Multidimensional social exposure clusters and incident multimorbidity in a population-based cohort

Area of Science:

• Social Epidemiology
• Public Health
• Health Disparities Research

Background:

• Multimorbidity exhibits a pronounced social gradient, but the combined impact of social determinants on risk is unclear.
• Existing research often isolates individual determinants, potentially missing crucial socially patterned subgroups influencing multimorbidity.
• Understanding these complex social exposures is vital for addressing health inequities.

Purpose of the Study:

• To investigate the association between multidimensional social exposure profiles and multimorbidity risk.
• To identify distinct subgroups based on combined individual and area-level social determinants.
• To explore sex-specific differences in the relationship between social exposure and multimorbidity.

Main Methods:

• Utilized unsupervised clustering to derive six distinct social exposure profiles from a Canadian population-based cohort.
• Linked Canadian Community Health Survey data (2001-2011) with area-level Census data.
• Employed sex-stratified Weibull models to analyze incident multimorbidity risk associated with social exposure profiles.

Main Results:

• Multimorbidity onset varied significantly across the six identified social exposure profiles.
• Elevated multimorbidity risk was linked to multiple patterns of social disadvantage, deviating from a simple linear gradient.
• Disadvantage profiles were associated with earlier multimorbidity onset in both females (HR: 1.70) and males (HR: 1.59).

Conclusions:

• Multidimensional social exposure profiles effectively capture population-level social patterning related to differential multimorbidity risk.
• Findings highlight the need for upstream policy interventions to mitigate health inequities stemming from social determinants.
• Addressing complex social disadvantage is crucial for reducing the burden of multimorbidity.