An unequal burden: Trends in prevalence and distribution of multimorbidity in Canada

Abstract

Multimorbidity poses a major challenge to health care systems around the world. In this study, I estimated the trends in prevalence of multimorbidity in the Canadian adult population. Furthermore, I substantiated the findings of Roberts et al. (2015) by examining the socio-economic and health and behavioural risk factors associated with multimorbidity. I pooled the Canadian Community Health Survey cycles from 2007-2013 to obtain a sample size of 451, 734 Canadian adults. Multimorbidity was defined as two or more and three or more chronic diseases from a list of eight. I conducted logistic regression analysis to determine the overall and stratified by age groups time trends in prevalence of multimorbidity as well as determinants of multimorbidity. Prevalence of two or more chronic diseases increased from 11.8% to 12.6% and three or more chronic diseases increased from 3.6% to 3.9% from 2007 to 2013 and this increase in prevalence of multimorbidity was largely due an ageing population. In the overall population, female sex, older age, low household income, being Canadian-born in comparison to being an immigrant, high blood pressure, high stress, obesity, smoking and physical inactivity were associated with multimorbidity. With a rise in proportion of Canadians aged 65 years and older, the prevalence of multimorbidity is also expected to rise. This rising burden of multimorbidity will require health authorities to scale-up the successful integrated care pilots to improve the management of patients with multimorbidity. Since Canadians living in the lowest socio-economic group are more likely to develop multimorbidity, preventative measures such as social assistance programs will need continuous improvements to address the root causes of poor health outcomes.