Changes in prevalence and patterns of non-communicable disease multimorbidity across socioeconomic spectra in rural Southwest China.

BACKGROUND: Globally, the burden of non-communicable diseases (NCDs) and multimorbidity continues to grow. This study aimed to uncover the changes in the prevalence and patterns of multimorbidity involving eight common NCDs across socioeconomic gradients in rural Southwest China. METHODS: Data were collected through two waves of community-based, cross-sectional health interviews and physical examinations among individuals aged ≥ 35 years in rural Southwest China. Individual socioeconomic position (SEP) was constructed using principal component analysis. Association rule mining was employed to identify the NCD multimorbidity patterns of eight chronic conditions. Anthropometric measurements, blood pressure, fasting blood glucose, and post-bronchodilator spirometry were recorded for all participants. The survey's response rates of 98.9% in 2014 and 98.2% in 2024. RESULTS: From 2014 to 2024, the age-standardized prevalence of hypertension (35.6% vs. 52.4%), diabetes (8.9% vs. 10.4%), dyslipidemia (4.4% vs. 6.8%), obesity (7.3% vs. 11.7%), CHD (3.0% vs. 5.0%), stroke (2.3% vs. 3.3%), chronic obstructive pulmonary disease (3.4% vs. 4.2%), and multimorbidity of eight NCDs (14.5% vs. 22.8%) increased significantly (P < 0.01). This increasing rate was also observed across all subgroups by sex, age, level of education, level of income, access to medical services, and SEP (P < 0.05). In both 2014 and 2024, all NCD multimorbidity patterns involved hypertension. The most prevalent NCDs combination was hypertension + obesity in 2014 and hypertension + diabetes in 2024. Over this decade, the number of identified NCDs multimorbidity patterns increased across SEP subgroups, with the most pronounced increase observed in those with high SEP. CONCLUSIONS: The prevalence of NCDs multimorbidity rose substantially across socioeconomic gradients from 2014 to 2024, and significant socioeconomic disparities were observed in temporal trends of NCDs multimorbidity patterns in rural Southwest China. Future interventions to improve prevention and management of NCDs multimorbidity must be tailored to account for socioeconomic factors.