THE INFLUENCE OF SOCIO-ECONOMIC DEPRIVATION ON MULTIMORBIDITY: A SYSTEMATIC REVIEW

Micky Oloo Olutende, Elizabeth Mse, Maximilla N. Wanzala, Edwin Kadima Wamukoya

Abstract


Introduction: Multimorbidity poses a current global health challenge due to its increasing prevalence and burden on individuals and health systems. Evidence suggests that more socially disadvantaged individuals share a disproportionate burden of multimorbidity. The evidence on the relationship between area-level socioeconomic disadvantage and multimorbidity is unclear. Thus, the aim of the current study is to synthesise evidence on the association between area-level socio-economic disadvantage and multimorbidity. Methods: A systematic review was conducted of published literature from inception to January 2020. Search strategy was applied to identify evidence on PubMed (Medline), Ovid (Medline, Embase, Psycinfo) and Web of Science. Studies were selected according to the inclusion and exclusion criteria. Newcastle Ottawa Scale for observational studies was used for quality assessment of included studies. Evidence was synthesised narratively. Results: We identified eight out of 2588 studies identified in the search as per the inclusion and exclusion criteria. Out of the eight studies, five studies confirmed a positive association between area-level socio-economic disadvantage and multimorbidity, two studies presented a negative association, and one study presented no association. Three studies found individuals in deprived areas to have higher multimorbidity than those in affluent areas. Two studies established that individuals in rural areas had higher multimorbidity than their urban counterparts. Two studies found individuals in urban areas to have a higher multimorbidity than those in rural areas. Conclusion: Evidence shows that association between area-level socioeconomic disadvantage and multimorbidity exist. Except for area of residence, clear positive associations were confirmed between area deprivation and multimorbidity.

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socio-economic deprivation, multimorbidity

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Fortin M, Hudon C, Dubois MF, Almirall J, Lapointe L, Soubhi H. Comparative assessment of three different indices of multimorbidity for studies on health-related quality of life. Health Qual Life Outcomes. 2005;3:74.

Greene R, Dasso E, Ho S, Frank J, Scandrett G, Genaidy A. Patterns and expenditures of multi-morbidity in an insured working population in the United States: insights for a sustainable health care system and building healthier lives. Population health management. 2013;16(6):381-9.

Chung RY, Mercer S, Lai FT, Yip BH, Wong MC, Wong SY. Socioeconomic Determinants of Multimorbidity: A Population-Based Household Survey of Hong Kong Chinese. PLoS One. 2015;10(10):e0140040.

Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005;3.

Smith SM, Soubhi H, Fortin M, Hudon C, O'Dowd T. Managing patients with multimorbidity: systematic review of interventions in primary care and community settings. Bmj. 2012;345:e5205.

Afshar S, Roderick PJ, Kowal P, Dimitrov BD, Hill AG. Multimorbidity and the inequalities of global ageing: a cross-sectional study of 28 countries using the World Health Surveys. BMC Public Health. 2015.

Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med. 2012;10.

Smith SM, Wallace E, O'Dowd T, Fortin M. Interventions for improving outcomes in patients with multimorbidity in primary care and community settings. Cochrane Database Syst Rev. 2016;3:Cd006560.

Li J, Green M, Kearns B, Holding E, Smith C, Haywood A, et al. Patterns of multimorbidity and their association with health outcomes within Yorkshire, England: baseline results from the Yorkshire Health Study. BMC public health. 2016;16:649.

Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M, et al. Prevalence, Determinants and Patterns of Multimorbidity in Primary Care: A Systematic Review of Observational Studies. PLOS ONE. 2014;9(7):e102149.

Mondor L, Cohen D, Khan AI, Wodchis WP. Income inequalities in multimorbidity prevalence in Ontario, Canada: a decomposition analysis of linked survey and health administrative data. International Journal for Equity in Health. 2018(1).

Sondergaard E, Willadsen TG, Guassora AD, Vestergaard M, Tomasdottir MO, Borgquist L, et al. Problems and challenges in relation to the treatment of patients with multimorbidity: General practitioners' views and attitudes. Scandinavian journal of primary health care. 2015;33(2):121-6.

Glynn LG, Valderas JM, Healy P, Burke E, Newell J, Gillespie P, et al. The prevalence of multimorbidity in primary care and its effect on health care utilization and cost. Fam Pract. 2011;28.

Khanam MA, Streatfield PK, Kabir ZN, Qiu C, Cornelius C, Wahlin A. Prevalence and patterns of multimorbidity among elderly people in rural Bangladesh: a cross-sectional study. J Heal Popul Nutr. 2011;29.

Charlton J, Rudisill C, Bhattarai N, Gulliford M. Impact of deprivation on occurrence, outcomes and health care costs of people with multiple morbidity. Journal Of Health Services Research & Policy. 2013;18(4):215-23.

Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380.

Zulman DM, Pal Chee C, Wagner TH, Yoon J, Cohen DM, Holmes TH, et al. Multimorbidity and healthcare utilisation among high-cost patients in the US Veterans Affairs Health Care System. BMJ open. 2015;5(4):e007771.

Kuo RN, Lai MS. The influence of socio-economic status and multimorbidity patterns on healthcare costs: a six-year follow-up under a universal healthcare system. Int J Equity Health. 2013;12:69.

Bahler C, Huber CA, Brungger B, Reich O. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. BMC Health Serv Res. 2015;15:23.

Pathirana TI, Jackson CA. Socioeconomic status and multimorbidity: a systematic review and meta-analysis. Australian And New Zealand Journal Of Public Health. 2018;42(2):186-94.

Orueta JF, Garcia-Alvarez A, Alonso-Moran E, Vallejo-Torres L, Nuno-Solinis R. Socioeconomic variation in the burden of chronic conditions and health care provision - analyzing administrative individual level data from the Basque Country, Spain. BMC Public Health. 2013.

Ataguba J, Akazili J, McIntyre D. Socioeconomic-related health inequality in South Africa: evidence from General Household Surveys. Int J Equity health. 2011;10.

Katikireddi SV, Skivington K, Leyland AH, Hunt K, Mercer SW. The contribution of risk factors to socioeconomic inequalities in multimorbidity across the lifecourse: a longitudinal analysis of the Twenty-07 cohort. BMC Med. 2017;15(1):152.

von dem Knesebeck O, Bickel H, Fuchs A, Gensichen J, Hofels S, Riedel-Heller SG, et al. Social inequalities in patient-reported outcomes among older multimorbid patients--results of the MultiCare cohort study. Int J Equity Health. 2015;14:17.

Brewer N, Borman B, Sarfati D, Jeffreys M, Fleming ST, Cheng S, et al. Does comorbidity explain the ethnic inequalities in cervical cancer survival in New Zealand? A retrospective cohort study. BMC Cancer. 2011;11(1):132.

Stephanie A. Robert a. Community-Level Socioeconomic Status Effects on Adult Health. Journal of Health and Social Behavior. 1998(1):18.

Susanna S, Peter C, Sarah C. Modelling Inequality in Reported Long Term Illness in the UK: Combining Individual and Area Characteristics. Journal of Epidemiology and Community Health (1979-). 1996(3):366.

Pickett KE, Pearl M. Multilevel Analyses of Neighbourhood Socioeconomic Context and Health Outcomes: A Critical Review. Journal of Epidemiology and Community Health (1979-). 2001(2):111.

Coren E, Fisher M. The conduct of systematic research reviews for SCIE knowledge reviews. 2006.

Wells G SB, O'Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [06/08/2018]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. 2004.

PRISMA. Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Accessed from: http://www.prisma-statement.org/.

Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA. Epidemiology and impact of multimorbidity in primary care: A retrospective cohort study. British Journal of General Practice. 2011;61(582):e12-e21.

Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012;380(9836):37-43.

Roberts KC, Rao DP, Bennett TL, Loukine L, Jayaraman GC. Prevalence and patterns of chronic disease multimorbidity and associated determinants in Canada. Health promotion and chronic disease prevention in Canada : research, policy and practice. 2015;35(6):87-94.

Orueta JF, Alonso-Moran E, Nuno-Solinis R, Alday-Jurado A, Gutierrez-Fraile E, Garcia-Alvarez A. Prevalence and costs of chronicity and multimorbidity in the population covered by the Basque public telecare service

Prevalencia de cronicidad y multimorbilidad en la poblacion cubierta por el servicio publico de teleasistencia de Euskadi: Impacto en costes y calidad de la atencion. Anales del sistema sanitario de Navarra. 2013;36(3):429-40.

Prazeres F, Santiago L. Prevalence of multimorbidity in the adult population attending primary care in Portugal: a cross-sectional study. BMJ open. 2015;5(9):e009287.

Nunes BP, Chiavegatto ADP, Pati S, Teixeira DSC, Flores TR, Camargo-Figuera FA, et al. Contextual and individual inequalities of multimorbidity in Brazilian adults: a cross-sectional national-based study. BMJ open. 2017;7(6).

Wang S, D'Arcy C, Yu Y, Li B, Liu Y, Tao Y, et al. Prevalence and patterns of multimorbidity in northeastern China: a cross-sectional study. Public health. 2015;129(11):1539-46.

Alaba O, Chola L. The social determinants of multimorbidity in South Africa. International Journal for Equity in Health. 2013;12(1):63.

Wang SB, D'Arcy C, Yu YQ, Li B, Liu YW, Tao YC, et al. Prevalence and patterns of multimorbidity in northeastern China: a cross-sectional study. Public health. 2015;129(11):1539-46.

Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA. Epidemiology and impact of multimorbidity in primary care: a retrospective cohort study. 2011:18.

Orueta JF, Nuno-Solinis R, Garcia-Alvarez A, Alonso-Moran E. Prevalence of multimorbidity according to the deprivation level among the elderly in the Basque Country. BMC Public Health. 2013;13:918.

Pati S, Agrawal S, Swain S, Lee JT, Vellakkal S, Hussain MA, et al. Non communicable disease multimorbidity and associated health care utilization and expenditures in India: cross-sectional study. BMC Health Serv Res. 2014;14:451.




DOI: http://dx.doi.org/10.46827/ejpe.v6i12.3656

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