Associations Among Reduced Income, Unhealthy Habits, the Prevalence of Non-Communicable Diseases, and Multimorbidity in Middle-Aged and Older US Adults: A Cross-Sectional Study

Introduction: Evidence supports the relationships between socioeconomic status and access to health care, incidence of pathologies, and lifestyle. Objective: The aim of this research was to investigate whether there are associations between having a household income below the poverty line, and participation in unhealthy lifestyle habits, the prevalence of non-communicable diseases, and the number of comorbidities in US middle-aged and older adults. Methods: This cross-sectional study is based on the NHANES 2011-2020. A total of 10,788 US middle-aged and older adults (5653 males and 5135 females) participated in this research. Associations were studied through the Chi-squared test, and odds ratios were calculated using a binary logistic regression model. Results: There were associations between a household income below the poverty line and physical inactivity, unhealthy diet, and being or having been an alcoholic. Associations were found between this adverse economic situation and having hypertension, diabetes, liver disease, kidney problems, arthritis, congestive heart failure, angina pectoris, heart attack, stroke, and also with having two or more, three or more, four or more, and five or more comorbidities. Increased odds of being involved in these unhealthy habits and of suffering these diseases and multimorbidity were found for those with a family income below the poverty threshold. Conclusions: The existence of associations between having a family income under the poverty threshold and having unhealthy habits, suffering non-communicable diseases, and having multimorbidity is confirmed in US middle-aged and older adults. Increased odds for various non-communicable diseases, multimorbidity, and for being involved in these unhealthy habits were found for this low-income group. These findings should serve to draw the attention of policy makers to the increased health vulnerability of the adult population below the poverty line in the US.