Wagner, Cornelia; Jackisch, Josephine; Ortega, Natalia; Chiolero, Arnaud; Cullati, Stéphane; Carmeli, Cristian (2024). Educational inequalities in multimorbidity at older ages: a multi-generational population-based study. European journal of public health, 34(4), pp. 704-709. Oxford University Press 10.1093/eurpub/ckae096
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BACKGROUND
Social inequalities in multimorbidity may occur due to familial and/or individual factors and may differ between men and women. Using population-based multi-generational data, this study aimed to (1) assess the roles of parental and individual education in the risk of multimorbidity and (2) examine the potential effect modification by sex.
METHODS
Data were analysed from 62 060 adults aged 50+ who participated in the Survey of Health, Ageing and Retirement in Europe, comprising 14 European countries. Intergenerational educational trajectories (exposure) were High-High (reference), Low-High, High-Low and Low-Low, corresponding to parental-individual educational attainments. Multimorbidity (outcome) was ascertained between 2013 and 2020 as self-reported occurrence of ≥2 diagnosed chronic conditions. Inequalities were quantified as multimorbidity-free years lost (MFYL) between the ages of 50 and 90 and estimated via differences in the area under the standardized cumulative risk curves. Effect modification by sex was assessed via stratification.
RESULTS
Low individual education was associated with higher multimorbidity risk regardless of parental education. Compared to the High-High trajectory, Low-High was associated with -0.2 MFYL (95% confidence intervals: -0.5 to 0.1), High-Low with 3.0 (2.4-3.5), and Low-Low with 2.6 (2.3-2.9) MFYL. This pattern was observed for both sexes, with a greater magnitude for women. This effect modification was not observed when only diseases diagnosed independently of healthcare-seeking behaviours were examined.
CONCLUSIONS
Individual education was the main contributor to intergenerational inequalities in multimorbidity risk among older European adults. These findings support the importance of achieving a high education to mitigate multimorbidity risk.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) |
UniBE Contributor: |
Ortega Herrero, Natalia, Chiolero, Arnaud |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
1101-1262 |
Publisher: |
Oxford University Press |
Funders: |
[4] Swiss National Science Foundation |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
11 Jun 2024 16:22 |
Last Modified: |
06 Aug 2024 13:33 |
Publisher DOI: |
10.1093/eurpub/ckae096 |
PubMed ID: |
38840419 |
BORIS DOI: |
10.48350/197646 |
URI: |
https://boris.unibe.ch/id/eprint/197646 |
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