Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study
Abstract
:1. Introduction
2. Materials & Methods
2.1. Study Population and Sample
2.2. Outcome Variable
All-Cause Mortality
2.3. Independent Variables
Multimorbidity
- (1)
- individual disease counts;
- (2)
- organ-grouped disease counts;
- (3)
- a threshold of three or more individual conditions;
- (4)
- a threshold of three or more organ-grouped conditions called complex multimorbidity;
- (5)
- co-occurrence of two or more individual conditions and frailty (measured as one of four dimensions (poor self-rated health, mental illness, physical impairment or social impairment)) called multimorbidity with frailty.
2.4. Sociodemographic Variables
2.5. Statistical Analysis
2.6. Patient and Public Involvement
2.7. Ethics Statement
3. Results
4. Discussion
4.1. Summary of Findings
4.2. Possible Mechanisms and Explanations
4.3. Comparison with Existing Literature
4.4. Strengths and Limitations
4.5. Interpretation/Implication
4.6. Future Research
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics and Outcomes | Occupational Group | |||||||
---|---|---|---|---|---|---|---|---|
High | Middle | Low | Total | |||||
Cohort, baseline, No. (%) | 7501 | (100) | 8370 | (100) | 15,261 | (100) | 31,132 | (100) |
Women No. (%) | 3702 | (49.4) | 4427 | (52.9) | 8821 | (57.8) | 16,950 | (54) |
Men No. (%) | 3799 | (50.6) | 3943 | (47.1) | 6440 | (42.2) | 14,182 | (46) |
Age, years, mean (SD) | 53 | (10.2) | 55 | (10.7) | 56 | (10.5) | 55 | (10.5) |
Health status, baseline | ||||||||
Individual LTCs, median (IQR) | 3 | (1 to 5) | 3 | (2 to 5) | 4 | (2 to 6) | 3 | (2 to 5) |
Organ-grouped LTCs, median (IQR) | 2 | (1 to 3) | 3 | (1 to 4) | 3 | (2 to 4) | 3 | (1 to 4) |
≥3 individual LTCs, No. (%) | 3919 | (52.2) | 5088 | (60.8) | 10,402 | (68.2) | 19,409 | (62.3) |
Complex multimorbidity, No. (%) a | 3191 | (42.5) | 4298 | (51.4) | 9057 | (59.3) | 16,546 | (53.1) |
Multimorbidity with frailty, No. (%) b,c | 2070 | (27.6) | 3081 | (36.8) | 6710 | (44.0) | 11,861 | (38.1) |
End of follow-up | ||||||||
Follow-up time, years, mean (SD) | 11.1 | (1.3) | 11.1 | (1.5) | 11.0 | (1.6) | 11.1 | (1.5) |
Person-years, thousands (%) | 83.5 | (24.3) | 93.0 | (27.0) | 167.6 | (48.7) | 344.2 | (100) |
Deaths, No. (%) | 373 | (5.0) | 571 | (6.8) | 1310 | (8.6) | 2254 | (7.2) |
Deaths in women, No. (%) | 118 | (31.6) | 210 | (36.8) | 608 | (46.4) | 936 | (41.5) |
Deaths in men, No. (%) | 255 | (68.4) | 361 | (63.2) | 702 | (53.6) | 1318 | (58.5) |
Age at death, years, mean (SD) | 71.2 | (8.7) | 72.9 | (8.2) | 71.9 | (8.6) | 72.0 | (8.5) |
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Vinjerui, K.H.; Bjorngaard, J.H.; Krokstad, S.; Douglas, K.A.; Sund, E.R. Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study. J. Clin. Med. 2020, 9, 2759. https://doi.org/10.3390/jcm9092759
Vinjerui KH, Bjorngaard JH, Krokstad S, Douglas KA, Sund ER. Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study. Journal of Clinical Medicine. 2020; 9(9):2759. https://doi.org/10.3390/jcm9092759
Chicago/Turabian StyleVinjerui, Kristin Hestmann, Johan H. Bjorngaard, Steinar Krokstad, Kirsty A. Douglas, and Erik R. Sund. 2020. "Socioeconomic Position, Multimorbidity and Mortality in a Population Cohort: The HUNT Study" Journal of Clinical Medicine 9, no. 9: 2759. https://doi.org/10.3390/jcm9092759