National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
BMJ Open. 2022 Feb 23;12(2):e053274. doi: 10.1136/bmjopen-2021-053274.
To assess the effects of individual educational level in adulthood and parental educational level during childhood, as well as combinations of individual and parental educational levels, on multimorbidity classes.
In this longitudinal study, we used data from a random sample of the Danish population aged 32-56 years without multimorbidity in 2010 (n=102 818). The study population was followed until 2018. Information on individual and parental educational levels and chronic conditions was obtained from national registers. Multinomial logistic regression analyses were adjusted for sex, age and ethnicity.
Seven multimorbidity classes were identified using latent class analysis based on 47 chronic conditions. Persons deceased during follow-up comprised a separate class.
We found an independent effect of individual educational level on five multimorbidity groups and death, most pronounced for the multimorbidity group 'Many conditions' (OR=1.89, 95% CI 1.58 to 2.26 for medium and OR=3.22, 95% CI 2.68 to 3.87 for short compared with long educational level) and of parental education on four groups and death, most pronounced for the multimorbidity group 'Many conditions' (OR=1.36, 95% CI 1.07 to 1.73 for medium and OR=1.48, 95% CI 1.15 to 1.89 for short compared with long educational level). Odds of belonging to four multimorbidity classes increased with lower combination of individual and parental educational levels, most pronounced for the multimorbidity group 'Many conditions'.
As both individual and parental educational levels contribute to the risk of multimorbidity, it is important to address inequality throughout the life course to mitigate multimorbidity. Future studies could adopt a life course approach to investigate the mediating role of behavioural, clinical, environmental and other social factors.
评估成人个体受教育程度和儿童时期父母受教育程度，以及个体和父母受教育程度组合对多种疾病类别（multimorbidity classes）的影响。
在这项纵向研究中，我们使用了丹麦随机抽样的无多种疾病（multimorbidity）人群的 2010 年数据，年龄在 32-56 岁之间（n=102818）。研究人群随访至 2018 年。个体和父母的教育水平以及慢性疾病的信息来自国家登记处。采用多分类逻辑回归分析调整了性别、年龄和种族因素。
我们使用基于 47 种慢性疾病的潜在类别分析确定了七种多种疾病类别。在随访期间死亡的人构成了一个单独的类别。
个体和父母的受教育程度都与多种疾病的风险有关，因此，在整个生命周期中解决不平等问题对于减轻多种疾病的发生非常重要。未来的研究可以采用生命历程的方法来研究行为、临床、环境和其他社会因素的中介作用。
