Multimorbidity Patterns and Their Association with Social Determinants, Mental and Physical Health during the COVID-19 Pandemic

Int J Environ Res Public Health. 2022 Dec 15;19(24):16839. doi: 10.3390/ijerph192416839.

Abstract

Background: The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities.

Methods: This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model.

Results: We obtained a model with five patterns (entropy = 0.727): 'Relative Healthy', 'Cardiometabolic', 'Musculoskeletal', 'Musculoskeletal and Mental', and 'Complex Multimorbidity'. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression.

Conclusions: We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments.

Keywords: COVID-19; latent class analysis; mental health; multimorbidity patterns; physical health; social determinants.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19* / epidemiology
  • Humans
  • Multimorbidity*
  • Pandemics
  • Social Determinants of Health
  • Socioeconomic Factors

Grants and funding

This publication was supported by public funds by the ITI call (Integrated Territorial Investment), developed by the Health Department of the Andalusian Government (ITI-0028-2019). The DEMMOCAD project has been 80% co-financed by funds from the European Regional Development Fund (ERDF) operational program of Andalusia 2014–2020.