Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys
Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys
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DOI：
10.1186/s12889-015-2008-7
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发表时间：
2015-08-13
影响因子：
4.5
通讯作者：
Hill, Allan G.
中科院分区：
文献类型：
--
作者：
Afshar, Sara;Roderick, Paul J.;Hill, Allan G.
背景：多重发病被定义为“两种或两种以上慢性疾病并存”，在全球范围内的患病率正在上升。本研究的目的是比较低收入和中等收入国家（LMICs）的多病患病率，并调查按年龄和教育程度划分的模式，作为社会经济地位（SES）的代表。方法：提取世界卫生调查（2003年）28个国家的慢性病数据，并通过国内生产总值（GDP）检查国家间社会经济差异。采用回归分析，按年龄和性别分布调整地区，检验教育与多发病的关系。结果：低收入国家的世界标准化多病平均患病率为7.8% （95% CI, 7.79% - 7.83%）。在所有国家，多重发病率都随着年龄的增长而显著增加。国家GDP与多病患病率之间存在正但非线性的关系。受教育程度对多发病的趋势分析表明，存在代际差异，与老年人相比，年轻人的受教育程度梯度更相反。在全地区分析中，高等教育与多病风险降低显著相关。结论：多重发病是一种全球现象，而不仅仅影响hic的老年人。世界各地的决策者需要解决这些卫生不平等问题，并支持日益增长的多种疾病人口的复杂服务需求。
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.