Abstract
Introduction: Diagnosis counts and general health ratings describe different aspects of health. We examined their joint distribution and discordance using a restricted five-condition list, without treating it as comprehensive multimorbidity.
Methods: This exploratory secondary analysis included 5526 adults aged at least 20 with valid household-interview responses in NHANES 2017–2018. We counted ever-diagnosed hypertension, diabetes, asthma, arthritis and cancer/malignancy; retained five health-response levels; and estimated weighted proportions with stratified-cluster variance. Logistic association models compared grouped counts, with 4747 complete cases for demographic/socioeconomic adjustment. Sensitivities addressed borderline diabetes, current asthma and the component list.
Result: Fair or poor health was 9.9%, 17.4%, 29.7%, 40.5% across counts 0, 1, 2 and at least 3. Adjusted odds ratios versus 0 were 2.42 (1.72–3.40), 5.78 (3.50–9.55), 10.20 (5.50–18.94). In the highest count group, 59.5% reported good or better health; with no selected diagnoses, 9.9% reported fair or poor health. Similar broad patterns appeared in coding sensitivities, while complete-case selection and small cells remained limitations.
Conclusion: Higher restricted diagnosis counts were associated with less favorable self-rated health, but substantial discordance persisted. These cross-sectional results support transparent joint description; they do not establish causality, comprehensive multimorbidity, prognosis or an individual decision rule.
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