Chronic disease burden and health-related quality of life among missouri adults

PURPOSE: This cross-sectional study examined associations between chronic disease burden, specific chronic conditions, and Short Form 36 (SF-36) health-related quality of life (HRQoL) scores among Missouri adults 18 years of age or older. METHODS: We analyzed survey-weighted data from the 2024 Center for Medical Epidemiology and Population Health Adult Health Survey (N = 547). The primary chronic condition count included cardiovascular disease, chronic respiratory disease, arthritis, diabetes, depressive disorder, non-skin cancer, and kidney disease and was categorized as zero, one, or two or more conditions. Obesity was examined as a condition-specific exposure and in sensitivity analyses. Survey-weighted linear regression models adjusted for age, sex, race/ethnicity, educational attainment, employment status, and rurality. The Benjamini-Hochberg procedure was used to control the false discovery rate across the 10 HRQoL outcomes. RESULTS: Overall, 30.0% of Missouri adults had two or more of the seven selected chronic conditions. Compared with adults with no chronic conditions, adults with two or more conditions had lower scores for nine of the 10 HRQoL outcomes after false discovery rate correction. The largest adjusted differences were observed for Role-Physical (β = -30.65; 95% CI, -46.56 to -14.74), Physical Functioning (β = -28.70; 95% CI, - 38.60 to -18.81), Bodily Pain (β = -28.28; 95% CI, -38.96 to -17.59), Social Functioning (β = -26.18; 95% CI, -35.43 to -16.92), and General Health (β = -24.18; 95% CI, - 30.75 to - 17.62). Physical Component Summary (PCS) was 12.82 points lower (95% CI, -16.98 to -8.66), and Mental Component Summary (MCS) was 6.10 points lower (95% CI, -9.47 to -2.73). Arthritis and cardiovascular disease had the strongest associations with lower PCS, while depressive disorder had the strongest association with lower MCS. In supplementary continuous-count models, each additional condition was associated with a 4.57-point lower PCS score and a 2.20-point lower MCS score. CONCLUSIONS: Greater chronic disease burden was associated with poorer physical and mental HRQoL among Missouri adults. Adding HRQoL assessment to chronic disease surveillance and clinical follow-up may help identify functional limitations and mental health needs that are not apparent from diagnoses alone.