Perceived Discrimination Is a Mediator of Rural Identity and Cardiometabolic Multimorbidity Among U.S. Adults

LaToya J. O’Neal (), Lisa Scarton, Ara Jo, Biswadeep Dhar, Folakemi T. Odedina and Diana J. Wilkie
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LaToya J. O’Neal: Department of Family, Youth and Community Sciences, Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA
Lisa Scarton: Department of Family, Community and Health Systems Science, College of Nursing, University of Florida, Gainesville, FL 32611, USA
Ara Jo: Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA
Biswadeep Dhar: Department of Family, Youth and Community Sciences, Institute of Food and Agricultural Sciences, College of Agricultural and Life Sciences, University of Florida, Gainesville, FL 32611, USA
Folakemi T. Odedina: Division of Hematology/Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
Diana J. Wilkie: Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, FL 32611, USA

IJERPH, 2025, vol. 22, issue 3, 1-10

Abstract: The rise in prevalence of cardiometabolic multimorbidity indicates the need for more research examining associated risk factors. Identifying multilevel risk factors is especially critical for U.S. health disparity populations who have been shown to experience a disproportionate burden of chronic disease-related morbidity and mortality. This study examines differences in the prevalence of and risk factors associated with cardiometabolic multimorbidity status among health disparity populations in a representative sample of U.S. adults. Additionally, we investigate the role of perceived discrimination as a mediator of the relationship between rural identity and cardiometabolic multimorbidity status. We report the overall and stratified prevalence of cardiometabolic multimorbidity. Findings from multivariate logistic regression indicated that age, rural identity, healthcare access, and perceived discrimination were associated with higher odds of cardiometabolic multimorbidity. Perceived discrimination was found to be a significant mediator for the relationship between rural identity and cardiometabolic multimorbidity status. These findings have implications for the design and implementation of effective multilevel interventions to reduce the impact of perceived discrimination on cardiometabolic multimorbidity among rural adults.

Keywords: rural health; multimorbidity; chronic conditions; cardiometabolic conditions; health disparities; health equity; population health; social determinants of health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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