Study Shows More Than 50% of Americans Have at Least 1 Chronic Health Condition, Mental Disorder, or Substance Use Issue

The election has brought discussion about the complexity of the US health care system to the forefront. A new study from Psychology, Health & Medicine reveals just how intricate the medical needs of Americans really are.

The study examined the concurrence between mental illness, substance abuse/dependence, and chronic mental conditions, coupled with various medical and socioeconomic disabilities. Using publicly available data from the National Survey on Drug Use and Health, the researchers examined what proportion of US adults experience each combination of mental illness, substance abuse/dependence, and chronic mental conditions, and if living in poverty was associated to the cumulative burden of these conditions.

Overall, 18.4% of adults reported a mental illness in the past year, and 8.6% reported substance abuse/dependence during the same time. Nearly 40% had 1 or more chronic medical conditions in their lifetimes, and 14.7% were living in poverty. In general, increased numbers of reported mental health conditions were commensurate with higher overall poorer health and further elevated by the rate of poverty.

Compared with adults without any condition, those with one of the aforementioned conditions reported higher percentages of living in poverty, receiving government assistance, having less than a high-school education, being unemployed, and having no health insurance.

A combined comparison revealed that 6.4% of individuals reported mental illness and chronic conditions, 2.2% reported mental illness and substance abuse/dependence, 1.5% reported substance abuse/dependence and chronic medical conditions, and 1.2%—or approximately 2.2 million people—reported all 3 conditions.

The study further revealed a strong link between mental illness and substance abuse. People with any mental illness were over 3 times more likely to report substance abuse/dependence while also 1.5 times more likely to have a chronic medical condition, and 1.2 times more likely to live in poverty.

"Just over half of adults in the US have 1 or more chronic condition, mental disorder, or dependence on substances. These conditions commonly overlap with each other and with poverty, which contributes to poor health,” Elizabeth Lee Reisinger Walker, author of the study, said in a press release.

After examining the relationship between multimorbidities, the study authors concluded that improvements to the health of those suffering from multiple medical conditions must involve increased access to care and coordination of various health services. Specifically, they recommended collaborative care models: “Collaborative care models are effective in treating mental illnesses in primary care and providing primary care in specialty mental health settings."

The study’s results stress the importance of the need to broaden our view of the complexity of multiple illnesses—beyond the health care system—to address various socioeconomic determinants of health. Walker concludes, "In order to promote overall health, it is important to consider all of a person's health conditions, along with poverty and other social factors."