Despite increasing national healthcare expenditures, the U.S. consistently ranks among the lowest performers in health outcomes among advanced national economies. While there is debate over the origins of the problem, consensus exists that inefficient healthcare delivery and persistent population health inequities contribute to market failure of healthcare as a commodity. Persons with serious mental illnesses (SMI) represent a group for whom health inequities have long persisted. According to the National Institute of Mental Health, SMI are those psychological disorders (excluding substance abuse and developmental disorders) which cause functional impairment and interfere substantially with major life activities. SMI affect four percent of the U.S. population and constitute a leading cause of disability worldwide. Persons with SMI experience a disproportionate burden of chronic disease such as diabetes and cardiovascular disease in the U.S. which manifests as elevated prevalence and mortality rates compared to the general population. Disproportionate chronic disease burden among persons with SMI in the U.S. is a form of health inequity for which significant costs are incurred by individuals and society. Using Grossman’s model of health demand, this study investigated the relationship between comorbid SMI and chronic disease and national healthcare costs.
