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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

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

Authors: Sara Afshar, Paul J. Roderick, Paul Kowal, Borislav D. Dimitrov, Allan G. Hill

Published in: BMC Public Health | Issue 1/2015

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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.
Appendix
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Metadata
Title
Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys
Authors
Sara Afshar
Paul J. Roderick
Paul Kowal
Borislav D. Dimitrov
Allan G. Hill
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2008-7

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