Table 1.

Definitions for chronic disease indicators, covariates associated with class membership, and health events and healthcare utilization.

Disease	Definition
Arthritis	Self-report arthritis diagnosis or treatment in the last 6 months
Anxiety/depression	Self-report anxiety or depression diagnosis/ treatment in the last 6 months, or Centers for Epidemiologic Studies Depression Scale (CES-D) scores of 23+ (Carleton et al., 2013).
Diabetes	Self-reported diabetes medication taken in past 6 months, or Hemoglobin A1c (HbA1c) concentration of >6.5
Hypertension	Self-reported hypertension medication in the last 6 months, or 2+ study visits with blood pressure readings of systolic ≥140 or diastolic ≥90
HIV	Self-reported antiretroviral therapy (ART) in the last 6 months or confirmed HIV antibody test.
Liver fibrosis	Transient elastography (FibroScan) measurements of median liver stiffness, classified by cutoffs for F2 fibrosis (kPa ≥ 9.3) (Kirk et al., 2009)
Major psychiatric disorders	Self-reported medications for/diagnosis of bipolar disorder, schizophrenia, or schizoaffective disorder.
Obstructive airway	Forced expiratory volume in 1 s to forced vital capacity of ≤70%
Renal dysfunction	Estimated glomerular filtration rate < 60 mL/min/1.73m2 using MDRD equation.
Covariate	Definition (at first study visit)
Age	Measured as a continuous variable at the first study visit and transformed into a dichotomous variable near the median age of 55 years old.
Sex	Dichotomous variable comparing self-report male vs. female sex.
Race	Classified as Black compared to non-Black race.
Income	A dichotomous variable comparing individuals with an income less than $5000 dollars per year to income greater than $5000 per year
Disability	Measured as a dichotomous variable based on the following question: “Currently, are you receiving SSI (Supplemental Security Income) or SSDI (Social Security Disability Income), or any other type of disability?”
Insurance	Self-report health insurance in the last six months
Continuity of care	Self-report of healthcare visits with the same healthcare provider for the last 2 years at the first visit
Drug use	Self-report of heroin, cocaine, crack, and/or speedball use and route in the last 6 months classified the following categories: Injection only, non-injection only, both injection and non-injection and no substance use (ref)
Alcohol use	Self-report of any alcohol use in the last 6 months.
Cigarette use	Binary variable for self-report of any cigarette use in the last 6 months.
Health events	Definition
Infectious	Self-report of diagnosis or treatment for sepsis, pneumonia, endocarditis or skin infection in the last 6 months at a study visit between 2015 and 2019
Cardiovascular	Self-report of diagnosis or treatment for myocardial infarction, heart failure, heart disease, or stroke in the last 6 months at a study visit between 2015 and 2019
Healthcare utilization	Definition (at last study visit)
Emergency room	Self-report utilization of emergency room services in the last six months
Outpatient visit	Self-report utilization of outpatient healthcare services in the last 6 months
Medication for opioid use	disorder Self-report prescription of buprenorphine, naltrexone, or methadone in the last 6 months