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Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults

BACKGROUND: Chinese individuals face an increase in multimorbidity, but little is known about the mortality gradients of multimorbid people in different socio-economic groups. This study measures relative and absolute socio-economic inequality in mortality among multimorbid Chinese. METHODS: For thi...

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Autores principales: Zou, Siyu, Wang, Zhicheng, Tang, Kun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977254/
https://www.ncbi.nlm.nih.gov/pubmed/35922875
http://dx.doi.org/10.1093/inthealth/ihac052
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author Zou, Siyu
Wang, Zhicheng
Tang, Kun
author_facet Zou, Siyu
Wang, Zhicheng
Tang, Kun
author_sort Zou, Siyu
collection PubMed
description BACKGROUND: Chinese individuals face an increase in multimorbidity, but little is known about the mortality gradients of multimorbid people in different socio-economic groups. This study measures relative and absolute socio-economic inequality in mortality among multimorbid Chinese. METHODS: For this study, the prospective China Kadoorie Biobank (CKB) enrolled 512 712 participants ages 30–79 y from 10 areas of China between 25 June 2004 and 15 July 2008. All-cause mortality was accessed with a mean follow-up period of 10 y (to 31 December 2016). Associations between multimorbidity and mortality were assessed using Cox proportional hazards models, with the relative index of inequality (RII) and slope index of inequality (SII) in mortality calculated to measure disparities. RESULTS: Mortality risk was highest for those who had not attended formal school and with four or more long-term conditions (LTCs) (hazard ratio 3.11 [95% confidence interval {CI} 2.75 to 3.51]). Relative educational inequality was lower in participants with four or more LTCs (RII 1.92 [95% CI 1.60 to 2.30]), especially in rural areas. Absolute disparities were greater in adults with more LTCs (SII 0.18 [95% CI 0.14 to 0.21] for rural participants with three LTCs). CONCLUSIONS: Whereas the relative inequality in all-cause mortality was lower among multimorbid people, absolute inequality was greater among multimorbid men, especially in rural areas.
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spelling pubmed-99772542023-03-02 Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults Zou, Siyu Wang, Zhicheng Tang, Kun Int Health Review Article BACKGROUND: Chinese individuals face an increase in multimorbidity, but little is known about the mortality gradients of multimorbid people in different socio-economic groups. This study measures relative and absolute socio-economic inequality in mortality among multimorbid Chinese. METHODS: For this study, the prospective China Kadoorie Biobank (CKB) enrolled 512 712 participants ages 30–79 y from 10 areas of China between 25 June 2004 and 15 July 2008. All-cause mortality was accessed with a mean follow-up period of 10 y (to 31 December 2016). Associations between multimorbidity and mortality were assessed using Cox proportional hazards models, with the relative index of inequality (RII) and slope index of inequality (SII) in mortality calculated to measure disparities. RESULTS: Mortality risk was highest for those who had not attended formal school and with four or more long-term conditions (LTCs) (hazard ratio 3.11 [95% confidence interval {CI} 2.75 to 3.51]). Relative educational inequality was lower in participants with four or more LTCs (RII 1.92 [95% CI 1.60 to 2.30]), especially in rural areas. Absolute disparities were greater in adults with more LTCs (SII 0.18 [95% CI 0.14 to 0.21] for rural participants with three LTCs). CONCLUSIONS: Whereas the relative inequality in all-cause mortality was lower among multimorbid people, absolute inequality was greater among multimorbid men, especially in rural areas. Oxford University Press 2022-08-03 /pmc/articles/PMC9977254/ /pubmed/35922875 http://dx.doi.org/10.1093/inthealth/ihac052 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Zou, Siyu
Wang, Zhicheng
Tang, Kun
Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults
title Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults
title_full Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults
title_fullStr Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults
title_full_unstemmed Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults
title_short Social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million Chinese adults
title_sort social inequalities in all-cause mortality among adults with multimorbidity: a 10-year prospective study of 0.5 million chinese adults
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9977254/
https://www.ncbi.nlm.nih.gov/pubmed/35922875
http://dx.doi.org/10.1093/inthealth/ihac052
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