P9 Social Determinants of Health and Disruptive Life Events Among Patients with Schizophrenia or Bipolar Disorder

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Conference Proceeding

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Value in Health


Objective: To assess risk of disruptive life events (DLEs) and the effects of social determinants of health (SDoH) on DLEs in patients with schizophrenia (SCZ) or bipolar I disorder (BP-I). Methods: Multi-site retrospective, cohort study using electronic medical record data from Kaiser Permanente Southern California and Henry Ford Health System matched to DLE data (address changes, judgements, lien filings, bankruptcy, arrests) from TransUnion. Adults with SCZ or BP-I were matched to major depressive disorder (MDD) and general health (GH) controls based on date of incident or first prevalent diagnosis and demographic characteristics. Generalized estimating equation regression models assessed impact of covariates on outcomes. Results: Samples included 15,634 patients with SCZ and 29,380 patients with BP-I matched to MDD controls and 16,095 patients with SCZ and 29,850 patients with BP-I matched to GH controls. Differences in DLEs were found between patients with SCZ and BP-I and their control groups. Comparing patients with SCZ and BP-I to their matched controls, the likelihood of experiencing DLEs differed by race, age, and gender. Compared to white patients, Asian patients were less likely to experience any DLE, while Black patients were more likely to experience any DLE. Patients currently under age 65 (vs. ≥65) were more likely to move, have judgements, declare bankruptcy, and have been arrested. Odds of having a lien were less for patients 18-44 years but more for those 45-64 years (both vs. ≥65). Findings for gender were mixed based on comparator cohort. Conclusions: Further research is warranted to understand the role of social determinants of health on the occurrence of DLEs among patients with mental illness to develop policies and clinical pathways that help improve equitable access to care.





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