Lam Anastasia, Keenan Katherine, Myrskylä Mikko, Kulu Hill
University of St Andrews.
Max Planck Institute for Demographic Research.
Popul Stud (Camb). 2025 Mar;79(1):1-26. doi: 10.1080/00324728.2024.2331447. Epub 2024 May 16.
Multimorbidity is increasing globally as populations age. However, it is unclear how long individuals live with multimorbidity and how it varies by social and economic factors. We investigate this in South Africa, whose apartheid history further complicates race, socio-economic, and sex inequalities. We introduce the term 'multimorbid life expectancy' (MMLE) to describe the years lived with multimorbidity. Using data from the South African National Income Dynamics Study (2008-17) and incidence-based multistate Markov modelling, we find that females experience higher MMLE than males (17.3 vs 9.8 years), and this disparity is consistent across all race and education groups. MMLE is highest among Asian/Indian people and the post-secondary educated relative to other groups and lowest among African people. These findings suggest there are associations between structural inequalities and MMLE, highlighting the need for health-system and educational policies to be implemented in a way proportional to each group's level of need.
随着全球人口老龄化，多重疾病状况日益增加。然而，目前尚不清楚个体患有多重疾病的时长以及其如何因社会和经济因素而有所不同。我们在南非对此展开研究，该国的种族隔离历史使种族、社会经济和性别不平等问题更加复杂。我们引入“多重疾病预期寿命”（MMLE）这一术语来描述患有多重疾病的时长。利用南非国民收入动态研究（2008 - 2017年）的数据以及基于发病率的多状态马尔可夫模型，我们发现女性的多重疾病预期寿命高于男性（分别为17.3年和9.8年），并且这种差异在所有种族和教育群体中都是一致的。相对于其他群体，亚洲/印度人群体和受过高等教育的人群的多重疾病预期寿命最高，而非洲人群体的则最低。这些发现表明结构性不平等与多重疾病预期寿命之间存在关联，凸显了卫生系统和教育政策需要根据每个群体的需求程度以相应比例实施的必要性。
