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Abstract #153099
Handout (free access)Ranjana Banerjea, PhD1, Leonard Pogach, MD, MBA1, and Usha Sambamoorthi, PhD2. (1) Center for Healthcare Knowledge Management, Department of Veterans Affairs, NJ Health Care System, 385 Tremont Ave, East Orange, NJ 07018, 973-676-1000, x2552, ranjana.banerjea@gmail.com, (2) Center for Helathcare Knowledge Management, Dept of Veteran Affairs - NJ Healthcare System, 385 Tremont Avenue, East Orange, NJ 07018
Background: While it is widely known that substance use disorder (SUD) and mental illness (MI) are common conditions among male veteran population, it is not so well known how often these two co-occur in women veterans with a chronic condition like diabetes. The complexity of care increases with the co-occurrence of these multiple conditions and with a high prevalence of serious mental illness among women, it is very likely that their comorbid conditions are higher in the more complex categories of MI/SUD. Objectives: Define the complex categories of chronic illness in women with MI and SUD and determine the predictors of MI/SUD categories. Methods: Cross-sectional analysis of women veterans with diabetes, alive by FY1999, and not enrolled in Medicare HMO (N = 10,315). Chi-square, multinomial logistic regression used to examine association between SUD, MI and covariates. SUD, MI identified using ICD-9-CM codes; diabetes derived from FY1999 Diabetes Epidemiologic Cohort (DEpiC). Results: 42% of women had either MI or SUD or both (alcohol/drug combination or tobacco use); majority of these had a serious mental illness (SMI) (26%). The predictors of MI and SUD varied; African-American women reported lower likelihood of SMI (AOR: 0.69) but higher incidence of alcohol/drug use. Older women (50+ years) reported lower incidence of MI/SUD (AOR: 0.02-0.81).Severely disabled were likely to belong to MI/SUD groups (AOR: 1.59-1.98) (p<.001), Conclusion: Majority of women in SUD groups suffered from MI. High rates of comorbid conditions and severe disabilities in the mentally ill women suggest this population may suffer worse outcomes.
Learning Objectives:
- a) recognize the need for greater identification and intervention of diabetic female patients who are mentally ill and often also abuse substances; b) and prioritize delivery of health care based on their age, ethnicity and gender.
Keywords: Chronic Illness, Mental Illness
Presenting author's disclosure statement:
Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
The 135th APHA Annual Meeting & Exposition (November 3-7, 2007) of APHA