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Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys

Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys
Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys
BACKGROUND:Multimorbidity defined as the "the coexistence of two or more chronic diseases" in one individual, is increasing in prevalence globally. The aim of this study is to compare the prevalence of multimorbidity across low and middle-income countries (LMICs), and to investigate patterns by age and education, as a proxy for socio-economic status (SES).

METHODS:Chronic disease data from 28 countries of the World Health Survey (2003) were extracted and inter-country socio-economic differences were examined by gross domestic product (GDP). Regression analyses were applied to examine associations of education with multimorbidity by region adjusted for age and sex distributions.

RESULTS: The mean world standardized multimorbidity prevalence for LMICs was 7.8 % (95 % CI, 7.79 % - 7.83 %). In all countries, multimorbidity increased significantly with age. A positive but non-linear relationship was found between country GDP and multimorbidity prevalence. Trend analyses of multimorbidity by education suggest that there are intergenerational differences, with a more inverse education gradient for younger adults compared to older adults. Higher education was significantly associated with a decreased risk of multimorbidity in the all-region analyses.

CONCLUSIONS: Multimorbidity is a global phenomenon, not just affecting older adults in HICs. Policy makers worldwide need to address these health inequalities, and support the complex service needs of a growing multimorbid population.
multimorbidity, ageing, health inequalities, epidemiological transition, adult health
1471-2458
1-10
Afshar, Sara
8ad10b7e-2005-4e93-9948-164a69489350
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Kowal, Paul
8e394653-90a8-41d6-b15f-2023ecfa5c2a
Dimitrov, Borislav D.
366d715f-ffd9-45a1-8415-65de5488472f
Hill, Allan G.
5b17aa71-0c14-4fbf-8bc9-807c8294d4ae
Afshar, Sara
8ad10b7e-2005-4e93-9948-164a69489350
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Kowal, Paul
8e394653-90a8-41d6-b15f-2023ecfa5c2a
Dimitrov, Borislav D.
366d715f-ffd9-45a1-8415-65de5488472f
Hill, Allan G.
5b17aa71-0c14-4fbf-8bc9-807c8294d4ae

Afshar, Sara, Roderick, Paul J., Kowal, Paul, Dimitrov, Borislav D. and Hill, Allan G. (2015) Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys. BMC Public Health, 15 (776), 1-10. (doi:10.1186/s12889-015-2008-7). (PMID:26268536)

Record type: Article

Abstract

BACKGROUND:Multimorbidity defined as the "the coexistence of two or more chronic diseases" in one individual, is increasing in prevalence globally. The aim of this study is to compare the prevalence of multimorbidity across low and middle-income countries (LMICs), and to investigate patterns by age and education, as a proxy for socio-economic status (SES).

METHODS:Chronic disease data from 28 countries of the World Health Survey (2003) were extracted and inter-country socio-economic differences were examined by gross domestic product (GDP). Regression analyses were applied to examine associations of education with multimorbidity by region adjusted for age and sex distributions.

RESULTS: The mean world standardized multimorbidity prevalence for LMICs was 7.8 % (95 % CI, 7.79 % - 7.83 %). In all countries, multimorbidity increased significantly with age. A positive but non-linear relationship was found between country GDP and multimorbidity prevalence. Trend analyses of multimorbidity by education suggest that there are intergenerational differences, with a more inverse education gradient for younger adults compared to older adults. Higher education was significantly associated with a decreased risk of multimorbidity in the all-region analyses.

CONCLUSIONS: Multimorbidity is a global phenomenon, not just affecting older adults in HICs. Policy makers worldwide need to address these health inequalities, and support the complex service needs of a growing multimorbid population.

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More information

Accepted/In Press date: 1 July 2015
e-pub ahead of print date: 13 August 2015
Published date: 13 August 2015
Keywords: multimorbidity, ageing, health inequalities, epidemiological transition, adult health
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 390165
URI: https://eprints.soton.ac.uk/id/eprint/390165
ISSN: 1471-2458
PURE UUID: 5ec6cf5f-da5b-45cc-a93e-030aa9e1f7dc
ORCID for Paul J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Allan G. Hill: ORCID iD orcid.org/0000-0002-4418-0379

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Date deposited: 21 Mar 2016 15:07
Last modified: 20 Jul 2019 01:19

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