Social disadvantage linked to earlier multiple chronic diseases
Relative rates of developing multiple chronic diseases were 1.70 for women and 1.59 for men in disadvantaged profiles compared with the most advantaged profile.
Our read
Populations- Studied:
- Cohort study of 100,601 Ontario respondents without baseline study chronic conditions, up to 22 years (Dose-response)
- What changed:
- Multiple chronic diseases developed earlier in disadvantaged women (hazard ratio 1.77) and men (hazard ratio 1.56) than socially advantaged peers
- The catch:
- Diagnosis dates reflect healthcare encounters, not when diseases actually began
- In the record:
- The 7th paper on social disadvantage with results in people; 16 on record in all.
Editor of record: Boris Djordjevic · AgingResearch.News
Ontario adults aged 25–74—100,601 women and men without any of the six chronic conditions studied at enrollment—were followed for up to 22 years in an observational cohort study. Researchers grouped participants into six social profiles using survey information on circumstances such as income, housing and employment, alongside neighborhood census measures.
Linked health records tracked multimorbidity, defined here as developing at least two of six selected chronic conditions, through March 31, 2022. Multiple patterns of disadvantage were associated with earlier onset, rather than risk following a simple progression from greater advantage to greater disadvantage. During follow-up, multimorbidity developed in 3.6% of women and 5.7% of men. The analyses accounted for high blood pressure and lifestyle factors, including smoking and physical activity.
Why it matters
Developing multiple chronic diseases is an important concern as people age. The authors suggest that combined social profiles could help guide policies aimed at reducing inequalities in their development.
Caveats
Social measurements at enrollment did not capture later changes in participants’ circumstances, and the cohort excluded people already living with any of the six selected conditions. The abstract and detailed results report different adjusted hazard ratios.
From the paper
- Follow-up
Participants were followed for up to 22 years, until the earliest of: age of multimorbidity onset, age of multimorbidity free death, loss to follow up (defined as 7 years after the date of last contact with healthcare system) or study end (March 31, 2022).
- Result
In unadjusted analysis Cluster A had the highest hazard ratio (Unadjusted: Females: HR 2.49, 95%CI, 2.00-3.2; Males: HR 2.00, 95%CI, 1.68-2.37), indicating earlier multimorbidity onset relative to the reference (Cluster F).
- Limitation
Individual-level social determinants and lifestyle measures were self-reported and captured at a single time point, though these characteristics are likely to vary over the life course …
Quoted word for word from the full text on PubMed Central.
The paper
Multidimensional social exposure clusters and incident multimorbidity in a population-based cohort
University of Toronto
American Journal of Epidemiology, Jul 18, 2026, Open access
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