education and race

Multimorbidity – the coexistence of more than one chronic condition – can have serious consequences on long-term health and wellbeing. A recent study looked at how education and race/ethnicity affected multimorbidity in young adults.


The incidence of multimorbidity increases as we age and puts the population at greater risk of disability, hospitalization and death. Disparities in socioeconomic status among racial/ethnicity groups are associated with chronic conditions in older adults. Although increasing numbers of young adults (> 18 years) in the U.S. also have multimorbidity, research on this population is limited. As chronic disease progresses, so too does the likelihood of long-term disability, loss of productivity and quality of life. Therefore, identifying the factors contributing to multimorbidity in young adults is vital for their future health. A recent study published in Social Science & Medicine – Population Health analyzed how education and race/ethnicity affected multimorbidity in young adults.

The authors obtained cross-sectional data on 115 097 adults aged 30-64 years from the 2002-2014 National Health Interview Surveys. Adults had at least one self-reported chronic disease condition (asthma, arthritis, heart disease, stroke, chronic obstructive pulmonary disease, hypertension, cancer, diabetes or kidney failure). Of these participants, 27.3% had multimorbidity, or at least two of these conditions. Participants were categorized into groups based on education level (less than high school [HS], completed HS/some college or a bachelor’s degree/higher) and race (non-Hispanic whites, non-Hispanic blacks, Hispanic or non-Hispanic other). Associations were determined between multimorbidity and education or race using logistic regression analyses, and various demographic and socioeconomic covariates were also considered.

Individuals with lower education levels (less than HS or completed HS/some college) had increased odds of multimorbidity, perhaps due to poorer social conditions and/or exposure to more psychological stressors, factors that can affect health and wellbeing. Non-Hispanic blacks also had increased odds of multimorbidity compared to non-Hispanic whites with comparable characteristics, which may be due to cultural differences and/or exposure to more psychological stressors. Conversely, Hispanics and other non-Hispanics had lower odds of multimorbidity. However, when the results were adjusted for individuals born in another country, Hispanics and other non-Hispanics had higher odds of multimorbidity, implying that Hispanics and other non-Hispanics born in the U.S. had a greater risk of multimorbidity than those who were born in another country.

This study did not consider the severity, complexity or duration of the nine self-reported chronic conditions, and the quality of education received is unknown. Further longitudinal studies are required to determine the long-term consequences of multimorbidity in young adults. Despite these issues, this study emphasizes that multimorbidity in young adults is an area of healthcare that should be pursued. Further research may help young adults, regardless of socioeconomic background, reduce the burden and progression of multimorbidity by identifying strategies that enhance health and wellbeing.


Written By: Natasha Tetlow, PhD

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