Study highlights socioeconomic inequalities in prevalence of multiple long-term health conditions


A study published today (27 March 2024) in the Lancet Public Health suggests that, if current patterns in multimorbidity accumulation persist, there will be approximately a one-third (34%) increase in the prevalence of people living with multiple long-term conditions in 2049 compared with 2019.

This study, from researchers at the University of Liverpool, uses a microsimulation – modelling of individuals – to project socioeconomic inequalities in multimorbidity in England among adults aged 30 years and over. It uses primary care data between 2004-2019 of 1m individuals from the Clinical Practice Research Datalink, and identified those with multimorbidity based on a list of 211 chronic conditions.

Corresponding author Dr Anna Head said: “There are socioeconomic inequalities in the proportion of people living with multimorbidity and how it develops across adulthood. Estimates of multimorbidity prevalence in English primary care increased by more than two-thirds from 2004 to 2019. We developed a microsimulation model to quantify how projected multimorbidity inequalities in the English adult population may change.”

The results suggest that, if current patterns in multimorbidity accumulation persist, the proportion and absolute numbers of adults living with multimorbidity will rise from 2019 to 2049, with approximately a one-third (34%) increase in the prevalence of people living with multimorbidity in 2049 compared with 2019.

Dr Head said: “Socioeconomic inequalities gradually increase at each stage of accumulation of multiple chronic conditions. In the future, wide socioeconomic inequalities are likely to persist, largely driven by inequalities in new multimorbidity cases among the working-age population.”

The projections suggest that the growing burden of multimorbidity will have profound impacts on the day-to-day lives of the population, increase demands on health-care and social-care systems, and lead to substantial productivity losses from sickness days and non-participation in the workforce and society.

There is a need to understand the extent to which overall levels of multimorbidity and socioeconomic inequalities could be reduced through prevention-oriented policies.

Dr Head adds: “Policies for both the prevention and management of multimorbidity will be necessary as we move towards a society in which people live longer lives, have more diverse health needs, and are expected to work for longer.”

This research was funded by the National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR), a partnership between nine leading centres of academic public health research excellence across England.

Click here to access the full study: Socioeconomic inequalities in accumulation of multimorbidity in England from 2019 to 2049: a microsimulation projection study.