Evidence map›Paper›PMID 39017703›Full record

ArticleSocial psychiatry and psychiatric epidemiology2025

Multiple chronic diseases and psychological distress among adults in the United States: the intersectionality of chronic diseases, race/ethnicity, immigration, sex, and insurance coverage.

David Adzrago, David R Williams, Faustine Williams

Abstract read
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In one paragraph

Article in Social psychiatry and psychiatric epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed.

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  14. Intersectionality and Long Covid: Understanding the Lived Experiences of Ethnic Minority Groups in the United Kingdom.Health expectations : an international journal of public participation in health care and health policy · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

David AdzragoDivision of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA. David.Adzrago@nih.gov.
David R WilliamsDepartment of Social and Behavioral Sciences, Department of African and African American Studies, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, MA, USA.
Faustine WilliamsDivision of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA. Faustine.Williams@nih.gov.

Funding

Understanding Population Mental Health to Promote and Improve Mental Well-Being ZIAMD000015 · NIMHD · NATIONAL INSTITUTE ON MINORITY HEALTH AND HEALTH DISPARITIES · PI WILLIAMS, FAUSTINE · 2020 to 2025
$2.9M
Intramural NIH HHS ZIA MD000015
6 · The paper itself

Abstract

purposePsychological distress significantly contributes to the burdens of morbidity and mortality in the United States (U.S.), but our understanding is limited with regards to the risk factors associated with psychological distress. We used nationally representative data to examine (1) the comorbidities of chronic diseases and their risks for psychological distress and (2) the ways in which chronic diseases combine with demographic factors such as sex, race/ethnicity, immigration status, and health insurance coverage to affect the patterning of psychological distress.

methodsWe analyzed the 2005-2018 National Health Survey Interview cross-sectional data on U.S. adults aged ≥ 18 years (n = 351,457). We fitted sequential multivariable logistic regression models.

resultsThere was a dose-response relationship between the number of chronic diseases and psychological distress, with increased number of chronic diseases associated with increased psychological distress risk. Females (vs. males) and those without health insurance (vs. insured) were more likely to experience psychological distress. Immigrants (vs. non-immigrants) and racial/ethnic minorities (vs. White individuals) were less likely to experience psychological distress. There were significant interactions between chronic diseases and insurance coverage, immigration status, and race/ethnicity, but the three-way interactions were not statistically significant with psychological distress: chronic disease status vs. immigration status vs. health insurance coverage, and chronic disease vs. race/ethnicity vs. immigration status.

conclusionThe findings suggest a critical need to consider the complex ways in which chronic diseases and psychosocial factors combine to affect psychological distress and their implications for tailoring mental health screening, initiatives to reduce distress, and prevention strategies for effectively addressing health-related disparities in the general population.

Indexed as

Emigrants and ImmigrantsEthnicityInsurance CoverageInsurance, HealthMultiple Chronic ConditionsPsychological DistressStress, PsychologicalAdolescentAdultAgedChronic DiseaseComorbidityCross-Sectional StudiesFemaleHealth SurveysHumansAnxiety/depressionChronic diseasesImmigration statusIntersectionalityMental health disparitiesPhysical health disparities

Identifiers

PMID39017703
PMCPMC11739432

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.