Managing Complexity: Black Older Adults With Multimorbidity.

Area of Science:

• Gerontology
• Health Services Research
• Sociology of Health and Illness

Background:

• Black older adults face higher rates of multimorbidity and less effective support compared to white adults.
• Disparities in multimorbidity care for Black older adults are linked to a lack of understanding of their lived experiences.
• Existing research offers limited insight into the specific challenges faced by Black older adults in managing multiple chronic conditions.

Purpose of the Study:

• To conceptualize the multimorbidity management (MM) experience for Black older adults.
• To identify the core challenges and domains involved in MM for this demographic.
• To inform the development of culturally relevant interventions and improve care.

Main Methods:

• Qualitative study employing in-depth interviews with 30 Black older adults (aged 65+) with self-reported multimorbidity.
• Grounded theory analysis used to develop a conceptual model of the MM experience.
• Participants resided in a large midwestern city in the United States.

Main Results:

• "Managing complexity" emerged as the central theme describing the MM experience.
• Key domains identified include "social context," "daily logistics," "care time," and "care roles."
• The concept of managing complexity is distinct from patient complexity and relates to cumulative inequality.

Conclusions:

• The findings highlight the multifaceted nature of multimorbidity management for Black older adults.
• Interventions should address social determinants, provider empathy, and patient agency.
• Addressing "managing complexity" is crucial for reducing health disparities in this population.