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Global patterns of multimorbidity: a comparison of 28 countries using the World Health Surveys

Global patterns of multimorbidity: a comparison of 28 countries using the World Health Surveys
Global patterns of multimorbidity: a comparison of 28 countries using the World Health Surveys
Multimorbidity , defined as the coexistence of two or more chronic diseases in one individual, is increasing in prevalence globally. This study compares the prevalence of multimorbidity across low and middle income countries (LMICs) ; with stratification by age, sex and socio-economic status (SES). Population-based chronic disease data from 28 countries of the World Health Survey (WHS) 2003 were used (27 LMICs and 1 HICs). Inter-country socio-economic differences were examined using gross domestic product (GDP). Regression analyses were used to examine associations of SES with multimorbidity by region and by age. The mean world standardized prevalence of multimorbidity was 7.8 % (95 % CI, 7.79–7.83 %). Multimorbidity was positively associated with the female sex and with age, although it was common among younger adults in LMICs. A positive but non–linear relationship was found between country GDP and multimorbidity prevalence. Multimorbidity was inversely associated with SES in countries with the highest GDP; this gradient was flatter, and sometimes reversed, in countries with lower GDP. Higher SES was significantly associated with a decreased risk of multimorbidity in the all-region analyses. Multimorbidity is a global phenomenon not just affecting older adults in HICs. Policy makers worldwide need to address this combination of chronic diseases in the individual—which is contributing to health inequalities—and to support the complex health care service needs of a growing multimorbid population.
2352-376X
8
381-402
Springer
Afshar, Sara
8ad10b7e-2005-4e93-9948-164a69489350
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Kowal, Paul
8e394653-90a8-41d6-b15f-2023ecfa5c2a
Dimitrov, Borislav D.
366d715f-ffd9-45a1-8415-65de5488472f
Hill, Allan G.
02d10a36-dc8d-4215-a3e3-5da52e69d416
Hoque, Nazrul
Pecotte, Beverly
McGehee, Mary A.
Afshar, Sara
8ad10b7e-2005-4e93-9948-164a69489350
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Kowal, Paul
8e394653-90a8-41d6-b15f-2023ecfa5c2a
Dimitrov, Borislav D.
366d715f-ffd9-45a1-8415-65de5488472f
Hill, Allan G.
02d10a36-dc8d-4215-a3e3-5da52e69d416
Hoque, Nazrul
Pecotte, Beverly
McGehee, Mary A.

Afshar, Sara, Roderick, Paul, Kowal, Paul, Dimitrov, Borislav D. and Hill, Allan G. (2017) Global patterns of multimorbidity: a comparison of 28 countries using the World Health Surveys. In, Hoque, Nazrul, Pecotte, Beverly and McGehee, Mary A. (eds.) Applied Demography and Public Health in the 21st Century. (Applied Demography Series, , (doi:10.1007/978-3-319-43688-3_21), 8) Cham, CH. Springer, pp. 381-402. (doi:10.1007/978-3-319-43688-3_21).

Record type: Book Section

Abstract

Multimorbidity , defined as the coexistence of two or more chronic diseases in one individual, is increasing in prevalence globally. This study compares the prevalence of multimorbidity across low and middle income countries (LMICs) ; with stratification by age, sex and socio-economic status (SES). Population-based chronic disease data from 28 countries of the World Health Survey (WHS) 2003 were used (27 LMICs and 1 HICs). Inter-country socio-economic differences were examined using gross domestic product (GDP). Regression analyses were used to examine associations of SES with multimorbidity by region and by age. The mean world standardized prevalence of multimorbidity was 7.8 % (95 % CI, 7.79–7.83 %). Multimorbidity was positively associated with the female sex and with age, although it was common among younger adults in LMICs. A positive but non–linear relationship was found between country GDP and multimorbidity prevalence. Multimorbidity was inversely associated with SES in countries with the highest GDP; this gradient was flatter, and sometimes reversed, in countries with lower GDP. Higher SES was significantly associated with a decreased risk of multimorbidity in the all-region analyses. Multimorbidity is a global phenomenon not just affecting older adults in HICs. Policy makers worldwide need to address this combination of chronic diseases in the individual—which is contributing to health inequalities—and to support the complex health care service needs of a growing multimorbid population.

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e-pub ahead of print date: 20 October 2016
Published date: 2017
Organisations: Primary Care & Population Sciences

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Local EPrints ID: 399529
URI: http://eprints.soton.ac.uk/id/eprint/399529
ISSN: 2352-376X
PURE UUID: e9566815-ac34-41fe-883a-37450ef80d3b
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850

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Date deposited: 19 Aug 2016 09:33
Last modified: 27 Jan 2020 13:35

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