Multimorbidity and Mental Health: The Role of Gender among Disease-Causing Poverty, Rural, Aged Households in China.

Chen Jiao,Qinfeng Zhao,Jian Wang,Anli Leng,Stephen Nicholas,Elizabeth Maitland,Lizheng Xu,Chaofan Gong

doi:10.3390/ijerph17238855

Abstract

(1) Background: The association between multimorbidity and mental health is well established. However, the role of gender in different populations remains unclear. Currently, China is facing an increased prevalence of multimorbidity, especially in its disease-causing poverty population. The present study explores the gender-based differences in the relationship between multimorbidity and mental health using data from the rural, disease-causing poverty, older-age population in Shandong province, China, as a case study. (2) Methods: The data were obtained from the survey on the health and welfare of disease-causing poverty households in rural Shandong province. We identified 936 rural participants who were over 60 years old from disease-causing poverty households. The mental health status was measured using the Kessler Psychological Distress Scale (K10) instrument. Using a multivariable linear regression model, including the interaction of gender and multimorbidity, gender differences in the association between multimorbidity and mental health were explored. (3) Results: Multimorbidity was a serious health problem in rural, disease-causing poverty, older-age households, with the prevalence of multimorbidity estimated as 40% for women and 35.4% for men. There was a strong association between multimorbidity and mental health, which was moderated by gender. Women had higher K10 scores than men, and the mean K10 score was highest in women with three or more chronic diseases. Compared with men, women with multimorbidity had a higher risk of mental health problems. (4) Conclusions: The prevalence of multimorbidity in older-age rural disease-causing poverty subpopulations is a severe public health problem in China. The association between multimorbidity and mental health differed by gender, where multimorbid women suffered an increased mental health risk compared with men. Gender differences should be addressed when delivering effective physical and mental healthcare support to disease-causing poverty, older-age, rural households.

Highlights

Global aging is a defining social trend in the 21st century
This study investigated the association in multimorbidity and status of mental health between different genders in disease-causing poverty, older-age households
An understanding of the relationship between multimorbid, rural, older-age adults in disease-causing poverty households and their mental health will help healthcare managers design more appropriate and targeted interventions. To address this gap in the literature, first, we evaluated the association between multimorbidity and mental health among the rural, disease-causing poverty, older-age adults in Shandong Province, China

Summary

Introduction

Global aging is a defining social trend in the 21st century. In 2020, the World Health Organization’s (WHO) global health and research priority is healthy aging [1]. The main public health and individual medical problem faced by older-age adults is chronic diseases. The prevalence of two or more coexisting multiple chronic diseases [2], or multimorbidity, has become a major challenge for chronic disease control [3] and a common phenomenon in people aged over 60 years old [4]. Multimorbidity impairs an individual’s overall health and imposes a heavy financial burden on families, the health system, and the society [5]. In 2013, it was reported that 28% of Americans suffered from multimorbidity, and multimorbidities accounted for 66% of total healthcare spending [6]

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Conclusion