Social/Emotional Health, Mental Health and Quality of Life among Adults with Comorbid Diabetes and Hypertension: A Population-based Cross-sectional Study.

Introduction: West Virginia has a disproportionately large population of rural adults with diabetes and hypertension, two common chronic, comorbid conditions that represent a national economic, social, and public health burden. Anxiety, depression, and severe mental illness are associated with poor motivation to engage in coping/self-care behaviors and related increased morbidity/mortality.

Purpose: This study examines the relationship between self-reported mental health, selected social and emotional health factors, health-related quality of life (HRQoL), and clinical outcomes among adults with comorbid diabetes and hypertension.

Methods: This cross-sectional study consisted of 75 participants who participated in a diabetes and hypertension self-management program (DHSMP) in West Virginia. Baseline measures (2018-2019) were used to explore associations and included demographics, self-rated mental health, diabetes distress, HRQoL, HbA1c, and blood pressure. One-way ANOVA was performed to compare mentally healthy v. unhealthy participants by their demographics, diabetes distress and its domains, HRQoL and its domains, and clinical outcomes.

Results: The mean age and BMI were 60.8 ± 12.2 and 36.4 ± 8.1, respectively, indicating that the average participant was older and obese. Participants who self-reported fair or poor mental health had significantly higher BMI, higher diabetes distress, and lower HRQoL. Participants with good to excellent mental health had lower systolic blood pressure.

Implications: Findings indicate the potential role of social and emotional health on clinical outcomes and HRQoL among patients with comorbid chronic conditions, especially for older obese patients. Future studies with larger sample sizes should explore tailoring lifestyle and educational programs to address these factors for improved health outcomes.