Abstract
Background
Despite increasing multimorbidity across the lifespan little is known about co-occurrence of conditions and risk factors among younger adults. This population-based study examines multimorbidity, social determinants and associated mortality among younger and middle-age adults.
Method
Analysis was based on the Northern Ireland population aged 25-64 years enumerated in the 2011 Census (n=878,345), with all-cause mortality follow-up to 2014 ( 8,659 deaths). Logistic regression was used to examine social determinants and Cox proportional hazards models in the analysis of associated mortality.
Results
Prevalence of multimorbidity was 13.7% in females and 12.7% in males. There was a strong association between multimorbidity that included mental/cognitive illness and deprivation. Among those never married, multimorbid physical conditions were less likely (RRR=0.92: 95%CI=0.88, 0.95 for males; and RRR=0.90: 0.87, 0.94 for females). Rurality was associated with lower physical multimorbidity (RRR=0.92: 0.89, 0.95) but higher mental/cognitive multimorbidity (RRR=1.35: 1.12, 1.64) among females. All multimorbid categories were associated with elevated risk of mortality.
Conclusion
The health and economic challenges created by multimorbidity should be addressed further ‘upstream’. Future multimorbidity research should include younger adults to inform the development of preventative interventions and align health and social care services more closely with patients' needs.
Despite increasing multimorbidity across the lifespan little is known about co-occurrence of conditions and risk factors among younger adults. This population-based study examines multimorbidity, social determinants and associated mortality among younger and middle-age adults.
Method
Analysis was based on the Northern Ireland population aged 25-64 years enumerated in the 2011 Census (n=878,345), with all-cause mortality follow-up to 2014 ( 8,659 deaths). Logistic regression was used to examine social determinants and Cox proportional hazards models in the analysis of associated mortality.
Results
Prevalence of multimorbidity was 13.7% in females and 12.7% in males. There was a strong association between multimorbidity that included mental/cognitive illness and deprivation. Among those never married, multimorbid physical conditions were less likely (RRR=0.92: 95%CI=0.88, 0.95 for males; and RRR=0.90: 0.87, 0.94 for females). Rurality was associated with lower physical multimorbidity (RRR=0.92: 0.89, 0.95) but higher mental/cognitive multimorbidity (RRR=1.35: 1.12, 1.64) among females. All multimorbid categories were associated with elevated risk of mortality.
Conclusion
The health and economic challenges created by multimorbidity should be addressed further ‘upstream’. Future multimorbidity research should include younger adults to inform the development of preventative interventions and align health and social care services more closely with patients' needs.
| Original language | English |
|---|---|
| Journal | Journal of Public Health |
| Early online date | 22 Dec 2020 |
| DOIs | |
| Publication status | E-pub ahead of print - 22 Dec 2020 |
Keywords
- epidemiology
- morbidity and mortality
- social determinants