Mental Health, Chronic Disease, and Substance Use: Findings From Rural Texas

There are vital links among mental health conditions, chronic diseases, and substance use disorders. Simultaneous examination of the relationship among these three conditions is essential for providing well-integrated care to rural residents who have limited resources and for representing medically underserved areas. We aimed to assess the burden of behavioral health conditions and chronic diseases from a rural Texas community to garner context-specific insights and inform effective health promotion strategies in similar communities. We conducted a cross-sectional study among 181 residents from various zip codes in a rural Texas county. A self-administered, 18-item health-needs questionnaire was used to collect data from the participants. Of the total participants, 30.0% reported mental health conditions, 16.0% reported substance use disorders, and 44.2% reported having at least one type of chronic disease. Overall, mental health conditions were associated with substance use disorders [OR: 1.58 (95% CI: 0.73–2.42)] and chronic disease [OR: 1.07 (95% CI: 0.39–1.75)], but no associations were observed between substance use and chronic disease [OR: 0.62 (95% CI: -0.20–1.43)]. The economic and accessibility barriers that rural residents commonly face call attention to the need for integrated care that combines primary care and behavioral health services.