Yale Researchers Report Race and Ethnicity-Based Variations in Contributions of Chronic Conditions to Mortality

The impact of chronic conditions on human health has become a research topic of growing focus in recent years. The prevalence of individuals living with two or more chronic diseases at the same time, combined with an aging population, has placed growing demands on the U.S. health care system.

To better understand how the contribution of chronic conditions to mortality varies by race and ethnicity, a team of researchers led by Yale School of Medicine’s Heather Allore, PhD, with collaborators from Oregon Health and Science University/Portland State University and University of Arkansas for Medical Sciences, conducted a large-scale study. Their findings were published in Aging and Health Research.

For the study, researchers analyzed data from over 10,000 patients in the Health and Retirement Study from 1998-2020, assessing the prevalence and incidence of chronic conditions—including heart disease, stroke, diabetes, lung disease, cancer, depression, and dementia—and their association with mortality. They found substantial variations by both chronic condition and racial and ethnic groupings.

Long-term chronic conditions accounted for 58-74% of documented mortality among Hispanic, Black, and White U.S.-born adults in the study. However, different chronic conditions were found to contribute most to mortality in each group. Heart disease, cancer, hypertension, and pulmonary conditions contributed most to mortality for White adults. In contrast, hypertension, heart disease, diabetes, and dementia were found to be the highest contributors to mortality events in Hispanic and Black adults.

The researchers noted that the findings have important implications for expanding access to preventive care and effective treatments for these individuals.

“This research highlights the importance of advancing effective health care delivery models that support the needs of diverse older adults with these conditions,” says Allore, a professor of medicine (geriatrics) at YSM and of biostatistics at Yale School of Public Health.

She adds that efforts are needed to improve access to high-quality, patient-centered care that improves the management of existing chronic conditions and delays or prevents the onset of multimorbidity, which can result in serious and sometimes fatal consequences.

The research reported in this news article was funded by the National Institute on Aging/National Institutes of Health (awards R01AG055681 and RF1AG058545). The work was also supported by the Yale Claude D. Pepper Older Americans Independence Center (award P30AG021342), Yale Alzheimer’s Disease Research Center (awards P30AG066508 and R33AG045050), and Advancing Geriatrics Infrastructure and Network Growth Initiative (award R33AG057806). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other funders.

Geriatrics, one of 10 sections in the Yale Department of Internal Medicine, strives to improve the health of older adults by providing exceptional patient care, training future leaders and innovators in aging, and engaging in cutting-edge research. To learn more, visit Geriatrics.