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Socioeconomic Determinants of Multimorbidity: A Population-Based Household Survey of Hong Kong Chinese

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  • Roger Y Chung
  • Stewart Mercer
  • Francisco T T Lai
  • Benjamin H K Yip
  • Martin C S Wong
  • Samuel Y S Wong

Abstract

Introduction: Multimorbidity has been well researched in terms of consequences and healthcare implications. Nevertheless, its risk factors and determinants, especially in the Asian context, remain understudied. We tested the hypothesis of a negative relationship between socioeconomic status and multimorbidity, with contextually different patterns from those observed in the West. Methods: We conducted our study in the general Hong Kong (HK) population. Data on current health conditions, health behaviours, socio-demographic and socioeconomic characteristics was obtained from HK Government’s Thematic Household Survey. 25,780 individuals aged 15 or above were sampled. Binary logistic and negative binomial regression analyses were conducted to identify risk factors for presence of multimorbidity and number of chronic conditions, respectively. Sub-analysis of possible mediation effect through financial burden borne by private housing residents on multimorbidity was also conducted. Results: Unadjusted and adjusted models showed that being female, being 25 years or above, having an education level of primary schooling or below, having less than HK$15,000 monthly household income, being jobless or retired, and being past daily smoker were significant risk factors for the presence of multimorbidity and increased number of chronic diseases. Living in private housing was significantly associated with higher chance of multimorbidity and increased number of chronic diseases only after adjustments. Conclusions: Less advantaged people tend to have higher risks of multimorbidity and utilize healthcare from the public sector with poorer primary healthcare experience. Moreover, middle-class people who are not eligible for government subsidized public housing may be of higher risk of multimorbidity due to psychosocial stress from paying for the severely unaffordable private housing.

Suggested Citation

  • Roger Y Chung & Stewart Mercer & Francisco T T Lai & Benjamin H K Yip & Martin C S Wong & Samuel Y S Wong, 2015. "Socioeconomic Determinants of Multimorbidity: A Population-Based Household Survey of Hong Kong Chinese," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-15, October.
    • Handle: RePEc:plo:pone00:0140040
    DOI: 10.1371/journal.pone.0140040
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    References listed on IDEAS

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    1. Imai, Kosuke & Keele, Luke & Tingley, Dustin & Yamamoto, Teppei, 2011. "Unpacking the Black Box of Causality: Learning about Causal Mechanisms from Experimental and Observational Studies," American Political Science Review, Cambridge University Press, vol. 105(4), pages 765-789, November.
    2. Leung, Gabriel M. & O.L. Wong, Irene & Chan, Wai-Sum & Choi, Sarah & Lo, Su-Vui, 2005. "The ecology of health care in Hong Kong," Social Science & Medicine, Elsevier, vol. 61(3), pages 577-590, August.
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    2. Ruwan Jayathilaka & Sheron Joachim & Venuri Mallikarachchi & Nishali Perera & Dhanushika Ranawaka, 2020. "Do chronic illnesses and poverty go hand in hand?," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-19, October.
    3. Eliza Lai yi Wong & Richard Huan Xu & Annie Wai ling Cheung, 2019. "Measuring the impact of chronic conditions and associated multimorbidity on health-related quality of life in the general population in Hong Kong SAR, China: A cross-sectional study," PLOS ONE, Public Library of Science, vol. 14(11), pages 1-16, November.
    4. Ho Cheung William Li & Laurie Long Kwan Ho & Oi Kwan Joyce Chung & Ankie Tan Cheung & Wei Xia & Peige Song, 2022. "A Descriptive Study on Multiple Health-Risk Behaviors among Chinese Adults in Hong Kong," IJERPH, MDPI, vol. 19(18), pages 1-10, September.
    5. Elizabeth Ingram & Manuel Gomes & Sue Hogarth & Helen I. McDonald & David Osborn & Jessica Sheringham, 2022. "Household Tenure and Its Associations with Multiple Long-Term Conditions amongst Working-Age Adults in East London: A Cross-Sectional Analysis Using Linked Primary Care and Local Government Records," IJERPH, MDPI, vol. 19(7), pages 1-18, March.
    6. David E. V. Olivares & Frank R. V. Chambi & Evelyn M. M. Chañi & Winston J. Craig & Sandaly O. S. Pacheco & Fabio J. Pacheco, 2017. "Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study," IJERPH, MDPI, vol. 14(3), pages 1-22, March.

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