A study of 56,000 US Medicare Advantage enrollees (mean age, 71; 58%, women; 78%, White) identified the prevalence and risks associated with health-related social needs (HRSNs), including food insecurity and inadequate housing, and mental illness. The authors found that 38.6% of participants had at least one mental illness diagnosis; 54% had an HRSN; and 25.3% had both mental illness and an HRSN in the past year. The association of mental illness with the presence of HRSNs was most substantial among those with a serious and persistent mental illness.

Compared with the general population, those with mental illness have higher morbidity and mortality, and those with serious mental illness die a decade earlier. These premature deaths reflect not only higher rates of chronic diseases, such as diabetes, cancer, and cardiovascular disease, but unmet social needs that emerge from stigma, isolation, and homelessness.

HRSNs addressed in the study included financial strain, food insecurity, housing instability, severe loneliness, transportation problems and utility affordability. The HRSN with the largest risk differences was severe loneliness; compared with those without mental illness, those with a mental health diagnosis but no serious and persistent mental illness had 2.07 times higher odds of severe loneliness; those with a serious and persistent mental illness had 3.35 times higher odds.

"Increasing mental illness–related deaths nationwide suggest that the number of individuals in the US concurrently dealing with social and mental problems has increased—and likely will continue to increase—unless new strategies are implemented to simultaneously address social needs, physical health, and mental health," said coauthor Matthew Ruble, MD, chief medical officer of Discovery Behavioral Health.

To read the article, published in JAMA Network Open, click here