Comorbidities Associated With Social Determinants of Health in Latinx Patients Receiving Mental Health Care at a Community Clinic in South Florida

Abstract

Abstract Objectives Mental and physical health conditions are intrinsically linked. Depression and anxiety may co-exist with an array of chronic diseases and conditions. Social Determinants of Health (SDOH) may have a powerful impact on health and may contribute to chronic disease disparities in underrepresented and underserved communities. The objective of this study was to examine the comorbidities found in patients seeking mental health care and their relationships to SDOH. Methods A needs assessments was completed using a random sample of 100 de-identified medical records of individuals seeking mental health care at Caridad Center in Boynton Beach, Fl. Demographics, diagnoses, laboratory tests results and the Protocol for Responding to and Assessing Patients’ Assets, Risks, and Experiences (PRAPARE) questionnaire data were abstracted. Statistical analyses included descriptive statistics, Spearman's correlations, Mann-Whitney U, and chi-square. Results The patients’ mean age was 51.9 ± 11.9 years and 79.4% were female. About 64% were below 100% of the federal poverty level and 52% were unemployed. About 43% were diagnosed with depression, 38% with anxiety and 17% with both depression and anxiety. In addition, 33% had 2 or more other diagnosed comorbidities and 11% had 3 or more comorbidities. Annual income was negatively correlated with the number of CVD risk factors (r = −0.283, P = 0.008). Median annual income was lower for those with hypertension compared to those without hypertension ($14,472 (IQR = $7200-$19,260) vs. $19,200 (IQR = 14,400–28,800), P < 0.001). Higher rates of unemployment in those diagnosed with diabetes were found compared to those without diabetes (67.6% vs. 56.6%, P = 0.035). Three or more social contacts per week was associated with lower median hemoglobin A1C levels (5.9 mmol/mol (IQR = 5.6–7.7) vs. 6.9 mmol/mol (IQR = 6–10.4) P = 0.05) compared to less contacts. Conclusions SDOH were associated with comorbid conditions in this Latinx sample who are sought mental health care at a community clinic in South Florida. Minority populations such as Latinx may suffer a greater burden of disease and health complications. Assessing SDH may be an important marker for identifying and intervening within the most vulnerable members of the population afflicted by multiple comorbidities. Funding Sources FIU RCMI/NIMHD.