Occurrence and inequalities by education in multimorbidity in Brazilian adults between 2013 and 2019: evidence from the National Health Survey
Keywords:Multimorbidity, Chronic Disease, Health Status Disparities, Adult, Cross- Sectional Studies
Objective The objectives of this study were: 1) to estimate the prevalence of multimorbidity in 2013 and 2019 in adults aged 20 to 59 years; 2) assess inequalities in the prevalence of multimorbidity in 2013 and 2019 according to educational level. Methods We used data from two cross-sectional surveys from the Brazilian National Health Survey (PNS) in 2013 and 2019. Multimorbidity was assessed from 14 lifetime self-reported morbidities (except back problems) and defined using the cutoff point of ≥ 2 diseases. The prevalence of multimorbidity and individual morbidities were described according to sex, age, skin color, and education. For education, crude, and relative inequalities in prevalence of multimorbidity were calculated using the Slope Index of Inequality (SII) and the Concentration Index (CIX), respectively. Results The prevalence of multimorbidity increased from 18.7% (95%: CI 18.0-19.3) in 2013 to 22.3% (95%: CI 21.7-22.9) in 2019, being higher among women and adults between 30-59 years. Asthma/bronchitis, depression, and back problems were the conditions that increased the most in the study period. Absolute and relative inequalities by education status were observed in the study period, with worse multimorbidity profiles among the less educated. Conclusion The prevalence of multimorbidity increased between 2013 and 2019. Inequalities in the prevalence of multimorbidity were observed according to educational level.
Copyright (c) 2021 Felipe Mendes Delpino, Andrea Wendt, Pedro Augusto Crespo, Cauane Blumenberg, Doralice Severo da Cruz Teixeira, Sandro Rodrigues Batista, Deborah Carvalho Malta, J. Jaime Miranda, Thaynã Ramos Flores, Bruno Pereira Nunes, Fernando C Wehrmeister
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