MULTIMORBIDITY TRAJECTORY CLASSES AS PREDICTED BY RACE, ETHNICITY, AND SOCIAL RELATIONSHIP QUALITY

Growth mixture modeling was used to classify
multimorbidity (≥2 chronic conditions) trajectories over a
10-year period (2006-2016) in the Health and Retirement
Study (N = 7,151, mean age = 68.6 years). Race/ethnicity
(non-Hispanic Black, Hispanic, non-Hispanic White) and social relationship quality (positive social support and negative social exchanges, such as criticisms) were then used to
predict trajectory class membership, controlling for age, sex,
education, and wealth. We identified three trajectory classes:
initial low levels and rapid accumulation of multimorbidity
(increasing: 12.6%), initial high levels and gradual accumulation of multimorbidity (high: 19.5%), and initial
low levels and gradual accumulation of multimorbidity
(low: 67.9%). Blacks were more than twice as likely to
be in the increasing (OR = 2.04, CI[1.29,3.21]) and high
(OR = 2.28 CI[1.58,3.206]) multimorbidity groups compared with Whites, but there were no significant differences
between Hispanics and Whites for either trajectory class
(OR = .84 CI[.47,1.51]and OR = .74 CI[.41,1.34], respectively). Increments in perceived support were associated with
significantly lower risk of membership in the increasing
(OR = .59, CI[.46,.78]) and high classes (OR = .54
CI[.42,.69]), and increments in negative exchanges were
associated with significantly higher risk of membership in
the increasing (OR = 1.64 CI[1.19,2.25]) and high classes
(OR = 2.22 CI[1.64,3.00]). These results provide important
new information for understanding health disparities and the
role of social relationships associated with multimorbidity in
middle and later life that may aid in identifying those most
at risk and suggesting possible interventions for mitigating
that risk.