The 130th Annual Meeting of APHA

Abstract #37607

Bruce P Dembling, PhD¹, Michael B Blank, PhD², and Stephen Metraux, PhD². (1) School of Medicine, Department of Health Evaluation Sciences, University of Virginia, Box 800717, Charlottesville, VA 22908-0717, 434-924-9813, dembling@virginia.edu, (2) Center for Mental Health Policy and Services Research, University of Pennsylvania, 3535 Market Street, Room 3020, Philadelphia, PA 19104

Individuals with serious mental illness have higher levels of mortality than expected due to medical comorbidity and behavioral risks factors. This study uses data from Philadelphia to replicate and extend findings from a Massachusetts study (Dembling, Chen & Vachon, 1999) which found excess morality rates for the SMI and different patterns including higher rates of suicide, homicide, accidental death, and deaths due to AIDS, after adjusting for age differences between cohorts. That study was unable to determine differential rates for specific diagnoses since diagnostic information was unavailable. This study used Pennsylvania's death registry to capture mortality outcomes for 53,355 persons with serious mental illness who received Medicaid health care between 1987-1998 in Philadelphia. There were 5,756 deaths among these persons (10.8%). The Medicaid claims included diagnostic information for these persons. We compute standardized mortality ratios for the mentally ill population and sub-populations of persons with schizophrenia spectrum disorders, depression, and other affective disorders. Implications for public mental health policy are discussed. Assessing the value of systems of mental health should include the impact of general health outcomes attributable to this care. Often mental health care is delivered without reference to the interaction of mental disorders with other health risks.

Learning Objectives:

• Participants will identify serious long term health risks posed to a poor urban population with serious mental illness. Particpants will quantify the relative weight of disease and injury as a cause of death and reduced life expectancy in the presence of comorbid mental illness. Participants may develop action strategies that would improve the level of primary health care to those with serious mental illness.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.