Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands.
Department of Anthropology, University of Amsterdam, Amsterdam, the Netherlands.
J Glob Health. 2021 Apr 17;11:04029. doi: 10.7189/jogh.11.04029.
Disease clustering is a growing public health concern and is increasingly linked to adverse socioeconomic conditions. Few population-based studies have focussed on interaction between non-communicable diseases. In this cross-sectional study, we examine clustering of, and synergistic interactions between, frequently occurring non-communicable diseases in Katwijk, a former fishing village in the Netherlands. Additionally, our study identifies contextual variables associated with these clusters of non-communicable diseases.
In a survey among adults (>19 years) living in the former fishing village Katwijk, Netherlands, were asked about non-communicable diseases, psychological distress, self-rated health scores and contextual factors, eg, socio-demographic, psychosocial and health behavior characteristics. Interaction was measured on the additive and the multiplicative scale. We used generalized ordered logistic regression analysis to examine associations with contextual variables.
Three disease clusters were found to be most prevalent among the study participants (n = 1408). Each cluster involved a combination of frequently occurring conditions in this population: psychological distress (n = 261, 19%), cardiometabolic diseases (n = 449, 32%) and musculoskeletal pain (n = 462, 33%). These three diseases interact synergistically on the additive scale to increase the odds of reporting a low self-rated health. None of the disease clusters showed a statistically significant positive interaction on a multiplicative scale. Multiple contextual factors were associated with these disease clusters, including gender, loneliness, experiencing financial stress, and a BMI≥30.
Our findings imply that psychological distress, cardiometabolic diseases and musculoskeletal pain synergistically interact, leading to a much lower self-rated health than expected. Several contextual factors are related to this interaction emphasizing the importance of a multicomponent, ecological approach.
疾病聚集是一个日益严重的公共卫生问题，与不利的社会经济条件密切相关。很少有基于人群的研究关注非传染性疾病之间的相互作用。在这项横断面研究中，我们检查了荷兰前渔村卡特维克经常发生的非传染性疾病的聚集情况和协同作用。此外，我们的研究确定了与这些非传染性疾病群集相关的背景变量。
在对荷兰前渔村卡特维克的成年人（>19 岁）进行的一项调查中，询问了他们非传染性疾病、心理困扰、自我评估的健康评分和背景因素，例如社会人口统计学、心理社会和健康行为特征。在加性和乘法尺度上测量了相互作用。我们使用广义有序逻辑回归分析来研究与背景变量的关联。
在研究参与者中发现了三个最常见的疾病集群（n=1408）。每个集群都涉及该人群中经常发生的疾病的组合：心理困扰（n=261，19%）、心血管代谢疾病（n=449，32%）和肌肉骨骼疼痛（n=462，33%）。这些三种疾病在加性尺度上协同作用，增加了报告低自我评估健康的几率。在乘法尺度上，没有一种疾病集群显示出统计学上显著的正相互作用。多个背景因素与这些疾病集群相关，包括性别、孤独感、经济压力和 BMI≥30。
我们的研究结果表明，心理困扰、心血管代谢疾病和肌肉骨骼疼痛协同作用，导致自我评估的健康状况远低于预期。一些背景因素与这种相互作用有关，强调了多组分、生态方法的重要性。
