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Abstract
Background
Limited attention has focused on midlife health. Yet, this is a time of great change, including onset of chronic conditions and changes in mental health.
Objective
To examine unmet healthcare needs among midlife adults (50–64 years) in the US with severe psychological distress (SPD) and/or multiple chronic conditions (MCC).
Methods
Nationally representative data for midlife adults (50–64 years) from NHIS 2014–2018 were examined (n = 39,329). Multimorbidity status: no MCC/SPD, MCC alone, SPD alone, or both. We used logistic regression to estimate adjusted odds ratios (AOR) of delayed or foregone care by multimorbidity status.
Results
Nearly 40% of midlife adults had MCC, SPD, or SPD/MCC. SPD with or without MCC had higher prevalence of social disadvantage, fair/poor health, activity limitations, and delayed/foregone healthcare. Compared to those with neither, adults with SPD/MCC were more likely to delay care due to limited office hours (AOR = 4.2, 95% CI 3.1–5.5) and had nearly three to four times higher odds of delays for all other reasons. Those with SPD/MCC had higher odds of needing but not getting mental healthcare (AOR = 6.4, 95% CI 4.5–9.1), prescriptions (AOR = 4.8, 95% CI 3.9–5.9), or follow-up care (AOR = 5.0, 95% CI 3.7–6.6), and three to four times higher odds of all other types of foregone care.
Conclusions
Midlife adults with SPD/MCC have substantial unmet healthcare needs. Midlife is a critical time to manage both chronic conditions and mental illness. Coordinated efforts by policymakers and healthcare systems are crucial to address complex healthcare needs of this population at a critical stage of the life-course.
Disclosure statement
All authors confirm no conflicts of interest.