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A new citywide study reveals that New York City adults with multiple chronic diseases are significantly more likely to report mental health treatment utilization, though the strength of this relationship varies across race and ethnicity, education, sexual orientation, and household poverty levels.
Led by Dr. Thinh Toan Vu at the Center for Innovation in Mental Health, the study analyzed data from the 2019–2020 NYC Community Health Survey, which included over 17,000 adults. Dr. Vu examined how having multiple chronic diseases, such as obesity, diabetes, hypertension, and asthma, relates to mental health treatment utilization, including counseling or psychiatric medication use.
Findings revealed a clear dose–response pattern: the more chronic diseases an individual has, the more likely they are to use mental health services. Particularly, adults with one or two chronic conditions were 26% more likely to use counseling or psychiatric medication, while those with more than two conditions were nearly twice as likely compared to adults without chronic diseases. Yet this association was not uniform across populations. For example, Hispanic adults and individuals with lower household annual incomes showed steeper increases in mental health treatment as chronic disease burden rose, while Black adults consistently had lower treatment rates compared to white adults regardless of how many chronic diseases they reported.
“The dose–response pattern highlights growing mental health treatment needs among people with multiple chronic diseases,” says Dr. Vu. “However, persistent racial and socioeconomic disparities suggest that access to care is still constrained by structural barriers, not just health status. Our findings underscore the need for tailored, intersectional public health strategies that integrate physical and mental health care while addressing barriers to equitable access.”
Other sociodemographic factors, including age, sex, sexual orientation, race and ethnicity, place of birth, education, employment status, and insurance coverage also played a significant role. For instance, women and individuals identifying as gay, lesbian, bisexual, or other sexual minorities were more likely to report using mental health services, while minoritized populations, foreign-born adults and those without health insurance were less likely to do so.
These findings demonstrate that mental health treatment utilization is shaped by the intersecting effects of chronic diseases and social identities. Public health policies must address these overlapping vulnerabilities by expanding culturally competent care, integrating chronic disease and mental health services, and removing structural barriers to ensure equitable access for all New Yorkers.
