Unmet healthcare needs among midlife adults with mental distress and multiple chronic conditions. (3rd April 2022)

• Record Type: Journal Article
• Authors: Johnson, Pamela Jo; Mentzer, Kari McClure; Jou, Judy; Upchurch, Dawn M.
• Is Part Of: Aging & mental health. Volume 26:Number 4(2022)
• Page Start: 775
• Page End: 783
• Publication Date: 2022-04-03
• Subjects: Access to care -- chronic conditions -- mental illness -- midlife -- psychological distress -- healthcare utilization; Older people -- Mental health -- Periodicals; Geriatric psychiatry -- Periodicals; Older people -- Psychology -- Periodicals; Aging -- Psychological aspects -- Periodicals; Aged -- psychology -- periodicals; Mental Health -- periodicals; Mental Health Services -- periodicals; Aging -- psychology -- periodicals; Aged, 80 and over -- psychology -- periodicals; 618.97689
• DOI: 10.1080/13607863.2021.1904830
• Languages: English
• ISSNs: 1360-7863

Abstract

Abstract: Background: Limited attention has focused on midlife health. Yet, this is a time of great change, including onset of chronic conditions and changes in mental health. Objective: To examine unmet healthcare needs among midlife adults (50–64 years) in the US with severe psychological distress (SPD) and/or multiple chronic conditions (MCC). Methods: Nationally representative data for midlife adults (50–64 years) from NHIS 2014–2018 were examined ( n = 39, 329). Multimorbidity status: no MCC/SPD, MCC alone, SPD alone, or both. We used logistic regression to estimate adjusted odds ratios (AOR) of delayed or foregone care by multimorbidity status. Results: Nearly 40% of midlife adults had MCC, SPD, or SPD/MCC. SPD with or without MCC had higher prevalence of social disadvantage, fair/poor health, activity limitations, and delayed/foregone healthcare. Compared to those with neither, adults with SPD/MCC were more likely to delay care due to limited office hours (AOR = 4.2, 95% CI 3.1–5.5) and had nearly three to four times higher odds of delays for all other reasons. Those with SPD/MCC had higher odds of needing but not getting mental healthcare (AOR = 6.4, 95% CI 4.5–9.1), prescriptions (AOR = 4.8, 95% CI 3.9–5.9), or follow-up care (AOR = 5.0, 95% CI 3.7–6.6), and three to four times higher odds of all other types of foregone care. Conclusions: Midlife adults with SPD/MCC have substantial unmet healthcare needs. Midlife is a critical time to manage both chronic conditions and mental illness. Coordinated efforts by policymakers and healthcare systems are crucial to address complex healthcare needs of this population at a critical stage of the life-course.