# Perceived Discrimination Is a Mediator of Rural Identity and Cardiometabolic Multimorbidity Among U.S. Adults

## TL;DR

This study shows that perceived discrimination helps explain why rural U.S. adults have higher rates of multiple cardiometabolic conditions.

## Contribution

The paper identifies perceived discrimination as a key mediator linking rural identity to cardiometabolic multimorbidity.

## Key findings

- Rural identity and perceived discrimination are linked to higher odds of cardiometabolic multimorbidity.
- Perceived discrimination significantly mediates the relationship between rural identity and multimorbidity.
- Healthcare access and age are also associated with higher odds of cardiometabolic multimorbidity.

## Abstract

The rise in prevalence of cardiometabolic multimorbidity indicates the need for more research examining associated risk factors. Identifying multilevel risk factors is especially critical for U.S. health disparity populations who have been shown to experience a disproportionate burden of chronic disease-related morbidity and mortality. This study examines differences in the prevalence of and risk factors associated with cardiometabolic multimorbidity status among health disparity populations in a representative sample of U.S. adults. Additionally, we investigate the role of perceived discrimination as a mediator of the relationship between rural identity and cardiometabolic multimorbidity status. We report the overall and stratified prevalence of cardiometabolic multimorbidity. Findings from multivariate logistic regression indicated that age, rural identity, healthcare access, and perceived discrimination were associated with higher odds of cardiometabolic multimorbidity. Perceived discrimination was found to be a significant mediator for the relationship between rural identity and cardiometabolic multimorbidity status. These findings have implications for the design and implementation of effective multilevel interventions to reduce the impact of perceived discrimination on cardiometabolic multimorbidity among rural adults.