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

Abstract

BackgroundMultimorbidity 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).MethodsChronic 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.ResultsThe 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.ConclusionsMultimorbidity 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2008-7) contains supplementary material, which is available to authorized users.

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Educational inequality in Rio de Janeiro and its impact on multimorbidity: evidence from the Pró-Saúde study. A cross-sectional analysis

“…22,23 The few studies conducted in Brazil were restricted to specific populations. They showed that multimorbidity was associated with higher risk of death and readmission after hospital discharge, among elderly people.…”

Capital social de las mujeres mayores usuarias de la red pública de la Atención Primaria de Salud

“…Al respecto, es preciso tener en cuenta, que en Valparaíso existe segregación urbana entre los cerros 14 . Las personas con mayores niveles de confianza en el contexto externo y mayor participación ciudadana presentarían mayor resiliencia y reportan mejor condición de salud [24][25][26][27][28] . Lo anteriormente señalado, está refrendado por los antecedentes epidemiológicos que confirman la relación entre diferentes mediciones de capital social y el nivel de salud especialmente, en países con desigualdad social 20,23 .…”

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