Household income level as a moderator of associations between chronic health conditions and serious mental illness

This study examined the influence of household income level on associations between common chronic health conditions (e.g., cardiovascular disease, diabetes, asthma) and probable serious mental illness (SMI). Data from the 2011 New York City Community Health Survey (N = 8,792) were examined using logistic regression modeling, including interaction terms or models stratified by household income to determine whether there was effect modification. Associations between chronic conditions and probable SMI varied across household income levels. Specifically, there was a significant interaction between diabetes and household income on probable SMI. In stratified models, asthma was associated with probable SMI only among individuals from poor households (<100% federal poverty), whereas diabetes was associated with probable SMI only among those from middle-income households (200% to <400% federal poverty). The findings highlight the mental health needs of individuals with chronic health conditions. Efforts to integrate physical and mental health services in community settings may be crucial for those from poor and middle-income households.