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We used nationally representative data to examine (1) the comorbidities of chronic diseases and their risks for psychological distress and (2) the ways in which chronic diseases combine with demographic factors such as sex, race\/ethnicity, immigration status, and health insurance coverage to affect the patterning of psychological distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed the 2005\u20132018 National Health Survey Interview cross-sectional data on U.S. adults aged\u2009\n                      <jats:italic>\u2265<\/jats:italic>\n                      \u200918 years (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009351,457). We fitted sequential multivariable logistic regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There was a dose-response relationship between the number of chronic diseases and psychological distress, with increased number of chronic diseases associated with increased psychological distress risk. Females (vs. males) and those without health insurance (vs. insured) were more likely to experience psychological distress. Immigrants (vs. non-immigrants) and racial\/ethnic minorities (vs. White individuals) were less likely to experience psychological distress. There were significant interactions between chronic diseases and insurance coverage, immigration status, and race\/ethnicity, but the three-way interactions were not statistically significant with psychological distress: chronic disease status vs. immigration status vs. health insurance coverage, and chronic disease vs. race\/ethnicity vs. immigration status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The findings suggest a critical need to consider the complex ways in which chronic diseases and psychosocial factors combine to affect psychological distress and their implications for tailoring mental health screening, initiatives to reduce distress, and prevention strategies for effectively addressing health-related disparities in the general population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00127-024-02730-1","type":"journal-article","created":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T11:01:57Z","timestamp":1721214117000},"page":"181-199","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Multiple chronic diseases and psychological distress among adults in the United States: the intersectionality of chronic diseases, race\/ethnicity, immigration, sex, and insurance coverage"],"prefix":"10.1007","volume":"60","author":[{"given":"David","family":"Adzrago","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faustine","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,17]]},"reference":[{"key":"2730_CR1","doi-asserted-by":"crossref","unstructured":"Gullett LR, Alhasan DM, Gaston SA, Jackson WB 2nd, Kawachi I, Jackson CL (2022) Neighborhood social cohesion and serious psychological distress among Asian, black, Hispanic\/Latinx, and White adults in the United States: a cross-sectional study. 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