This study will use the 2005-2010 Medical Expenditure Panel Survey to compare the prevalence of concurrent mental health and cardiometabolic illnesses across rural and urban populations and to describe relationships among comorbidity, residence, and healthcare utilization. Multivariate models will be employed to determine whether and how the effects of rural residence and psychiatric comorbidity interact to influence the health use patterns of adults with cardiometabolic disease.

Research findings indicate that patients with comorbid psychiatric and cardio-metabolic conditions experience worse healthcare access and outcomes than those with either condition alone, and that service models integrating behavioral health and primary care can help to reduce these disparities. Given recent private and public sector interest in behavioral health/primary care integration this project will provide critical information to policymakers, health plans, healthcare providers, and community organizations about the needs of this dually vulnerable population. More specifically, the study will indicate whether rural populations with comorbidities are at higher risk for access problems, and whether they should therefore be prioritized in public and private efforts to promote mental health/primary care integration.

Publications

• Implications of Rurality and Psychiatric Status for Diabetic Preventive Care Use Among Adults With Diabetes
  Policy Brief
  Maine Rural Health Research Center
  Date: 05/2014
  This brief examines patterns of diabetic preventive care use among adults with diabetes to determine whether these patterns vary according to respondents' rural/urban residence or the presence/absence of a mental health diagnosis.