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Physical-psychiatric comorbidity: Implications for health measurement and the Hispanic Epidemiological Paradox
Institution:1. Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, ON M5S 2W6, Canada;2. Nicotine Dependence Service, Centre for Addiction and Mental Health, 175 College Street, Toronto, ON, M5T 1P7, Canada;3. Department of Family Medicine, McMaster University, 100 Main Street West, 6th Floor, Hamilton, ON L8P 1H6, Canada;4. Psychiatry & Behavioural Neurosciences and Kinesiology, McMaster University, 100 West 5th Street, Hamilton, ON L8N 3K7, Canada;5. School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada;6. School of Kinesiology, University of British Columbia, 2146 Health Sciences Mall, Vancouver, BC V6T 1Z3, Canada
Abstract:Few studies examine the co-occurrence of physical and psychiatric health problems (physical-psychiatric comorbidity), and whether these patterns differ across social groups. Using the National Comorbidity Survey-Replication and National Latino and Asian American Study, the current study asks: what are the patterns of physical-psychiatric comorbidity (PPC) between non-Hispanic Whites and Latino subgroups, further differentiated by gender and nativity? Does the PPC measurement approach reveal different patterns across groups compared to when only physical or only psychiatric health problems are the health outcomes of interest? To what extent do sociodemographic characteristics (SES, stress exposure, social support, immigration-related factors) explain PPC differences between groups? Results reveal that compared to U.S.-born non-Hispanic White men, island-born Puerto Rican men experience elevated PPC risk. Mexican and Other Latino women and men experience relatively lower risk of PPC relative to their non-Hispanic White counterparts. Social factors explain some of the health disadvantage of island-born Puerto Rican men, but do not explain the health advantage of Mexicans and Other Latinos.
Keywords:Hispanic Epidemiological Paradox  Comorbidity  National comorbidity survey-replication  National Latino and Asian American study
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