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Household and area-level social determinants of multimorbidity: a systematic review
BACKGROUND: No clear synthesis of evidence examining household and area-level social determinants of multimorbidity exists. This study aimed to systematically review the existing literature on associations between household and area-level social determinants of health (SDoH) and multimorbidity preva...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892392/ https://www.ncbi.nlm.nih.gov/pubmed/33158940 http://dx.doi.org/10.1136/jech-2020-214691 |
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author | Ingram, Elizabeth Ledden, Sarah Beardon, Sarah Gomes, Manuel Hogarth, Sue McDonald, Helen Osborn, David P Sheringham, Jessica |
author_facet | Ingram, Elizabeth Ledden, Sarah Beardon, Sarah Gomes, Manuel Hogarth, Sue McDonald, Helen Osborn, David P Sheringham, Jessica |
author_sort | Ingram, Elizabeth |
collection | PubMed |
description | BACKGROUND: No clear synthesis of evidence examining household and area-level social determinants of multimorbidity exists. This study aimed to systematically review the existing literature on associations between household and area-level social determinants of health (SDoH) and multimorbidity prevalence or incidence in the general population. METHODS: Six databases (MedLine, EMBASE, PsychINFO, Web of Science, CINAHL Plus and Scopus) were searched. The search was limited to peer-reviewed studies conducted in high-income countries and published in English between 2010 and 2019. A second reviewer screened all titles with abstracts and a subset of full texts. Study quality was assessed and protocol pre-registered (CRD42019135281). RESULTS: 41 studies spanning North America, Europe and Australasia were included. Household income and area-level deprivation were the most explored with fairly consistent findings. The odds of multimorbidity were up to 4.4 times higher for participants with the lowest level of income compared with the highest level. Those living in the most deprived areas had the highest prevalence or incidence of multimorbidity (pooled OR 1.42, 95% CI 1.41 to 1.42). Associations between deprivation and multimorbidity differed by age and multimorbidity type. Findings from the few studies investigating household tenure, household composition and area-level rurality were mixed and contradictory; homeownership and rurality were associated with increased and decreased multimorbidity, while living alone was found to be associated with a higher risk of multimorbidity and not associated. CONCLUSION: Improving our understanding of broader social determinants of multimorbidity—particularly at the household level—could help inform strategies to tackle multimorbidity. |
format | Online Article Text |
id | pubmed-7892392 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-78923922021-03-03 Household and area-level social determinants of multimorbidity: a systematic review Ingram, Elizabeth Ledden, Sarah Beardon, Sarah Gomes, Manuel Hogarth, Sue McDonald, Helen Osborn, David P Sheringham, Jessica J Epidemiol Community Health Review BACKGROUND: No clear synthesis of evidence examining household and area-level social determinants of multimorbidity exists. This study aimed to systematically review the existing literature on associations between household and area-level social determinants of health (SDoH) and multimorbidity prevalence or incidence in the general population. METHODS: Six databases (MedLine, EMBASE, PsychINFO, Web of Science, CINAHL Plus and Scopus) were searched. The search was limited to peer-reviewed studies conducted in high-income countries and published in English between 2010 and 2019. A second reviewer screened all titles with abstracts and a subset of full texts. Study quality was assessed and protocol pre-registered (CRD42019135281). RESULTS: 41 studies spanning North America, Europe and Australasia were included. Household income and area-level deprivation were the most explored with fairly consistent findings. The odds of multimorbidity were up to 4.4 times higher for participants with the lowest level of income compared with the highest level. Those living in the most deprived areas had the highest prevalence or incidence of multimorbidity (pooled OR 1.42, 95% CI 1.41 to 1.42). Associations between deprivation and multimorbidity differed by age and multimorbidity type. Findings from the few studies investigating household tenure, household composition and area-level rurality were mixed and contradictory; homeownership and rurality were associated with increased and decreased multimorbidity, while living alone was found to be associated with a higher risk of multimorbidity and not associated. CONCLUSION: Improving our understanding of broader social determinants of multimorbidity—particularly at the household level—could help inform strategies to tackle multimorbidity. BMJ Publishing Group 2021-03 2020-11-06 /pmc/articles/PMC7892392/ /pubmed/33158940 http://dx.doi.org/10.1136/jech-2020-214691 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Review Ingram, Elizabeth Ledden, Sarah Beardon, Sarah Gomes, Manuel Hogarth, Sue McDonald, Helen Osborn, David P Sheringham, Jessica Household and area-level social determinants of multimorbidity: a systematic review |
title | Household and area-level social determinants of multimorbidity: a systematic review |
title_full | Household and area-level social determinants of multimorbidity: a systematic review |
title_fullStr | Household and area-level social determinants of multimorbidity: a systematic review |
title_full_unstemmed | Household and area-level social determinants of multimorbidity: a systematic review |
title_short | Household and area-level social determinants of multimorbidity: a systematic review |
title_sort | household and area-level social determinants of multimorbidity: a systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892392/ https://www.ncbi.nlm.nih.gov/pubmed/33158940 http://dx.doi.org/10.1136/jech-2020-214691 |
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