Psychosocial Factors Among Medically Underserved Individuals with MS.
|Title||Psychosocial Factors Among Medically Underserved Individuals with MS.|
|Publication Type||Journal Article|
|Authors||Johnson KL, Kuehn CM, Vollan T, Amtmann D|
|Journal||International Journal of MS Care|
Individuals who are medically underserved may suffer from psychosocial problems regardless of their health status. We surveyed individuals with multiple sclerosis (MS) from Eastern (N = 548) and Western (N = 739) Washington measuring demographic characteristics, disease history, symptoms, health care and health status. Using geographic information systems (GIS) software, addresses of respondents were linked with U.S. Census 2000 and Washington State Department of Health data. Individuals were designated â€œmedically underservedâ€ if they lived in a primary care shortage area, or had no health insurance. Urban/rural status was based on census data. Chi-square analysis indicated underserved status was strongly associated with depression, anxiety, difficulty thinking, and fatigue. We used multivariate logistic regression analysis to examine the association between psychosocial factors and underserved status among individuals with MS. Medically underserved individuals with MS were significantly more likely to be depressed (OR = 2.03, 95% CI 1.41, 2.94) and have difficulty thinking (OR = 1.18, 95% CI 1.0, 1.39). Those with more limited mobility as measured by EDSS were less likely to be medically underserved (OR = 0.72, 95% CI 0.56, 0.94), as were individuals who were currently employed (OR = 0.63, 95% CI 0.43, 0.93), and those living in urban areas (OR = 0.34, 95% CI 0.17, 0.70). Our results indicate that medically underserved individuals with MS are more likely to suffer from depression, have difficulty thinking, live in rural areas and be unemployed regardless of MS type. Opportunities exist for outreach from health care providers and consumer groups to underserved people with MS around these important psychosocial issues.