Family level multimorbidity among older adults in India: looking through a syndemic lens
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background
Most of the epidemiological reports on multimorbidity are drawn from individual level assessment despite the fact that the occurrence and outcomes of multimorbidity are modulated by the shared risk factors prevailing within household and family environment. Our study reports on the magnitude of family level multimorbidity and its healthcare expenditure among older adults using data from Longitudinal Ageing Study in India (LASI), wave-1.
Methods
LASI is a nationwide survey amongst older adults aged ≥45years conducted in 2017-2018. We included (n=22,526) families defined as two or more members co-residing in the same household. We propose two new terms “family level multimorbidity” defined as two or more members of a family having multimorbidity and “family level complex multimorbidity” defined as two or more members of a family having ≥3 chronic conditions in three or more organ systems. Multivariable logistic regression assessed correlates, expressed as adjusted odds ratio with 95% confidence interval.
Findings
Family level multimorbidity was prevalent among 44.46% families while 41.8% (both partners) had conjugal multimorbidity. Amongst siblings 42.86% and inter-generational (three generations) 46.07% reported multimorbidity. Family level complex multimorbidity was prevalent among 17.93% households. Family level multimorbidity was predominantly associated with urban and affluent class. Healthcare expenditure increased with more multimorbid individuals in a family.
Interpretation
Our study, reports on the novel concept of looking at multimorbidity by considering family or household as a unit. Multimorbidity is found to be increasingly prevalent in households thus, necessitating family centred intervention rather than individualized approach. Future studies should explore intermediaries of family level multimorbidity through a syndemic lens.
Most of the epidemiological reports on multimorbidity are drawn from individual level assessment despite the fact that the occurrence and outcomes of multimorbidity are modulated by the shared risk factors prevailing within household and family environment. Our study reports on the magnitude of family level multimorbidity and its healthcare expenditure among older adults using data from Longitudinal Ageing Study in India (LASI), wave-1.
Methods
LASI is a nationwide survey amongst older adults aged ≥45years conducted in 2017-2018. We included (n=22,526) families defined as two or more members co-residing in the same household. We propose two new terms “family level multimorbidity” defined as two or more members of a family having multimorbidity and “family level complex multimorbidity” defined as two or more members of a family having ≥3 chronic conditions in three or more organ systems. Multivariable logistic regression assessed correlates, expressed as adjusted odds ratio with 95% confidence interval.
Findings
Family level multimorbidity was prevalent among 44.46% families while 41.8% (both partners) had conjugal multimorbidity. Amongst siblings 42.86% and inter-generational (three generations) 46.07% reported multimorbidity. Family level complex multimorbidity was prevalent among 17.93% households. Family level multimorbidity was predominantly associated with urban and affluent class. Healthcare expenditure increased with more multimorbid individuals in a family.
Interpretation
Our study, reports on the novel concept of looking at multimorbidity by considering family or household as a unit. Multimorbidity is found to be increasingly prevalent in households thus, necessitating family centred intervention rather than individualized approach. Future studies should explore intermediaries of family level multimorbidity through a syndemic lens.
Date Issued
2022-08-10
Date Acceptance
2022-08-01
Citation
International Journal of Environmental Research and Public Health, 2022, 19 (16)
ISSN
1660-4601
Publisher
MDPI AG
Journal / Book Title
International Journal of Environmental Research and Public Health
Volume
19
Issue
16
Copyright Statement
© 2022 by the authors.
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
Licensee MDPI, Basel, Switzerland.
This article is an open access article
distributed under the terms and
conditions of the Creative Commons
Attribution (CC BY) license (https://
creativecommons.org/licenses/by/
4.0/).
License URL
Publication Status
Published
Article Number
ARTN 9850