Epidemiology and Health

Original Articles

Trends and all-cause mortality associated with multimorbidity of non-communicable diseases among adults in the United States, 1999-2018: a retrospective cohort study: Mengzi Sun, Ling Wang, Xuhan Wang, Li Tong, Lina Jin, Bo Li; Epidemiol Health. 2023;45:e2023023. Published online February 14, 2023; DOI: https://doi.org/10.4178/epih.e2023023

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Multimorbidity of non-communicable diseases (NCDs) has brought enormous challenges to public health, becoming a major medical burden. However, the patterns, temporal trends, and all-cause mortality associated with NCD multimorbidity over time have not been well described in the United States.
METHODS
All adult participants were sourced from nationally representative data from the National Health and Nutrition Examination Survey. In total, 55,081 participants were included in trend analysis, and 38,977 participants were included in Cox regression.
RESULTS
The 5 NCDs with the largest increases over the study period were diabetes, osteoporosis, obesity, liver conditions, and cancer. The estimated prevalence of multimorbidity increased with age, especially for middle-aged participants with 5 or more NCDs; in general, the prevalence of NCD multimorbidity was higher among females than males. Participants with 5 or more NCDs were at 4.49 times the risk of all-cause mortality of participants without any diseases. Significant interactions were found between multimorbidity and age group (p for interaction <0.001), race/ethnicity (p for interaction<0.001), and educational attainment (p for interaction=0.010).
CONCLUSIONS
The prevalence of multiple NCDs significantly increased from 1999 to 2018. Those with 5 or more NCDs had the highest risk of all-cause mortality, especially among the young population. The data reported by this study could serve as a reference for additional NCD research.; Summary

Key Message
This study included a series-cross sectional study and a retrospective cohort study, utilizing nationally representative data from the National Health and Nutrition Examination Survey (NHANES). Multimorbidity of non-communicable diseases (NCDs) has brought enormous challenges to public health, becoming a major medical burden. This study aimed to explore the patterns, temporal trends, and all-cause mortality of multimorbidity of NCDs in the United States from 1999 to 2018, by gender-specific and age-specific. The data reported by this study could serve as a reference for additional NCD research.

Associations between chronic conditions and oral health services utilization in older Peruvian adults: a pooled analysis of the Demographic and Health Survey 2015-2017: Diego Azañedo, Diego Chambergo-Michilot, Akram Hernández-Vásquez; Epidemiol Health. 2020;42:e2020023. Published online April 9, 2020; DOI: https://doi.org/10.4178/epih.e2020023

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Abstract PDF: Abstract
OBJECTIVES
This study was conducted to investigate the associations between chronic conditions (CCs) and oral health services utilization (OHSU) within the previous 6 months in older Peruvian adults (defined as those 60 years of age or more according to Peruvian law).
METHODS
An analytical cross-sectional study was performed based on the 2015-2017 Peruvian Demographic and Family Health Survey. Pooled data from 13,699 older adults were analyzed. A logistic regression model was used to analyze the associations between OHSU (dependent variable) and CCs (independent variables). Tobacco consumption, obesity, educational level, age, sex, welfare quintile, area of residence, having health insurance, and natural region of residence were included as covariates in the analysis.
RESULTS
The frequency of OHSU in older adults was 18.5% (95% confidence interval [CI], 17.8 to 19.3). The highest percentage point (%p) differences with regards to OHSU were found between the extreme categories of educational level (higher education vs. none or elementary school: +24.8%p) and welfare quintile (richest vs. poorest: +24.0%p). In the crude model, OHSU was associated with diabetes (odds ratio [OR], 1.46; 95% CI, 1.26 to 1.69), but this association disappeared after adjustment for covariates. Meanwhile, depression decreased the likelihood of OHSU (OR, 0.82; 95% CI, 0.72 to 0.95) in the adjusted model.
CONCLUSIONS
The frequency of OHSU was low in older Peruvian adults. Regarding CCs, we found that depression independently decreased the likelihood of OHSU in the adjusted model. Our results may be useful for the development of policies aimed at achieving greater OHSU in older adults with CCs, especially in those with depression.; Summary

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