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Social inequalities in multimorbidity trajectories in Scotland: longitudinal study using linked census-linked administrative data from middle-aged and older adults

Katherine Keenan, University of St Andrews
Genevieve Cezard, University of St Andrews

Multimorbidity – the co-occurrence of at least two chronic diseases - is an important public health challenge in ageing societies, but most evidence is cross-sectional, and social disparities are poorly understood. We address this gap by investigating 18-year multimorbidity trajectories of adults aged 40-69, and disparities in accumulation by education, area deprivation, housing type, marital status and living arrangement. We use an extract of the Scottish Longitudinal Study including 2001 census data, further linked to hospitalization and disease registries for a 5.3% sample of the Scottish population. We selected a cohort of 97,019 individuals aged 40-69 at 2001 and observed them for 18 years, or until their emigration or death. The outcome was a multimorbidity score based on ICD10 codes, and we used growth curve modelling to estimate accumulation by age, cohort and gender, and the socio-demographic, economic and housing indicators above. Multimorbidity severity rises steeply with age, and is higher in men, especially at older ages. There was evidence for earlier multimorbidity onset in younger cohorts. In adjusted models, multimorbidity levels are higher, and trajectories are steeper, for those in lower educational groups, living in more deprived areas, the unmarried and those who lived in social housing.

Keywords: Health and morbidity, Population ageing, Multi-level modeling, Inequality

See extended abstract.

  Presented in Session 181. Trajectories in Multimorbidity