Multimorbidity and Socioeconomic Deprivation among Older Adults: A Cross-sectional Analysis in Five Canadian Cities Using the CLSA

Wister, Andrew; Rosenkrantz, Leah; Shashank, Aateka; Walker, Blake Byron; Schuurman, Nadine

doi:10.1080/26892618.2020.1734138

Cited by 6 publications

(5 citation statements)

References 58 publications

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“…Sample sizes in the studies range from 264 to 3,759,836. 3 , 27 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 ,…”

Section: Resultsunclassified

“… 49 China UMIC 2020 2011–2015 Cross-sectional China Health and Retirement Longitudinal Study (CHARLS) for 2011, 2013, and 2015 Self-reported 11,817 ≥50 62 (median) 48.8 11 61.9 Wister et al. 50 Canada HIC 2020 2010 Cross-sectional Canadian Longitudinal Study on Aging (CLSA) dataset Self-reported 15,711 45–85 62 49 27 64 Yao et al. 51 China UMIC 2019 2011–2015 Cross-sectional China Health and Retirement Longitudinal Study (CHARLS) Self-reported 19,841 ≥50 NA 48.6 14 42.4 Zhang et al.…”

Section: Resultsmentioning

confidence: 99%

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Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis

Chowdhury¹,

Das²,

Sunna³

et al. 2023

eClinicalMedicine

163

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Section: Resultsunclassified

Section: Resultsmentioning

confidence: 99%

Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis

Chowdhury¹,

Das²,

Sunna³

et al. 2023

eClinicalMedicine

163

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“…Furthermore, the literature on resilience and aging has investigated a range of areas within which individuals harness resources to foster positive adaptation to illness, including psychological, emotional, spiritual, physical/functional, economic, cultural, and social or ecological domains (Cosco, Wister, Brayne, & Howse, 2018;Linkov & Kott, 2019;Ong et al, 2006;Silverman, Molton, Alschuler, Ehde, & Jensen, 2015;Wiles, Wild, Kerse, & Allen, 2012;Wister, Rosenkrantz, Shashank, Walker, & Schuurman, 2020). Applied to multimorbidity, some individuals may (or may not) possess important resilience attributes, such as healthy lifestyle routines, social support resources, economic resources, and social-psychological strengths that may generate positive appraisals of healthy aging (Kendig et al, 2014;Rybarczyk et al, 2012;Sells et al, 2009;Trivedi et al, 2011;Windle, 2012).…”

Section: Social Determinants and Health Behaviours For Healthy Agingmentioning

confidence: 99%

Social Determinants and Health Behaviours among Older Adults Experiencing Multimorbidity Using the Canadian Longitudinal Study on Aging

Wister

2021

Can. J. Aging

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This study examines associations between lifestyle behavioural factors and appraisals of “healthy aging” among older adults experiencing multimorbidity. A Social Determinants and Health Behaviour Model (SDHBM) is used to frame the analyses. Using baseline data from the Canadian Longitudinal Study on Aging (CLSA), we studied 12,272 Canadians 65 years of age or older who reported 2 or more of 27 chronic conditions. Additional analyses were conducted using three multimorbidity clusters: cardiovascular/metabolic, musculoskeletal, and mental health. Using hierarchical logistic regression, it was found that, for multmorbidity and the three illness clusters, healthy aging is consistently associated with not smoking (except for the mental health cluster), an absence of obesity (except for the cardiovascular and metabolic cluster), better sleep, and a better appetite. It is not associated with inactivity. Several socio-demographic, environmental, and illness covariates were also supported. The findings are examined using the SDHBM coupled with a resilience lens in order to elucidate how modifiable health behaviours can act as resources to mitigate multimorbidity adversities. This has implications for healthy aging for persons with multimorbidity, especially during the COVID-19 pandemic.

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“…Therefore, 31 studies can be considered largely atheoretical, without any emphasis on pathways through which socioeconomic disadvantage leads to multimorbidity. In the 33 studies applying a theory, the following theories were referred to: behavioural,10 34 35 37 38 40–42 46 51–53 59 71 72 79–82 materialist38 41 42 45 46 48 50 52 71 72 74 79 82–85 and psychosocial 34 42 51 52 57 72 73 82 84–86. In addition, four studies applied a theoretical construct called ‘sense of coherence’, which indicates an individual’s coping capacity to deal with life and stressful events,87 and is an indicator of self-efficacy and psychosocial well-being (consistent with psychosocial explanations),73 and also encompasses social capital51 and social support,57 which are widely considered as psychosocial assets (table 3).…”

Section: Resultsmentioning

confidence: 99%

“…Of the papers using theories, 15 explicitly stated those theories,10 35 38 41 57 63 64 72–74 80 82 84–86 and the other 21 studies were inferred to be consistent with a presumed theoretical pathway, based on definitions from existing literature.…”

Section: Resultsmentioning

confidence: 99%

Theoretical explanations for socioeconomic inequalities in multimorbidity: a scoping review

et al. 2022

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ObjectiveTo document socioepidemiological theories used to explain the relationship between socioeconomic disadvantage and multimorbidity.DesignScoping review.MethodsA search strategy was developed and then applied to multiple electronic databases including Medline, Embase, PsychInfo, Web of Science, Scielo, Applied Social Sciences, ERIC, Humanities Index and Sociological Abstracts. After the selection of studies, data were extracted using a data charting plan. The last search was performed on the 28 September 2021. Extracted data included: study design, country, population subgroups, measures of socioeconomic inequality, assessment of multimorbidity and conclusion on the association between socioeconomic variables and multimorbidity. Included studies were further assessed on their use of theory, type of theories used and context of application. Finally, we conducted a meta-narrative synthesis to summarise the results.ResultsA total of 64 studies were included in the review. Of these, 33 papers included theories as explanations for the association between socioeconomic position and multimorbidity. Within this group, 16 explicitly stated those theories and five tested at least one theory. Behavioural theories (health behaviours) were the most frequently used, followed by materialist (access to health resources) and psychosocial (stress pathways) theories. Most studies used theories as post hoc explanations for their findings or for study rationale. Supportive evidence was found for the role of material, behavioural and life course theories in explaining the relationship between social inequalities and multimorbidity.ConclusionGiven the widely reported social inequalities in multimorbidity and its increasing public health burden, there is a critical gap in evidence on pathways from socioeconomic disadvantage to multimorbidity. Generating evidence of these pathways will guide the development of intervention and public policies to prevent multimorbidity among people living in social disadvantage. Material, behavioural and life course pathways can be targeted to reduce the negative effect of low socioeconomic position on multimorbidity.

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Multimorbidity and Socioeconomic Deprivation among Older Adults: A Cross-sectional Analysis in Five Canadian Cities Using the CLSA

Cited by 6 publications

References 58 publications

Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis

Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis

Social Determinants and Health Behaviours among Older Adults Experiencing Multimorbidity Using the Canadian Longitudinal Study on Aging

Theoretical explanations for socioeconomic inequalities in multimorbidity: a scoping review

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