Surveillance and Epidemiology Division, Centre for Chronic Disease Prevention, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, Ontario, Canada.
Health Promot Chronic Dis Prev Can. 2015 Aug;35(6):87-94. doi: 10.24095/hpcdp.35.6.01.
INTRODUCTION: Multimorbidity is increasingly recognized as a key issue in the prevention and management of chronic diseases. We examined the prevalence and correlates of chronic disease multimorbidity in the general adult Canadian population in relation to age and other key determinants. METHODS: We extracted data from the Canadian Community Health Survey 2011/12 on 105 416 Canadian adults. We analysed the data according to the number of multimorbidities (defined as 2+ or 3+ diseases from a list of 9) and examined the determinants of multimorbidity using regression analyses. RESULTS: Our findings show that 12.9% of Canadians report 2+ chronic diseases and 3.9% report 3+ chronic diseases. Those reporting 3 or more chronic diseases were more likely to be female, older, living in the lowest income quintile and to have not completed high school. In the overall population, social deprivation is associated with a 3.7 odds of multimorbidity, but when examined across age groups, the odds of multimorbidity were notably higher in middle age, 7.5 for those aged 35 to 49 years and 5.4 for those aged 50 to 64 years. DISCUSSION: As the proportion of Canadians living with multiple chronic diseases increases, we need to assess chronic disease from a holistic perspective that captures multimorbidity and upstream factors, to facilitate broader and more context-appropriate associations with healthy living, quality of life, health care costs and mortality. Special consideration should be given to the role that social deprivation plays in the development of multimorbidity. Canadians living in the lowest socioeconomic group are not only more likely to develop multimorbidity, but the onset of multimorbidity is also likely to be significantly earlier.
简介: 多种慢性疾病日益成为慢性病预防和管理的一个关键问题。我们研究了加拿大普通成年人群中与年龄和其他关键决定因素相关的慢性疾病多种合并症的流行情况及其相关因素。
方法: 我们从 2011/12 年加拿大社区健康调查中提取了 105416 名加拿大成年人的数据。我们根据多种合并症的数量(从 9 种疾病列表中定义为 2 种或 3 种以上疾病)对数据进行分析,并使用回归分析研究多种合并症的决定因素。
结果: 我们的研究结果表明,12.9%的加拿大人报告有 2 种以上慢性疾病,3.9%报告有 3 种以上慢性疾病。报告有 3 种或更多种慢性疾病的人更有可能是女性、年龄较大、生活在收入最低的五分之一群体中,并且没有完成高中学业。在总体人群中,社会贫困与多种合并症的发病风险相关,其比值比为 3.7,但在按年龄组进行检查时,中年人群的多种合并症发病风险明显更高,35 至 49 岁人群为 7.5,50 至 64 岁人群为 5.4。
讨论: 随着患有多种慢性疾病的加拿大人比例增加,我们需要从整体角度评估慢性疾病,这种整体角度需要捕捉多种合并症和上游因素,以促进更广泛和更适合背景的健康生活、生活质量、医疗保健费用和死亡率的关联。应特别关注社会贫困在多种合并症发展中的作用。生活在社会经济地位最低群体的加拿大人不仅更有可能患上多种合并症,而且多种合并症的发病时间也可能明显更早。
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