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The Influence of Multiple Chronic Health Conditions on the Health of Older African Americans Living with Serious Mental Illness


Managing a serious mental illness (SMI) is a precursor for multiple comorbidities, geriatric syndromes and premature mortality. The purpose of this dissertation was to examine the health status of 150 older African Americans diagnosed with SMI. The first manuscript examined chronic illnesses and geriatric syndromes among two age cohorts (< 55 years of age and 56 and older years of age). Utilizing descriptive, correlational, and bivariate analyses, the most prevalent medical conditions in this sample were hypertension (64%), chronic pain (60%), and arthritis (44%). The most frequently reported geriatric syndromes were sleeping problems (65%), vision issues (58%), and dizziness (47%). Psychiatric illnesses and geriatric syndromes were more found to be higher in the younger age cohort as compared to the older cohort.

The second manuscript focused on understanding the intersection of quality of life (QOL), self-perceived health and chronic health conditions. Almost two-thirds of the sample population rated their health as “fair” or “poor”. Lower scores of QOL was associated with multiple chronic health illnesses and geriatric syndromes, including major depression (p=.021), pain (p=.002), lung disease (p=.042).

The third manuscript investigated functional status and chronic health conditions in this population. The majority of the subjects (N=66, 44%) reported that their health is the same, while 31% stated that their health is worse than one year ago. Lower physical functioning was associated with panic disorder (p=.018), seizures (p=.039), pain (p=.03), and falls (p=.011).

The fourth manuscript focused on substance use among this population. Findings showed that less than half (42%) consumed alcohol, 46% are tobacco smokers, and half (50%) have either a current or former history of illicit drug use. Cigarette smoking was associated with asthma (p=.018), bladder control problems (p=.015), and schizophrenia (p=.004). Illicit drug use was associated with falls (p=.05) and vision problems (p=.046). Alcohol use was significantly associated with major depression (p=.026), kidney disease (p=.019), stomach disease (p=.05) and bladder control issues (p=.038).

These findings contribute to a growing body of literature regarding the health of minority populations diagnosed with SMI. Overall, the results can lead to the creation and implementation of nurse-driven interventions for populations of color.

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