Intersecting gender, racial, and socioeconomic inequalities in multimorbid life expectancy in South Africa: a multistate modelling approach

Anastasia Lam, University of St Andrews
Katherine Keenan, University of St Andrews
Mikko Myrskyla, Max Planck Institute for Demographic Research
Hill Kulu, University of St Andrews

The burden of multimorbidity is expected to increase globally, particularly with ageing populations. The effect of multimorbidity on life expectancy is less clear, as is how it varies by gender, race, and socioeconomic factors, particularly in a middle-income country like South Africa. South Africa’s apartheid history adds further complexity to the roles of gender, race, and socioeconomic inequalities in society. This underlines the importance of taking an intersectional perspective when trying to understand the interplay of these factors and how they influence health and mortality. We estimated life expectancy and the time spent living with multimorbidity from age 20 using a discrete-time multistate modelling approach. Women had higher average life expectancy than men (51.0 years vs 48.3 years) but spent more time with multimorbidity. Africans and the lowest educated had the lowest average life expectancy, and Asians/Whites and the most educated had the highest. African men with some secondary school education or less lost more years of life as they accumulated disease compared to any other group. By quantifying the impact of gender, race, and socioeconomic inequalities on time spent with multimorbidity and total life expectancy, our findings highlight the need for interventions and policies to account for these disparities.

Keywords: Longitudinal studies, Panel studies, Mortality, Population ageing

See extended abstract.

  Presented in Session 181. Trajectories in Multimorbidity