Education, race/ethnicity, and multimorbidity among adults aged 30–64 in the National Health Interview Survey

Abstract

BackgroundDemographic risk factors for multimorbidity have been identified in numerous population-based studies of older adults; however, there is less data on younger populations, despite the fact that approximately 24% of US adults age 18+ have multimorbidity. Understanding multimorbidity earlier in the life course is critical because of the increased likelihood of long-term disability and loss of productivity associated with chronic disease progression.ObjectiveTo examine the associations of education and race/ethnicity with mutimorbidity among adults aged 30–64 using cross-sectional data from the 2002–2014 National Health Interview Surveys.DesignMultimorbidity was defined as having at least 2 of 9 self-reported health conditions. Educational attainment was categorized as less than high school (HS), completed HS or some college, and bachelor's degree or higher. Logistic regression models of multimorbidity controlled for time since last doctor's visit, demographic and socioeconomic measures.ResultsCompared to having a bachelor's degree or higher, completing less than HS (OR=1.58, 95% CI = 1.50–1.66) or HS/some college (OR=1.32, 95% CI = 1.27–1.37) were both associated with increased odds of multimorbidity net of all included covariates. Non-Hispanic Blacks had greater odds of multimorbidity (OR=1.07, 95% CI = 1.02–1.11) compared to Non-Hispanic Whites with comparable characteristics.ConclusionsEpidemiologic and demographic research on the burden of multimorbidity among non-elderly adults is limited, but warrants renewed attention given the potential for long-term loss of quality of life, productivity, and well-being for non-elderly adults. Reducing multimorbidity through health promotion efforts across the socioeconomic spectrum and earlier in the life course will be a requirement to age successfully and support overall well-being in the aging US population.

Prevalence of Multimorbidity among Asian Indian, Chinese, and Non-Hispanic White Adults in the United States

“…Our results showed that 39.0% of NHW adults had multimorbidity, higher than other published studies that used the NHIS data [31,44,45,79]. The discrepancy may be caused by differences in the study period, age composition, and the selection of chronic conditions.…”

“…We did not include other racial/ethnic groups such as Hispanic or Latinos and African Americans because many studies have compared multimorbidity prevalence among Hispanics and NHWs and African Americans and NHWs [44][45][46][47]. These studies reported that Non-Hispanic Blacks had greater odds of multimorbidity compared to NHWs after adjusting for other risk factors.…”

Use of an Electronic Clinical Decision Support System in Primary Care to Assess Inappropriate Polypharmacy in Young Seniors With Multimorbidity: Observational, Descriptive, Cross-Sectional Study

“…In addition to sex, several epidemiological studies have explored whether there are associations between multimorbidity and ethnicity, and examples of these studies are detailed more fully in Annex 7. 314,315,316,317,318,319,320,321 However, differences in study methodology and in the terminology used to describe ethnicity have meant that such work is difficult to synthesise and interpret. As a result, whether there are real inter-ethnic differences in the risk of developing multimorbidity -as opposed to rates of diagnosis or differential survival -remains to be determined.…”

“…Cross-sectional studies investigating multimorbidity prevalence in HICs have shown a negative (or inverse) relationship between multimorbidity and socioeconomic status (SES); that is, lower SES is associated with an increased prevalence of multimorbidity. 329,330,331,332,333,334,335,336,337,338 4. Determinants of multimorbidity Notably, one cross-sectional study of a primary care population in Scotland found that the onset of multimorbidity occurred 10 to 15 years earlier in those living in the most deprived areas compared with the most affluent (see Figure 4), and that the prevalence of multimorbidity including mental health conditions was almost twice as high in the most deprived areas compared with the most affluent areas.…”

Multimorbidity and lifestyle factors among adults with intellectual disabilities: a cross‐sectional analysis of a UK cohort

“…It has a prevalence of between 12.9% and 95.1%, depending on case definition and populations studied, and has fairly consistently been found to be associated with increasing age, lower socio-economic status and female gender in the general population (Violan et al 2014). A relationship between multimorbidity and ethnicity has also been observed in some populations, with a higher prevalence generally found among some minority ethnic populations (Mathur et al 2011;Ahmadi et al 2016;Johnson-Lawrence et al 2017).…”