Everyday discrimination increases the risk of having multiple chronic conditions among older adults

Background: Approximately 3 in 4 Americans aged 65 and older have at least one chronic condition; 2 in 3 simultaneously have two or more conditions. Having multiple chronic conditions (i.e. multimorbidity) is associated with greater health care utilization and higher health care costs. The current study assesses the impact of psychosocial stressors--particularly discrimination--on multimorbidity.

Methods: Using data from 3,564 participants from the second wave of the National Survey of Midlife Development in the United States (MIDUS II), the hypothesis that greater exposure to everyday discrimination is associated with increased risk of having multiple chronic conditions was tested. The association between discrimination and multimorbidity were examined using ordinal logistic regression.

Results: Approximately 70% of participants were between the ages of 45 and 74 years old. More than half of the sample (54%) reported having two or more chronic conditions. Exposure to discrimination was relatively infrequent; the average respondent reported “never” or “rarely” experiencing discrimination in their everyday lives. However, among those exposed to discrimination, the most frequently stated reasons for discrimination were gender (51%) and age (46%). Moreover, after adjusting for relevant covariates the odds of having multiple chronic conditions increased by 81% for every one-unit increase in everyday discrimination (OR=1.81, p<0.001).

Discussion: For older Americans, everyday discrimination increases the risk of having multiple chronic conditions. Therefore, deliberate and systematic efforts should be made to minimize exposure to discrimination. These efforts will not only improve the health of this population, it will also help curb escalating health care costs.