced not only population structure but also has dramatic implications for the individuals and public health services. The aim of the present pilot study was to examine the impact of physical well-being assessed by hand grip strength and social factors estimated by social contact frequency on health-related quality of life among 22 men and 41 women ranging in age between 60 and 94 years. Physical well-being was estimated by hand grip strength, data concerning subjective wellbeing and health related quality of life were collected by personal interviews based on the WHOQOL-BREF questionnaires. Number of offspring and intergenerational contacts were not related significantly to health-related quality of life, while social contacts with non-relatives and hand grip strength in contrast had a significant positive impact on health related quality of life among old aged men and women. Physical well-being and in particular muscle strength—estimated by grip strength—may increase health-related quality of life and is therefore an important source for well-being during old age. Grip strength may be used as an indicator of health-related quality of life.

Grip Strength as an Indicator of Health-Related Quality of Life in Old Age—A Pilot Study

Background and objectives: Readmissions of youths hospitalized for a severe mental disorder are common events and bear a remarkable human, social, and economic burden. The current study aimed at evaluating predictors of 1-year rehospitalization in a sample of adolescents and young adults with severe mental disorders. Materials and Methods: Data for ≤25-year-old inpatients with a severe mental disorder and consecutively admitted between 1 January 2016 and 30 June 2019 were collected. Subjects were retrospectively assessed over a follow-up period of one year after the index discharge to track readmissions-i.e., the primary outcome variable. Standard descriptive statistics were used. The association between variables and 1-year rehospitalization was estimated using the univariate Cox proportional hazards regression model. We then carried out a multivariable Cox regression model, also estimating the covariate-adjusted survivor function. Hazard ratios (HRs) with related 95% confidence intervals (95% CIs) were provided. Results: The final sample included 125 individuals. The multivariable Cox regression model estimated that co-occurring substance use disorders (HR = 2.14; 95% CI: 1.08 to 4.26; p = 0.029) and being admitted for a suicide attempt (HR = 2.49; 95% CI: 1.13 to 5.49; p = 0.024) were both significant predictors of 1-year rehospitalization. Conclusions: Our study showed that comorbid substance use disorders and being admitted for a suicide attempt were predictors of early readmission in youths with severe mental disorders. Although their generalizability is limited, our findings could contribute to improve the quality of young patients' mental health care by identifying vulnerable subjects who may benefit from tailored interventions to prevent rehospitalizations.

https://www.mdpi.com/1648-9144/56/11/613/pdf

Pre-Discharge Predictors of 1-Year Rehospitalization in Adolescents and Young Adults with Severe Mental Disorders: A Retrospective Cohort Study

Issues of poor physical functioning and disability are burdensome for midlife adults and evidence suggests that the prevalence of these conditions is increasing temporally. Physical functioning during the midlife period, however, may be highly amendable to intervention given the highly dynamic nature of functioning during this life stage. Thus, efforts to improve or forestall poor physical functioning and/or disability during midlife may not only improve the health status and quality of life for midlife adults but may have important ramifications on the health of these individuals who will become older adults in the future. This thematic series on women and disability includes contributions addressing issues of person, place and time with respect to disability in midlife and into late adulthood. The purpose of this commentary is to provide a summary overview of the major themes of the series and to offer insight into areas of most promise for intervention among midlife populations to improve physical functioning and prevent disability.

/pdf/the-urgent-need-for-disability-studies-among-midlife-adults-3i5ez4qfrx.pdf

The urgent need for disability studies among midlife adults.

The impact of obesity on health-related quality of life (HRQoL) in chronic kidney disease (CKD) population has not been elucidated, despite the impairment of HRQoL in the obese among general population. We hypothesized that the impact of obesity on HRQoL might be confounded by impaired renal function in CKD population, and that CKD would attenuate the impact of obesity on HRQoL. To compare the impact of obesity on HRQoL according to kidney function, 17,001 subjects from Korea National Health and Nutrition Examination Survey (2008–2011) were categorized by estimated glomerular filtration rate (eGFR), as follows: group 1, eGFR ≥ 90 mL/min/1.73 m2; group 2, eGFR of 60–89 mL/min/1.73 m2; group 3, eGFR < 60 mL/min/1.73 m2. The association between obesity parameters (body mass index, waist circumference and, truncal fat mass) and HRQoL parameters (EQ-5D index and EQ-VAS) were cross-sectionally analyzed. Despite robust correlations between obesity parameters and low EQ-5D index or EQ-VAS in general population, no significant association was observed in group 3 population. Impact of obesity on HRQoL in CKD population was only limitedly observed in the mobility domain of EQ-5D, as mobility limitation was associated with increased body mass index or waist circumference regardless of kidney function. Therefore, the impact of obesity on HRQoL seems significantly attenuated in CKD population, suggesting that the risk of obesity should not be over-estimated in patients with CKD, especially with respect to HRQoL.

/pdf/chronic-kidney-disease-attenuates-the-impact-of-obesity-on-imvuyzjnfp.pdf

Chronic kidney disease attenuates the impact of obesity on quality of life

OBJECTIVES Asian Americans are the fastest-growing minority group in the United States, yet little is known about their functional mobility. To overcome such a gap, this study examined the association between demographic/economic characteristics and functional limitations for middle-aged and older Asian Indians, Chinese, and Filipinos. METHOD This study utilized microdata from the National Health Interview Survey pooled sample (2010-2016 IPUMS NHIS with a sample size of 6,767 Asians). Logit regressions were used to examine factors associated with functional limitations. Measures include age, gender, currently married, education (categorized as less than high school, high school, some college, college, advanced degree), birth and citizenship status, household income, home ownership, types of health insurance (e.g., Medicaid, Medicare, private), and geographic region (i.e., Northeast, Midwest, South, and West). RESULTS Chinese (odds ratio [OR] 0.57, p < .01) and Filipinos (OR 0.74, p < .05) had lower odds for any functional limitations relative to Asian Indians. Currently married and individuals with a higher income were also associated with reduced odds for limitations in the overall analysis. As for the subgroup analysis, there was a positive association between age and the presence of any functional limitations for Asian Indians (OR 1.05, p < .01), Chinese (OR 1.08, p < .01), and Filipinos (OR 1.03, p < .01). In terms of gender, Asian Indian men were less likely (OR 0.51, p < .01), whereas Filipino men were more likely to have limitations (OR 1.09, p < .05). DISCUSSION Asian Indians appeared to have a poorer health profile for limitations in dressing, eating, walking, or working when compared with Chinese and Filipinos. A pronounced difference at older ages was also apparent for Asian Indians by gender and the likelihood of having any limitations increased much faster for Asian Indian women. For Chinese, there was a dramatic increase in functional limitations after age 75 (particularly for women) and the predicted probability for this subgroup approximated 20%. For Filipinos, men were more likely to have limitations. These findings raise interesting questions about the on-set of disability by age and gender for Asian subgroups.

A National Profile of Functional Limitations Among Asian Indians, Chinese, and Filipinos.

Body mass index and mobility limitations: An analysis of middle-aged and older Black, Hispanic, and White women in the U.S.

Generational trends and patterns in readmission within a statewide cohort of clients receiving heroin use disorder treatment in Maryland, 2007-2013.

Public health scholars and policy-makers are concerned that the United States continues to experience unmanageable health care costs while struggling with issues surrounding access and equity. To addresses these and other key issues, the National Academy of Medicine held a public symposium, Vital Directions for Health and Health Care: A National Conversation during September 2016, with the goal of identifying clear priorities for high-value health care and improved well-being. One important area was addressing social determinants of health. This article contributes to this objective by investigating the impact of wealth on older Black women's health. Employing the 2008/2010 waves of the RAND Health and Retirement Study on a sample of 906 older Black women, this panel study examined self-assessed health ratings of very good/good/fair/poor within a relaxed random effects framework, thereby controlling for both (i) observed and (ii) unobserved individual-level heterogeneity. This analysis did not find a statistically significant association with wealth despite a difference of approximately $75 000 in its valuation from very good to poor health. This also occurred after wealth was (i) readjusted for outliers and (ii) reformulated as negative, no change or positive change from 2008. This finding suggests that wealth may not play as integral a role. However, the outcome was significant for earnings and education, particularly higher levels of education. Scholars should further this inquiry to better understand how earnings/education/wealth operate as social determinants of health for minority populations.

Andy Sharma

Papers

A National Profile of Functional Limitations Among Asian Indians, Chinese, and Filipinos.

Body mass index and mobility limitations: An analysis of middle-aged and older Black, Hispanic, and White women in the U.S.

Generational trends and patterns in readmission within a statewide cohort of clients receiving heroin use disorder treatment in Maryland, 2007-2013.

Wealth and the health of older Black women in the United States

Exploratory and spatial analysis of disability among older Asian Indians