Objectives To explore prevalences and occupational group inequalities of two measures of multimorbidity with frailty.
Design Cross-sectional study.
Setting The Nord-Trøndelag Health Study (HUNT), Norway, a total county population health survey, 2006–2008.
Participants Participants older than 25 years, with complete questionnaires, measurements and occupation data were included.
Outcomes ≥2 of 51 multimorbid conditions with ≥1 of 4 frailty measures (poor health, mental illness, physical impairment or social impairment) and ≥3 of 51 multimorbid conditions with ≥2 of 4 frailty measures.
Analysis Logistic regression models with age and occupational group were specified for each sex separately.
Results Of 41 193 adults, 38 027 (55% female; 25–100 years old) were included. Of them, 39% had ≥2 multimorbid conditions with ≥1 frailty measure, and 17% had ≥3 multimorbid conditions with ≥2 frailty measures. Prevalence differences in percentage points (pp) with 95% confidence intervals of those in high versus low occupational group with ≥2 multimorbid conditions and ≥1 frailty measure were largest in women age 30 years, 17 (14 to 20) pp and 55 years, 15 (13 to 17) pp and in men age 55 years, 15 (13 to 17) pp and 80 years, 14 (9 to 18) pp. In those with ≥3 multimorbid conditions and ≥2 frailty measures, prevalence differences were largest in women age 30 years, 8 (6 to 10) pp and 55 years, 10 (8 to 11) ppand in men age 55 years, 9 (8 to 11) pp and 80 years, 6 (95% CI 1 to 10) pp.
Conclusion Multimorbidity with frailty is common, and social inequalities persist until age 80 years in women and throughout the lifespan in men. To manage complex multimorbidity, strategies for proportionate universalism in medical education, healthcare, public health prevention and promotion seem necessary.
- public health
- mental health
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Contributors KHV, ERS and KAD conceptualised the study and all authors contributed to its design. KHV has analysed the data under the supervision of ERS and all authors have contributed to interpreting the data. KHV wrote the original draft, which has been revised critically by ERS, KAD and PB. All authors have read and approved the final version of the manuscript to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Funding This study was funded by the Faculty of Medicine and Health Science at the Norwegian University of Science and Technology (NTNU) through the PhD programme in Behaviour and Health (KHV). NTNU has partly funded the HUNT3 Survey and have funded open access for this article. The Liaison Committee for Education, Research and Innovation in Central Norway (17/38297) supported a research stay for KHV at the Australian National University, Canberra. The funding sources have had no role in conceptualization this study, its design and methods, analysis and interpretation of data, writing of the article or the decision to submit the article for publication.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.
Patient consent for publication Not required.
Ethics approval The Regional Committee for Medical and Health Research Ethics in Norway approved the current study (Project No. 2014/2265).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request. To protect participants’ privacy, HUNT Research Centre aims to limit storage of data outside HUNT databank and cannot deposit data in open repositories. HUNT databank has precise information on all data exported to different projects and are able to reproduce these on request. There are no restrictions regarding data export given approval of applications to HUNT Research Centre. For more information, see http://www.ntnu.edu/hunt/data.