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Research

The influence of socioeconomic deprivation on multimorbidity at different ages: a cross-sectional study

Gary McLean, Jane Gunn, Sally Wyke, Bruce Guthrie, Graham CM Watt, David N Blane and Stewart W Mercer
British Journal of General Practice 2014; 64 (624): e440-e447. DOI: https://doi.org/10.3399/bjgp14X680545
Gary McLean
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
PhD
Roles: Research associate
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Jane Gunn
Primary Care Research Unit, University of Melbourne, Melbourne, Australia.
FRACGP DRANZCOG, PhD
Roles: Chair of primary care research, head of general practice and primary health care academic centre
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Sally Wyke
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
PhD, FRCGP (Hon)
Roles: Professor of health and wellbeing
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Bruce Guthrie
Quality, Safety and Informatics Research Group, University of Dundee, Dundee, UK.
MB, BChir, PhD
Roles: Professor of primary care medicine
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Graham CM Watt
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
MD, FRCGP
Roles: Norie Miller professor of general practice
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David N Blane
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
MBChB, MPH
Roles: Academic clinical fellow
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Stewart W Mercer
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
PhD, FRCGP
Roles: Professor of primary care research
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Article Figures & Data

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    Figure 1

    Number and type of chronic condition for overall population by number of patients (least and most deprived deciles).

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    Figure 2

    Prevalence of most common conditions in multimorbid patients, by age and deprivation. CKD = chronic kidney disease. CHD = coronary heart disease

Tables

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    Table 1

    Prevalence of chronic morbidity

    Age group, yearsAdult population (n = 1 272 685) n (%, 95% CI)No conditions (n = 597 363) n (%, 95% CI)One condition (n = 279 015) n (%, 95% CI)Two or more conditions (n = 396 307) n (%, 95% CI)
    25–34229 396 (18.0)169 747 (74.0)40 962 (17.9)18 687 (8.1)
    (17.9 to 18.1)(73.8 to 74.0)(17.7 to 18.0)(8.0 to 8.2)
    35–44278 993 (21.9)179 338 (64.3)60 771 (21.8)38 884 (13.9)
    (21.8 to 22.0)(64.2 to 64.4)(21.7 to 21.9)(13.8 to 14.0)
    45–54253 794 (19.9)131 920 (52.0)63 453 (25.0)58 421 (23.0)
    (19.8 to 20.0)(51.0 to 52.1)(24.9 to 25.1)(22.8 to 23.2)
    55–64219 333 (17.2)75 843 (34.6)58 171 (26.5)85 319 (38.9)
    (17.1 to 17.3)(34.5 to 34.7)(26.3 to 26.7)(38.7 to 39.1)
    65–74155 280 (12.2)28 662 (18.5)35 068 (22.6)91 550 (59.0)
    (12.1 to 12.3)(18.3 to 18.7)(22.4 to 22.8)(58.7 to 59.2)
    ≥75135 889 (10.7)11 853 (8.7)20 590 (15.2)103 446 (76.1)
    (10.6 to 10.8)(8.5 to 8.9)(15.0 to 15.3)(75.9 to 76.3)
    • Analysis based on 40 chronic conditions: 32 physical and eight mental. Percentages in ‘adult population’ column relate to distribution of age groups within the sample, whereas percentages in the conditions columns relate to distribution within each separate age group.

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    Table 2

    Type of multimorbidity for people with any multimorbidity

    Age groupPhysical-only multimorbidity n (%, 95% CI)Mental-only multimorbidity n (%, 95% CI)Mixed physical and mental multimorbidity n (%, 95% CI)
    25–34 (n = 18 687)5110 (27.3)4019 (21.5)9558 (51.1)
    (26.7 to 28.0)(20.9 to 22.1)(50.4 to 51.9)
    35–44 (n = 38 884)13 240 (34.0)4987 (12.8)20 657 (53.1)
    (33.5 to 34.5)(12.4 to 13.2)(52.6 to 53.6)
    45–54 (n = 58 421)26 642 (45.6)3138 (5.4)28 641 (49.0)
    (45.1 to 46.0)(5.1 to 5.5)(48.6 to 49.4)
    55–64 (n = 85 319)49 771 (58.3)1626 (1.9)33 922 (39.8)
    (58.0 to 58.6)(1.8 to 2.0)(39.4 to 40.1)
    65–74 (n = 91 550)62 536 (68.3)665 (0.7)28 349 (31.0)
    (68.0 to 68.6)(0.6 to 0.8)(30.7 to 31.3)
    ≥75 (n = 103 446)65 912 (63.7)586 (0.6)36 948 (35.7)
    (63.4 to 67.0)(0.5 to 0.7)(35.4 to 36.0)
    Total223 211 (56.3)15 021 (3.8)158 075 (39.9)
    (56.1 to 56.4)(3.7 to 3.9)(39.7 to 40.0)
    • Analysis based on 40 chronic conditions: 32 physical and eight mental. Percentages are the % in each age group.

    • View popup
    Table 3

    Differences between types of multimorbidity by age group and deprivation

    Age group, yearsPhysical-only multimorbidity n (%, 95% CI)Mental-only multimorbidity n (%, 95% CI)Mixed physical and mental multimorbidity n (%, 95% CI)
    Most deprivedLeast deprivedMost deprivedLeast deprivedMost deprivedLeast deprived
    25–34447 (1.9)340 (1.9)613 (2.6)159 (0.9)1289 (5.4)465 (2.7)
    (1.7 to 2.1)(1.7 to 2.1)(2.4 to 2.8)(0.7 to 1.1)(5.1 to 5.6)(2.4 to 2.9)
    35–441061 (4.3)1040 (4.1)815 (3.3)231 (0.9)2844 (11.5)1006 (3.9)
    (4.1 to 4.5)(3.8 to 4.3)(3.0 to 3.5)(0.7 to 1.1)(11.1 to 11.9)(3.7 to 4.1)
    45–542087 (10.3)2279 (8.9)440 (2.2)184 (0.7)3795 (18.8)1567 (6.1)
    (10.0 to 10.7)(8.5 to 9.2)(2.0 to 2.4)(6.2 to 8.3)(18.2 to 19.3)(5.8 to 6.4)
    55–643301 (22.9)4556 (20.4)147 (1.0)123 (0.6)3705 (25.7)2156 (9.7)
    (22.1 to 23.8)(19.9 to 20.9)(0.8 to 1.2)(4.5 to 6.5)(24.9 to 26.4)(9.2 to 10.0)
    65–744423 (39.1)5316 (37.9)50 (0.4)65 (0.5)3128 (27.6)1902 (13.6)
    (38.2 to 39.9)(37.1 to 38.7)(0.2 to 0.4)(0.3 to 0.5)(26.8 to 28.4)(13.0 to 14.1)
    ≥754177(46.1)6200 (48.1)37 (0.4)52 (0.4)2887 (31.8)3488 (27.0)
    (45.0 to 47.1)(47.2 to 48.9)(0.2 to 0.5)(0.3 to 0.5)(30.8 to 32.8)(26.2 to 27.8)
    • Analysis based on 40 chronic conditions: 32 physical and eight mental. Percentages are the % in each age group/deprivation group (n = 103 695 most deprived, 117 708 least deprived).

    • View popup
    Table 4

    Age differences between the top 10 most prevalent conditions in multimorbid patients

    Rank order of conditionsAge 25–34 % (95% CI) n = 18 687Age 35–44 % (95% CI) n = 38 884Age 45–54 % (95% CI) n = 58 421Age 55–64 % (95% CI) n = 85 319Age 65–74 % (95% CI) n = 91 550Age ≥75 % (95% CI) n = 103 446
    1Depression
    46.1 (45.3 to 46.8)
    Depression
    46.9 (46.4 to 47.4)
    Depression
    38.8 (38.4 to 39.2)
    Hypertension
    48.5 (49.2 to 48.9)
    Hypertension
    58.3 (58.0 to 58.6)
    Hypertension
    61.9 (61.5 to 62.3)
    2Drug misuse
    25.9 (25.2 to 26.5)
    Pain
    26.4 (25.9 to 26.8)
    Hypertension
    30.9 (30.4 to 31.2)
    Pain
    31.3 (31.0 to 31.6)
    Pain
    30.0 (29.7 to 30.3)
    CHD
    31.2 (30.9 to 31.5)
    3Asthma
    23.1 (22.4 to 23.7)
    Asthma
    19.0 (18.6 to 19.4)
    Pain
    29.6 (29.2 to 30.0)
    Depression
    28.0 (27.8 to 28.3)
    CHD
    26.1 (25.8 to 26.4)
    Pain
    23.6 (23.3 to 23.8)
    4Anxiety
    19.8 (19.3 to 20.4)
    Anxiety
    17.8 (17.4 to 18.1)
    Dyspepsia
    18.4 (18.1 to 18.7)
    Diabetes
    17.7 (17.4 to 18.0)
    Diabetes
    21.1 (20.8 to 21.4)
    CKD
    18.5 (18.2 to 18.7)
    5Pain
    19.1 (18.6 to 19.7)
    Dyspepsia
    16.5 (16.1 to 16.8)
    Asthma
    14.2 (13.9 to 14.4)
    Dyspepsia 17.2 (16.9 to 17.4)Depression
    18.5 (18.3 to 18.8)
    Depression
    17.2 (17.0 to 17.4)
    6Alcohol dependence
    14.5 (14.0 to 15.0)
    IBS
    15.2 (14.8 to 15.5)
    Diabetes
    13.6 (13.4 to 13.9)
    CHD
    15.9 (15.6 to 16.1)
    Dyspepsia
    15.9 (15.7 to 16.2)
    Diabetes
    17.2 (17.0 to 17.5)
    7IBS
    14.4 (13.9 to 14.9)
    Drug misuse
    14.8 (14.4 to 15.1)
    Anxiety
    13.6 (13.3 to 13.9)
    Thyroid
    13.9 (13.7 to 14.2)
    COPD
    14.6 (14.4 to 14.8)
    Constipation
    17.0 (16.7 to 17.2)
    8Dyspepsia
    10.4 (10.0 to 10.8)
    Hypertension
    13.7 (13.3 to 14.0)
    IBS
    13.5 (13.3 to 13.8)
    IPA
    13.3 (13.1 to 13.7)
    Thyroid
    14.5 (14.3 to 14.8)
    Stroke
    16.6 (16.4 to 16.8)
    9Thyroid
    7.5 (7.1 to 7.8)
    Alcohol dependence
    13.3 (13.0 to 13.6)
    Thyroid
    13.1 (12.8 to 13.4)
    COPD
    11.1 (10.8 to 11.3)
    IPA
    13.7 (13.5 to 13.9)
    Thyroid
    15.9 (15.7 to 16.1)
    10Hearing loss
    6.9 (6.6 to 7.3)
    Thyroid
    10.9 (10.6 to 11.2)
    Alcohol dependence
    12.3 (12.0 to 12.6)
    Anxiety
    10.8 (10.6 to 11.0)
    Stroke
    10.5 (10.3 to 10.7)
    Hearing loss
    15.5 (15.3 to 15.7)
    • CKD = chronic kidney disease. CHD = coronary heart disease. COPD = chronic obstructive pulmonary disease. IBS = irritable bowel syndrome. IPA = Inflammatory poly-arthropathy and includes rheumatoid arthritis and related conditions, systemic connective tissue disorders, and gout. Drug misuse includes prescription drug misuse of varying degrees.

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British Journal of General Practice: 64 (624)
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July 2014
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The influence of socioeconomic deprivation on multimorbidity at different ages: a cross-sectional study
Gary McLean, Jane Gunn, Sally Wyke, Bruce Guthrie, Graham CM Watt, David N Blane, Stewart W Mercer
British Journal of General Practice 2014; 64 (624): e440-e447. DOI: 10.3399/bjgp14X680545

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The influence of socioeconomic deprivation on multimorbidity at different ages: a cross-sectional study
Gary McLean, Jane Gunn, Sally Wyke, Bruce Guthrie, Graham CM Watt, David N Blane, Stewart W Mercer
British Journal of General Practice 2014; 64 (624): e440-e447. DOI: 10.3399/bjgp14X680545
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Keywords

  • chronic disease
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