Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct;53(13):6212-6222.
doi: 10.1017/S0033291722003488. Epub 2022 Nov 24.

Ethnic differences in physical and mental multimorbidity in working age adults with a history of depression and/or anxiety

Amy Ronaldson  1 , Jorge Arias de la Torre  1   2   3 , Matthew Broadbent  4 , Mark Ashworth  5 , David Armstrong  5 , Ioannis Bakolis  1 , Stephani L Hatch  1   6 , Matthew Hotopf  1   7 , Alex Dregan  1
Affiliations

Ethnic differences in physical and mental multimorbidity in working age adults with a history of depression and/or anxiety

Amy Ronaldson et al. Psychol Med. 2023 Oct.

Abstract

Background: The current study used data from an ethnically diverse population from South London to examine ethnic differences in physical and mental multimorbidity among working age (18-64 years) adults in the context of depression and anxiety.

Method: The study included 44 506 patients who had previously attended Improving Access to Psychological Therapies services in the London Borough of Lambeth. Multinomial logistic regression examined cross-sectional associations between ethnicity with physical and mental multimorbidity. Patterns of multimorbidity were identified using hierarchical cluster analysis.

Results: Within 44 056 working age adults with a history of depression or anxiety from South London there were notable ethnic differences in physical multimorbidity. Adults of Black Caribbean ethnicity were more likely to have physical multimorbidity [adjusted relative risk ratio (aRRR) = 1.25, 95% confidence interval (CI) 1.15-1.36] compared to adults of White ethnicity. Relative to adults of White ethnicity, adults of Asian ethnicity were more likely to have physical multimorbidity at higher thresholds only (e.g. 4 + conditions; aRRR = 1.53, 95% CI 1.17-2.00). Three physical (atopic, cardiometabolic, mixed) and three mental (alcohol/substance use, common/severe mental illnesses, personality disorder) multimorbidity clusters emerged. Ethnic minority groups with multimorbidity had a higher probability of belonging to the cardiometabolic cluster.

Conclusion: In an ethnically diverse population with a history of common mental health disorders, we found substantial between- and within-ethnicity variation in rates of physical, but not mental, multimorbidity. The findings emphasised the value of more granular definitions of ethnicity when examining the burden of physical and mental multimorbidity.

Keywords: Anxiety; cluster analysis; common mental health disorders; depression; ethnicity; multimorbidity.

PubMed Disclaimer

Conflict of interest statement

This study represents independent research part-funded by the National Institute for Health and Care Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. AR, JAT, MB, MA, DA, IB, MH, and AD have nothing to disclose. SH is a member of the following: Expert Review Group (ERG) of the UK Prevention Research Partnership (UKPRP) Ethnic inequalities in health care among people with multiple conditions (University of Sussex) – Advisory Board NHS Race and Health Observatory, Co-Chair Academic Reference Group and Board Member The Royal Foundation – Mental Health Research Group NHS England and NHS Improvement – The Mental Health Equalities Data Quality and Research Subgroup NHS England and NHS Improvement – Patient and Carers Race Equalities Framework [PCREF] Steering Group NHS England and NHS Improvement – Advancing Mental Health Equalities Taskforce Health Education England – Mental Health Workforce Equalities Subgroup Maudsley Learning – Maudsley Learning Advisory Board South London and Maudsley NHS Foundation Trust (SLaM) – Independent Advisory Groups, the SLaM Partnership Group Lambeth Public Health – Serious Youth Violence Public Health Task and Finish Group Thrive London – Thrive London Advisory Board Black Thrive – Black Thrive Advisory Board NHS England and NHS Improvement – The Mental Health Workforce Equalities Subgroup Commissions: Welsh Government's Race Equality Plan; contribution to the evidence review for Health and Social Care and Employment and Income policy areas.

Similar articles

See all similar articles

Cited by

References

    1. Agur, K., McLean, G., Hunt, K., Guthrie, B., & Mercer, S. W. (2016). How does sex influence multimorbidity? Secondary analysis of a large nationally representative dataset. International Journal of Environmental Research and Public Health, 4(13), 391. - PMC - PubMed
    1. Allen, J. D., Caspi, C., Yang, M., Leyva, B., Stoddard, A. M., Tamers, S., … Sorensen, G. C. (2014). Pathways between acculturation and health behaviors among residents of low-income housing: The mediating role of social and contextual factors. Social Science & Medicine, 123, 26–36. - PMC - PubMed
    1. Ashworth, M., Durbaba, S., Whitney, D., Crompton, J., Wright, M., & Dodhia, H. (2019). Journey to multimorbidity: Longitudinal analysis exploring cardiovascular risk factors and sociodemographic determinants in an urban setting. BMJ Open, 9, e031649. - PMC - PubMed
    1. Azur, M. J., Stuart, E. A., Frangakis, C., & Leaf, P. J. (2011). Multiple imputation by chained equations: What is it and how does it work? International Journal of Methods in Psychiatric Research, 20, 40–49. - PMC - PubMed
    1. Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study. Lancet (London, England), 380, 37–43. - PubMed

Publication types