{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T07:37:10Z","timestamp":1782027430855,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:p>To examine the relationship between socioeconomic deprivation and complex needs, defined as mental and physical comorbidities, we conducted a cross-sectional retrospective cohort analysis of adult Utah Medicaid beneficiaries. Our analysis included Medicaid beneficiaries with geocoded addresses aged \u226518\u202fyears in Utah (<jats:italic>N<\/jats:italic>\u202f=\u202f157,739). We geocoded beneficiary addresses and assigned them to census block groups. We compared the socioeconomic status of block groups (Singh\u2019s area deprivation index) with the proportion of complex needs, defined based on cluster analysis as 1 physical condition with depression or\u202f\u2265\u202f2 physical with \u22651 mental health condition. Spatial mapping was performed of prevalence quantiles grouped by count overlaid with Medicaid-covered mental health facilities. Prevalence of complex needs was 18.9% (<jats:italic>n<\/jats:italic>\u202f=\u202f29,742); beneficiaries with &amp;gt;3 emergency department visits had 12.8 odds of having complex needs; 39.7% of beneficiaries with &amp;gt;$5,000 in annual costs had complex needs. Common comorbid conditions among beneficiaries with complex needs were hypertension (56.0%), hyperlipidemia (35.5%), depression (68.8%), anxiety (56.2%), drug use (16.0%), and alcohol use disorders (15.2%). Census block groups with higher deprivation had a higher proportion of complex needs (<jats:italic>\u03c1<\/jats:italic>\u202f=\u202f0.21, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). There was a statistically significant spatial autocorrelation of the prevalence of complex needs (Moran\u2019s I index: 0.65; <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). Six high-count census blocks had no mental health facilities. Areas with increased socioeconomic deprivation had a greater proportion of complex needs and fewer mental health facilities. Integrated programs addressing both physical and mental health conditions with a focus on socioeconomically deprived areas might benefit Medicaid recipients in populations such as those in Utah.<\/jats:p>","DOI":"10.3389\/fpubh.2024.1454783","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T05:17:58Z","timestamp":1736140678000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Geographic disparities in physical and mental health comorbidities and socioeconomic status of residence among Medicaid beneficiaries in Utah"],"prefix":"10.3389","volume":"12","author":[{"given":"Roberta Z.","family":"Horth","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srimoyee","family":"Bose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Grafe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Navina","family":"Forsythe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Dunn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1056\/NEJMp1608511","article-title":"Caring for high-need, high-cost patients\u2014an urgent priority","volume":"375","author":"Blumenthal","year":"2016","journal-title":"N Engl J Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2564","DOI":"10.2105\/AJPH.2015.302836","article-title":"Prevalence, comorbidity, and prognosis of mental health among US veterans","volume":"105","author":"Trivedi","year":"2015","journal-title":"Am J Public Health"},{"key":"ref3","first-page":"14","volume-title":"Full report: clarifying multimorbidity patterns to improve targeting and delivery of clinical services for medicaid populations","author":"Boyd","year":"2010"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1056\/NEJMp1108649","article-title":"Moving beyond parity \u2014 mental health and addiction care under the ACA","volume":"365","author":"Barry","year":"2011","journal-title":"N Engl J Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1089\/pop.2016.0076","article-title":"An innovative approach to health care delivery for patients with chronic conditions","volume":"20","author":"Clarke","year":"2017","journal-title":"Popul Health Manag"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s12916-017-0913-6","article-title":"The contribution of risk factors to socioeconomic inequalities in multimorbidity across the lifecourse: a longitudinal analysis of the Twenty-07 cohort","volume":"15","author":"Katikireddi","year":"2017","journal-title":"BMC Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1111\/1753-6405.12762","article-title":"Socioeconomic status and multimorbidity: a systematic review and meta-analysis","volume":"42","author":"Pathirana","year":"2018","journal-title":"Aust N Z J Public Health"},{"key":"ref8","author":"Wilkness","year":"2017"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.2105\/AJPH.93.7.1137","article-title":"Area deprivation and widening inequalities in US mortality, 1969\u20131998","volume":"93","author":"Singh","year":"2003","journal-title":"Am J Public Health"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1377\/hlthaff.2014.1186","article-title":"For many patients who use large amounts of health care services, the need is intense yet temporary","volume":"34","author":"Johnson","year":"2015","journal-title":"Health Aff"},{"key":"ref11","volume-title":"ICD-9-CM \u2013 international classification of diseases, ninth revision, clinical modification","year":"2011"},{"key":"ref12","volume-title":"ICD-10-CM \u2013 international classification of diseases, tenth revision, clinical modification","year":"2017"},{"key":"ref13","article-title":"Condition categories - 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