Health Risk Behaviors of Medicaid Recipients Diagnosed with Chronic Mental and Physical Illness

Medicaid enrollees with comorbid chronic physical and mental health (CCPM) conditions engage in risky health behaviors which tend to occur in clusters contributing to poor health status and increased costs.  The aim of this study was to examine how health risk behaviors cluster in Medicaid CCPM enrollees.  As part of a longitudinal trial examining the benefits of health navigation, baseline data from 1,569 CCPM Medicaid enrollees was examined. Medicaid claims and enrollment data were utilized to group participants into three diagnostic categories: Chronic Behavioral health illness + Chronic Physical health illness (BH+PH; n=533), Serious mental illness (SMI; n=470), and a group comprising all three diagnoses (BH+PH+SMI; n=566). The most prevalent health risks triggered during the baseline assessment were emotional stress (96%), poor eating habits (79%), sedentary behavior (75%), and smoking (55%) with excessive alcohol reported by 11% of the sample.  BH+PH+SMI enrollees reported significantly more weight, smoking and sedentary health risk behaviors as compared to the other two diagnostic groups. Most enrollees reported between 3-5 (72%) or 6-7 (25%) health risks. An exploratory factor analysis supported two factors.  The first factor included sedentary behaviors, emotional stress, and pain (psycho-social health risks).  The second factor included smoking and excessive drinking. Enrollees report multiple health risk behaviors which can have a long-term impact on severity and prevalence of chronic disease. Both clinical and public health practitioners can utilize this information to guide efforts in addressing multiple risk behaviors in the context of chronic physical and mental illness.