Short and long term determinants of incident multimorbidity in a cohort of 1988 earthquake survivors in Armenia

International Journal for Equity in Health

Research

Haroutune K Armenian¹  Anahit Demirchyan²  Varduhi Petrosyan²  Vahe Khachadourian² 

[1] Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA;School of Public Health, American University of Armenia, 40 Marshal Baghramian Avenue, Yerevan 0019, Armenia;

关键词: Multimorbidity;    Determinants;    Inequity;    Life events;    Earthquake;    Cohort;    Armenia;   

DOI  :  10.1186/1475-9276-12-68

 received in 2013-03-19, accepted in 2013-05-23,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundMultimorbidity, presence of two or more health conditions, is a widespread phenomenon affecting populations’ health all over the world. It becomes a serious public health concern due to its negative consequences on quality of life, mortality, and cost of healthcare services utilization. Studies exploring determinants of multimorbidity are limited, particularly those looking at vulnerable populations prospectively over time. This study aimed at identifying short and long term socioeconomic, psychosocial, and health behavioral determinants of incident multimorbidity among a cohort of the 1988 Armenian earthquake survivors.MethodsThe study included a representative subsample of 725 from a larger initial cohort of the earthquake survivors. Data on this subsample were collected via four phases of this cohort study during the period 1990–2012. The final logistic regression analysis eliminated all those cases with baseline multimorbidity to investigate short and long term determinants of incident multimorbidity; this subsample included 600 participants.ResultsMore than 75% of the studied sample had multimorbidity. Perceived low affordability of healthcare services, poor living standards during the post-earthquake decade, and lower education were independent predictors of incident multimorbidity developed during the period 1990–2012. Stressful life events and poor social support were among psychosocial determinants of incident multimorbidity. Participants’ baseline BMI reported in 1990 was independently associated with incident multimorbidity.ConclusionsMost of the identified determinants of incident multimorbidity in our study population were markers of social inequities, indicating that inequities pose a serious threat to both individual and public health-related outcomes. Strategies targeting to decrease such inequities along with promotion of healthy lifestyle and strengthening of social networks may considerably reduce multimorbidity among population groups with similar socioeconomic and cultural profiles.

【 授权许可】

CC BY   
© Demirchyan et al.; licensee BioMed Central Ltd. 2013