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Social determinants of multimorbidity patterns: A systematic review
Javier Álvarez-Gálvez1,2, Esther Ortega-Martín1, Jesús Carretero-Bravo1
1Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain.
Frontiers in Public Health
|April 13, 2023
Summary
Social determinants significantly influence multimorbidity patterns, with socioeconomic status and behaviors like smoking impacting risk. Further research is needed in understudied populations and low-income countries.
Area of Science:
- Public Health
- Epidemiology
- Social Medicine
Background:
- Social determinants of multimorbidity are not well understood in clinical settings.
- Multimorbidity patterns and their associated social/behavioral factors require characterization.
- Existing research often overlooks specific demographics and lower-income country contexts.
Approach:
- Systematic literature review across major scientific databases.
- Inclusion of 97 studies from over 48,000 identified articles.
- Analysis of multimorbidity patterns and their social and behavioral determinants.
Key Points:
- Cardiometabolic, musculoskeletal, mental, and respiratory patterns are most common.
- Low socioeconomic status is linked to cardiometabolic multimorbidity, particularly in men.
- Women show higher prevalence of musculoskeletal, mental, and complex multimorbidity patterns.
- Alcohol and smoking increase multimorbidity risk, especially in men.
- Mild, mental, and respiratory multimorbidity patterns are observed across socioeconomic statuses.
Conclusions:
- Further research is essential to understand multimorbidity in underrepresented groups (women, children, ethnic minorities, disabled, isolated elderly).
- Studies need more diverse samples beyond older adults and employ robust methodologies.
- Urgent need for research on social determinants and inequalities of multimorbidity in low- and middle-income countries.
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