The concurrent burden of multimorbidity, mental health conditions, and severe obesity among United States health center patients

Abstract

This paper examines the association of multimorbidity, mental health (MH) conditions, and obesity severity among health center (HC) patients in the United States. We used cross-sectional data from the 2014 Health Center Patient Survey (n = 5370). We examined the independent association of multimorbidity and MH conditions with obesity severity using a multinomial logistic regression model, controlling for potential confounders. More than half (50.4%) of HC patients had obesity, including 15% with severe obesity. In addition, 41% had multimorbidity and 49% had one of five diagnosed MH conditions. We found higher odds of having mild (OR = 4.06), moderate (OR = 3.39), and severe (OR = 4.93) obesity with the presence of both multimorbidity and MH conditions. Multimorbidity alone was also associated with higher odds of obesity, but MH conditions alone were only associated with having moderate obesity. Findings show a higher burden of comorbidity and MH conditions given the severity of obesity among HC patients. This complex patient profile highlights the need for innovative approaches in effective care delivery and management of HC patients who are primarily low-income or uninsured. Approaches may include further integration of behavioral health and social services with primary care and the need for targeted practice guidelines for providers managing such patients. • Evidence of combined mental health, multimorbidity, and obesity severity is limited. • US health centers patients are disproportionately affected by above conditions. • Combined multimorbidity and mental health was associated with higher obesity severity. • Confluence of these conditions requires innovative obesity management approaches.