Prevalence and determinants of multimorbidity among resettled Bhutanese older adults in Ohio, USA

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BACKGROUND: Multimorbidity, the presence of two or more chronic conditions, is a significant global health issue, especially among older adults. Accelerated aging and a myriad of stressor factors related to displacement and socio-economic disadvantage position profoundly exacerbate physical health and well-being problems among refugees, including resettled Bhutanese older adults. Despite these risks, research on multimorbidity burden and its determinants among the resettled Bhutanese older adults is limited. This study aims to assess the prevalence of single and multiple chronic conditions (multimorbidity) and identify associated factors among resettled Bhutanese older adults in Ohio. METHODS: This cross-sectional study involved 276 resettled Bhutanese aged 55 and older from four major cities in Ohio—Akron, Cincinnati, Cleveland, and Columbus, recruited through snowball sampling. Multimorbidity, the dependent variable, was defined as the presence of two or more chronic conditions—specifically hypertension, arthritis, diabetes, high cholesterol, heart disease, chronic obstructive pulmonary disease, kidney disease, or cancer—based on participants’ self-reports of diagnoses or medication use. Binary logistic regression was used to identify associated factors. RESULTS: Common conditions included hypertension (63.0%), high cholesterol (43.5%), diabetes (42.8%), and arthritis (42.0%). Notable combinations were hypertension with high cholesterol (36.6%), diabetes (33.3%), and arthritis (31.5%). The study found a 62.0% prevalence of multimorbidity. Higher odds of multimorbidity were linked to identifying as ascribed to Hindu religion (aOR:2.50, 95% CI:1.26–4.96) and experiencing depressive symptoms (aOR:3.13, 95% CI:1.46–6.72). Employed individuals had 85% lower odds of multimorbidity (aOR:0.15, 95% CI:0.04–0.58). STUDY IMPLICATIONS: This study provides valuable insights into the high burden of chronic diseases and multimorbidity among resettled Bhutanese older adults in Ohio. The study emphasizes the need for targeted health research focused on chronic disease prevention and lifestyle management interventions aimed at preventing chronic conditions.

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