Multimorbidity patterns and associated factors in a megacity: a cross-sectional study.

Area of Science:

• Epidemiology
• Public Health
• Health Services Research

Background:

• Multimorbidity, the co-existence of multiple chronic conditions, poses a significant challenge to healthcare systems globally.
• Understanding specific patterns of multimorbidity is crucial for targeted interventions and resource allocation, especially in large urban populations.

Purpose of the Study:

• To identify empirical patterns of multimorbidity in São Paulo, a megacity.
• To quantify the associations between these multimorbidity patterns and socioeconomic, behavioral characteristics, and health outcomes.

Main Methods:

• Cross-sectional study involving household interviews with 3,184 urban residents aged 20 years and older.
• Latent class analysis used to identify patterns in the co-existence of 22 health conditions.
• Age-adjusted prevalence ratios estimated using Poisson regression.

Main Results:

• Four distinct multimorbidity patterns were identified: low disease probability, cardiovascular conditions, respiratory conditions, and rheumatic, musculoskeletal, and emotional conditions.
• 58.6% of individuals belonged to the low disease probability group.
• Older individuals with lower schooling and household income exhibited higher multimorbidity prevalence in specific patterns.

Conclusions:

• Four clinically recognizable and theoretically plausible multimorbidity patterns exist in the São Paulo megacity population.
• Identifying trends between these patterns is essential for estimating the scope of challenges in organizing health care policies.
• Findings underscore the need for tailored public health strategies addressing socioeconomic disparities in multimorbidity.