1 / 13

The Global Burden of Multimorbidity

The Global Burden of Multimorbidity. Presented by Sara Afshar, PhD Student for the Population Health Conference “ Tackling Population Health Challenges ” Joint Supervision - Faculty of Medicine & Faculty of Social Sciences

elaine
Download Presentation

The Global Burden of Multimorbidity

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Global Burden of Multimorbidity Presented by Sara Afshar, PhD Student for the Population Health Conference “Tackling Population Health Challenges” Joint Supervision - Faculty of Medicine & Faculty of Social Sciences Supervisors: Prof. Paul Roderick, Prof. Allan Hill & Dr. Borislav Dimitrov

  2. Background • Due to demographic and epidemiological transition, there is a greater disease burden from NCDs, paralleled by a rapidly ageing population globally • Although there is no consensus, multimorbidity commonly defined as presence of ≥ 2 chronic diseases within an individual • Multimorbidity is a consequence of human ageing and NCD burden, although relatively understudied, particularly in LMICs • Global morbidity studies largely single-disease focused

  3. In HIC, multimorbidity is: • associated with lower SES (Barnett et al, 2012), • assocated with increased health service utilisation and health expenditure; poorer health outcomes and quality of life; reduced functional capacity; and decreased survival • described as the ‘norm rather than the exception’ – majority of patients attending primary care >65 have MM

  4. Prevalence of Multimorbidity by age and socioeconomic statusSource: Barnett et al. Lancet (2012)

  5. Aims To compare the prevalence of multimorbidity across LMIC and HIC, and by age and SES (defined by education) • Examining inter and intra country differences, • how does multimorbidity prevalence vary across income group and within countries , respectively using GDP per capita and SES (education)? • how does multimorbidity prevalence vary across age groups?

  6. Methods • Data taken from the World Health Surveys (WHS) and Wave 1 of English Longitudinal Survey of Aging (ELSA) • WHS: a cross-sectional national survey, uses multi-stage clustering design to produce nationally representative samples; ages >18 years, 2003 • ELSA: a longitudinal survey of 11,500 people in England >50 years, multistage clustering design. Wave 1, 2003. • Multimorbidity defined as the presence of 2 or more of following doctor diagnosed conditions (n=6): arthritis, angina, asthma, diabetes, depression and schizophrenia

  7. Methods • Countries selected to represent all regions of the world with specific focus on middle-income countries • Countries excluded if RR to chronic disease questions <90% • Survey weights and post-stratification corrections applied to produce nationally representative samples • Age adjusted prevalence directly standardised to WHO Standard Population • Individual countries weighted by survey size to produce regional estimates for MM by SES (education)

  8. Multimorbidity/ % GDP, per capita Figure 1 : World Standardised Multimorbidity Prevalence by GDP across World Health Survey Countries (n=28) in 2003; with confidence intervals Notes:a) GDP are based on those provided by United Nations Statistical Division for 2003 estimates b) National Estimates have been adjusted to the WHO Standard Population Distribution (2000-2025) c) Human Development grouping based on Human Development Report estimates for 2003

  9. Results Figure 2: Age specific multimorbidity prevalence across World Health Survey Countries (n=28) in 2003 and the English Longitudinal Survey of Ageing (ELSA)

  10. Figure 3: Regionalmultimorbidity by socioeconomic status (education) Prevalence ratios for ≥ 55 years Prevalence ratios for < 55 years Notes:a) Lightest shade represents first category (secondary education achieved); darkest shade represents final category (less than primary school education achieved) b) Multimorbidity Prevalence ratios based on prevalence of multimorbidity in second category set at 1.

  11. Discussion • Implications for future is that LMIC is transitioning towards a HIC pattern; as younger generations age, there will be a higher burden in elderly population Limitations • Limited set of conditions in WHS; evidence from ELSA shows that increasing the number of conditions increases MM prevalence • Low response rate in low income countries means not represented • Doctor diagnosed conditions may be correlated to greater health access, although lower prevalence in Spain and England suggest more complex story

  12. Conclusion • Multimorbidity a global phenomenon and not just affecting older adults in HIC • Evidence of a MM transition in LMIC with increased multimorbidity prevalence, particularly for young adults in LMIC: suggests a change in lifestyle and accumulation of risk for NCDS • Implications for health care provision, planning, policy and public health intervention.

  13. Thank you. Any questions?

More Related