Srinivasa Vittal Katikireddi|Kathryn Skivington|Alastair H. Leyland|Kate Hunt|Stewart W Mercer
The contribution of risk factors to socioeconomic inequalities in multimorbidity across the lifecourse: a longitudinal analysis of the Twenty-07 cohort
MRC/CSO Social and Public Health Sciences Unit|University of Glasgow|MRC/CSO Social and Public Health Sciences Unit|University of Glasgow|MRC/CSO Social and Public Health Sciences Unit|University of Glasgow|MRC/CSO Social and Public Health Sciences Unit|University of Glasgow|University of Glasgow
multimorbidity major challenge health systems globally disproportionately affects socioeconomically disadvantaged populations examined socioeconomic inequalities developing multimorbidity across lifecourse investigated contribution five behaviourrelated risk factorsthe twenty07 study recruited participants aged approximately 15 35 55 years 1987 followed 20 years primary outcome development multimorbidity 2 health conditions relationship five different risk factors smoking alcohol consumption diet body mass index bmi physical activity development multimorbidity assessed social patterning development multimorbidity based two measures socioeconomic status areabased deprivation household income determined followed investigation potential mediation five risk factors multilevel logistic regression models predictive margins used statistical analyses socioeconomic inequalities multimorbidity quantified using relative indices inequality attenuation assessed addition risk factorsmultimorbidity prevalence increased markedly cohorts 20 years socioeconomic disadvantage associated increased risk developing multimorbidity vs least deprived areas odds ratio 146 95 confidence interval ci 126168 risk least great assessed income 153 95 ci 125187 defining multimorbidity 3 conditions smoking current vs never 156 136178 diet fruitvegetable consumption previous week vs consumption every day 157 95 ci 133184 bmi morbidly obese vs healthy weight 188 95 ci 142249 strong independent predictors developing multimorbidity doseresponse relationship observed number risk factors subsequent multimorbidity 3 risk factors vs none 191 95 ci 157233 however five risk factors combined explained 408 socioeconomic inequalities multimorbidity developmentpreventive measures addressing known risk factors particularly obesity smoking could reduce future multimorbidity burden however major socioeconomic inequalities development multimorbidity exist even taking account known risk factors tackling social determinants health including holistic health social care necessary rising burden multimorbidity disadvantaged populations redressed