Comparisons of disease cluster patterns, prevalence and health factors in the USA, Canada, England and Ireland.

TitleComparisons of disease cluster patterns, prevalence and health factors in the USA, Canada, England and Ireland.
Publication TypeJournal Article
Year of Publication2021
AuthorsHernandez, B, Voll, S, Lewis, NA, McCrory, C, White, A, Stirland, L, Kenny, RAnne, Reilly, R, Hutton, CP, Griffith, LE, Kirkland, SA, Terrera, GMuñiz, Hofer, SM
JournalBMC Public Health
ISSN Number1471-2458
Keywordsdisease clusters, ELSA, Latent Class Analysis, multimorbidity, Sister studies, TILDA

BACKGROUND: Identification of those who are most at risk of developing specific patterns of disease across different populations is required for directing public health policy. Here, we contrast prevalence and patterns of cross-national disease incidence, co-occurrence and related risk factors across population samples from the U.S., Canada, England and Ireland.

METHODS: Participants (n = 62,111) were drawn from the US Health and Retirement Study (n = 10,858); the Canadian Longitudinal Study on Ageing (n = 36,647); the English Longitudinal Study of Ageing (n = 7938) and The Irish Longitudinal Study on Ageing (n = 6668). Self-reported lifetime prevalence of 10 medical conditions, predominant clusters of multimorbidity and their specific risk factors were compared across countries using latent class analysis.

RESULTS: The U.S. had significantly higher prevalence of multimorbid disease patterns and nearly all diseases when compared to the three other countries, even after adjusting for age, sex, BMI, income, employment status, education, alcohol consumption and smoking history. For the U.S. the most at-risk group were younger on average compared to Canada, England and Ireland. Socioeconomic gradients for specific disease combinations were more pronounced for the U.S., Canada and England than they were for Ireland. The rates of obesity trends over the last 50 years align with the prevalence of eight of the 10 diseases examined. While patterns of disease clusters and the risk factors related to each of the disease clusters were similar, the probabilities of the diseases within each cluster differed across countries.

CONCLUSIONS: This information can be used to better understand the complex nature of multimorbidity and identify appropriate prevention and management strategies for treating multimorbidity across countries.

Citation Key11867
PubMed ID34526001
PubMed Central IDPMC8442402
Grant ListR01 AG017644 / AG / NIA NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States