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Wilk P, Stranges S, Bellocco R, Bohn T, Samouda H, Nicholson K, Makovski TT, Maltby A. Multimorbidity in large Canadian urban centres: A multilevel analysis of pooled 2015-2018 cross-sectional cycles of the Canadian Community Health Survey. JOURNAL OF MULTIMORBIDITY AND COMORBIDITY 2021; 11:26335565211058037. [PMID: 35004338 PMCID: PMC8728777 DOI: 10.1177/26335565211058037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 10/18/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND There is limited knowledge on how the prevalence of multimorbidity varies within and across major Canadian urban centres. The objective of this study was to investigate the between-neighbourhood variation in the prevalence of multimorbidity in Canada's large urban centres, controlling for compositional effects associated with individual-level demographic and socioeconomic factors. METHODS Cross-sectional data from the 2015-2018 cycles of the Canadian Community Health Survey (CCHS) were pooled at the microdata level. Respondents (20 years and older) residing in one of the 35 census metropolitan areas (CMAs) were included (N = 100,803). Census tracts (CTs) were used as a measure of neighbourhood. To assess the between-neighbourhood differences in multimorbidity prevalence, we fitted three sequential random intercept logistic regression models. RESULTS During the 2015-2018 period, 8.1% of residents of large urban centres had multimorbidity. The results from the unadjusted model indicate that 13.4% of the total individual variance in multimorbidity could be attributed to the between-neighbourhood differences. After adjustment for overall characteristics of the CMAs in which these neighbourhoods are located, as well as for individual-level demographic and socioeconomic factors related to compositional effects, 11.0% of the individual variance in multimorbidity could still be attributed to the between-neighbourhood differences. CONCLUSION There is significant and substantial geographic variation in multimorbidity prevalence across neighbourhoods in Canada's large urban centres. Residing in some neighbourhoods could be associated with increased odds of having multimorbidity, even after accounting for overall characteristics of the CMAs in which these neighbourhoods are located, as well as individual-level factors.
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Affiliation(s)
- Piotr Wilk
- Department of Epidemiology and
Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Paediatrics, Schulich
School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Saverio Stranges
- Department of Epidemiology and
Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Family Medicine,
Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Population Health,
Nutrition and Health Research Group, Luxembourg Institute of
Health, Strassen, Luxembourg
| | - Rino Bellocco
- Department of Medical Epidemiology
and Biostatistics, Karolinska Institute, Solna, Sweden
| | - Torsten Bohn
- Department of Population Health,
Nutrition and Health Research Group, Luxembourg Institute of
Health, Strassen, Luxembourg
| | - Hanen Samouda
- Department of Population Health,
Nutrition and Health Research Group, Luxembourg Institute of
Health, Strassen, Luxembourg
| | - Kathryn Nicholson
- Department of Epidemiology and
Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Tatjana T Makovski
- Department of Family Medicine, Care
and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Chairgroup of Complex Genetics and
Epidemiology, Nutrition and Metabolism in Translational Research, Care and
Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Alana Maltby
- Department of Epidemiology and
Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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