CVD-MH illness comorbidity is highly prevalent in urban Haiti, especially among older adults and women, underscoring the need for integrated, contextually adapted approaches to address multimorbidity in crisis-affected low- and middle-income countries.
Key Findings
Results
CVD-mental health illness comorbidity prevalence was 30% among adults in urban Haiti.
Comorbidity prevalence was 30% (95% CI, 28-32) among 2993 adults enrolled in the Haiti Cardiovascular Disease Cohort Study (2019-2021).
CVD prevalence alone was 34% and mental health illness prevalence alone was 85%.
CVD was defined as hypertension, heart failure, stroke, or myocardial infarction, adjudicated by a physician panel integrating clinical examinations, imaging, and laboratory data.
Mental health illness was defined as depression symptoms (PHQ-9 score >5) or stress (Perceived Stress Score >5).
Results
Older age was strongly associated with CVD-mental health illness comorbidity.
Adults aged ≥60 years had an adjusted prevalence ratio of 5.79 (95% CI, 4.57-7.38) compared with those aged <40 years.
The median age of the study population was 40 years.
This association was identified via multivariable Poisson regression adjusting for age, sex, low income, education, smoking, and alcohol consumption.
Results
Female sex was significantly associated with higher prevalence of CVD-mental health illness comorbidity.
The adjusted prevalence ratio for female versus male sex was 1.22 (95% CI, 1.06-1.42).
42% of the 2993 adults in the analysis were women.
This association remained significant after adjusting for age, income, education, smoking, and alcohol consumption.
Results
Lower education level was significantly associated with CVD-mental health illness comorbidity.
Secondary versus primary education was associated with an adjusted prevalence ratio of 1.46 (95% CI, 1.24-1.71).
This was identified in multivariable Poisson regression adjusting for all other risk factors including age, sex, income, smoking, and alcohol consumption.
Methods
The study population was predominantly low-income, with 70% earning less than 1 USD per day.
70% of the 2993 enrolled adults earned an income of less than 1 USD per day.
Adults were recruited using multistage random sampling across Port-au-Prince.
Enrollment took place between 2019 and 2021 as part of the Haiti Cardiovascular Disease Cohort Study.
Yan L, Metz M, Sufra R, St Sauveur R, Celestin K, Hilaire E, et al.. (2026). High Burden of Cardiovascular Disease and Mental Health Illness Comorbidity in Urban Haiti.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.045112