Socioeconomic determinants of multimorbidity: a population-based household survey of Hong Kong Chinese

Chung, R. Y., Mercer, S., Lai, F. T.T., Yip, B. H.K., Wong, M. C.S. and Wong, S. Y.S. (2015) Socioeconomic determinants of multimorbidity: a population-based household survey of Hong Kong Chinese. PLoS ONE, 10(10), e0140040. (doi:10.1371/journal.pone.0140040) (PMID:26451589) (PMCID:PMC4599799)

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Abstract

Introduction Multimorbidity has been well researched in terms of consequences and healthcare implications. Nevertheless, its risk factors and determinants, especially in the Asian context, remain understudied. We tested the hypothesis of a negative relationship between socioeconomic status and multimorbidity, with contextually different patterns from those observed in the West.

Methods We conducted our study in the general Hong Kong (HK) population. Data on current health conditions, health behaviours, socio-demographic and socioeconomic characteristics was obtained from HK Government’s Thematic Household Survey. 25,780 individuals aged 15 or above were sampled. Binary logistic and negative binomial regression analyses were conducted to identify risk factors for presence of multimorbidity and number of chronic conditions, respectively. Sub-analysis of possible mediation effect through financial burden borne by private housing residents on multimorbidity was also conducted.

Results Unadjusted and adjusted models showed that being female, being 25 years or above, having an education level of primary schooling or below, having less than HK$15,000 monthly household income, being jobless or retired, and being past daily smoker were significant risk factors for the presence of multimorbidity and increased number of chronic diseases. Living in private housing was significantly associated with higher chance of multimorbidity and increased number of chronic diseases only after adjustments.

ConclusionsLess advantaged people tend to have higher risks of multimorbidity and utilize healthcare from the public sector with poorer primary healthcare experience. Moreover, middle-class people who are not eligible for government subsidized public housing may be of higher risk of multimorbidity due to psychosocial stress from paying for the severely unaffordable private housing.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mercer, Professor Stewart
Authors: Chung, R. Y., Mercer, S., Lai, F. T.T., Yip, B. H.K., Wong, M. C.S., and Wong, S. Y.S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:PLoS ONE
Publisher:Public Library of Science
ISSN:1932-6203
ISSN (Online):1932-6203
Copyright Holders:Copyright © 2015 2015 Chung et al.
First Published:First published in PLoS ONE 10(10):e0140040
Publisher Policy:Reproduced under a Creative Commons License

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