Key result
High socio-economic deprivation was associated with shorter healthy life expectancy at age 65 compared to low deprivation, with a 2-year gap for men (5.4 vs 7.7 years) and a 3-year gap for women.
Why the study?
Age of onset and prevalence of multimorbidity are well documented, but its contribution to inequalities in life expectancy has not yet been quantified.
Cohort (n=1,100,000)
Yes
Socio-economic deprivation is associated with earlier onset of multimorbidity and shorter healthy life expectancy in older adults, which is only partially explained by smoking.
Answers are grounded in this paper and cite their sources.
Socioeconomic gaps in multimorbidity onset and survival widen life expectancy disparities; leaves open whether targeting multimorbidity narrows them.
BACKGROUND: Age of onset of multimorbidity and its prevalence are well documented. However, its contribution to inequalities in life expectancy has yet to be quantified. METHODS: A cohort of 1.1 million English people aged 45 and older were followed up from 2001 to 2010. Multimorbidity was defined as having 2 or more of 30 major chronic diseases. Multi-state models were used to estimate years spent healthy and with multimorbidity, stratified by sex, smoking status and quintiles of small-area deprivation. RESULTS: Unequal rates of multimorbidity onset and subsequent survival contributed to higher life expectancy at age 65 for the least (Q1) compared with most (Q5) deprived: there was a 2-year gap in healthy life expectancy for men [Q1: 7.7 years (95% confidence interval: 6.4-8.5) vs Q5: 5.4 (4.4-6.0)] and a 3-year gap for women [Q1: 8.6 (7.5-9.4) vs Q5: 5.9 (4.8-6.4)]; a 1-year gap in life expectancy with multimorbidity for men [Q1: 10.4 (9.9-11.2) vs Q5: 9.1 (8.7-9.6)] but none for women [Q1: 11.6 (11.1-12.4) vs Q5: 11.5 (11.1-12.2)]. Inequalities were attenuated but not fully attributable to socio-economic differences in smoking prevalence: multimorbidity onset was latest for never smokers and subsequent survival was longer for never and ex smokers. CONCLUSIONS: The association between social disadvantage and multimorbidity is complex. By quantifying socio-demographic and smoking-related contributions to multimorbidity onset and subsequent survival, we provide evidence for more equitable allocation of prevention and health-care resources to meet local needs.
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Chan et al. (2019) conducted a cohort in Multimorbidity (n=1,100,000). High socio-economic deprivation (Quintile 5) vs. Low socio-economic deprivation (Quintile 1) was evaluated on Healthy life expectancy at age 65 for men (years). High socio-economic deprivation was associated with shorter healthy life expectancy at age 65 compared to low deprivation, with a 2-year gap for men (5.4 vs 7.7 years) and a 3-year gap for women.
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