Multimorbidity and its social determinants among older people in southern provinces, Vietnam

Ninh Thi Ha1, Ninh Hoang Le1, Vishnu Khanal2, Rachael Moorin2
1Institute of Public Health, Ho Chi Minh City, Vietnam
2School of Public Health, Curtin University, Bentley, Australia

Tóm tắt

Developing countries are poorly equipped for health issues related to ageing populations making multimorbidity challenging. As in Vietnam the focus tends to be on single conditions. Hence little is known about burden of multimorbidity. This study aimed to examine the prevalence and the determinants of multimorbidity among older people in Southern Vietnam. A cross-sectional study was conducted in two provinces of Southern Vietnam with a sample of 2400 people aged 60 years and older. The presence of chronic disease was ascertained by medical examination done by physicians at commune health stations. Information on social and demographic factors was collected using structured questionnaire. Univariate and multivariable logistic regression analyses were used to examine the factors associated with multimorbidity. Nearly 40 % of older people had multimorbidity. Currently not working, and healthcare utilisation were associated with higher prevalence of multimorbidity. Living in urban areas and being literate were associated with lower prevalence of multimorbidity. The study found a high burden of multimorbidity among illiterate, especially those living in rural areas. This highlights the need for targeted community based programs aimed at reducing the burden of chronic disease.

Từ khóa


Tài liệu tham khảo

United Nations Population Fund (UNFPA) in Viet Nam. The ageing population in Vietnam: current status, prognosis, and possible policy responses. Vietnam: United Nations Population Fund (UNFPA); 2011.

le Hoi V, Phuc HD, Dung TV, Chuc NT, Lindholm L. Remaining life expectancy among older people in a rural area of Vietnam: trends and socioeconomic inequalities during a period of multiple transitions. BMC Public Health. 2009;9:471.

Van Minh H, Lan Huong D, Bao Giang K, Byass P. Economic aspects of chronic diseases in Vietnam. Glob Health Action. 2009;2.

Hoy D, Rao C, Nhung NTT, Marks G, Hoa NP. Risk factors for chronic disease in Vietnam: a review of the literature. Prev Chronic Dis. 2013;10, E05.

le Hoi V, Chuc NT, Lindholm L. Health-related quality of life, and its determinants, among older people in rural Vietnam. BMC Public Health. 2010;10:549.

le Hoi V, Thang P, Lindholm L. Elderly care in daily living in rural Vietnam: need and its socioeconomic determinants. BMC Geriatr. 2011;11:81.

Van Minh H, Ng N, Juvekar S, Razzaque A, Ashraf A, Hadi A, et al. Self-reported prevalence of chronic diseases and their relation to selected sociodemographic variables: a study in INDEPTH Asian sites, 2005. Prev Chronic Dis. 2008;5:A86.

Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev. 2011;10:430–9.

General Statistic Office. Result of the Vietnam household living standards survey 2010. In Book Result of the Vietnam household living standards survey 2010 (Editor ed.^eds.). City: General Statistic Office; 2010.

Health Service Delivery Profile, Viet Nam [http://www.wpro.who.int/health_services/service_delivery_profile_vietnam.pdf]

Jerliu N, Toçi E, Burazeri G, Ramadani N, Brand H. Prevalence and socioeconomic correlates of chronic morbidity among elderly people in Kosovo: a population-based survey. BMC Geriatr. 2013;13.

Seal A, Branca F. Health and nutritional status of the elderly in the former Yugoslav Republic of Macedonia In Book Health and nutritional status of the elderly in the former Yugoslav Republic of Macedonia (Editor ed.^eds.). City: Institute of Child Health, London and National Institute of Nutrition, Rome; 2001.

WHO expert consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63.

van Oostrom SH, Picavet HS, de Bruin SR, Stirbu I, Korevaar JC, Schellevis FG, et al. Multimorbidity of chronic diseases and health care utilization in general practice. BMC Fam Pract. 2014;15:61.

Taylor A, Price K, Gill T, Adams R, Pilkington R, Carrangis N, et al. Multimorbidity - not just an older person’s issue. Results from an Australian biomedical study. BMC Public Health. 2010;10:718.

Khanam MA, Streatfield PK, Kabir ZN, Qiu C, Cornelius C, Wahlin Å. Prevalence and patterns of multimorbidity among elderly people in rural Bangladesh: a cross-sectional study. J Health Popul Nutr. 2011;29:406–14.

Marengoni AMDP, Winblad BMDP, Karp AP, Fratiglioni LMDP. Prevalence of chronic diseases and multimorbidity among the elderly population in Sweden. Am J Public Health. 2008;98:1198–200.

Lawson KD, Mercer SW, Wyke S, Grieve E, Guthrie B, Watt GC, et al. Double trouble: the impact of multimorbidity and deprivation on preference-weighted health related quality of life a cross sectional analysis of the Scottish Health Survey. Int J Equity Health. 2013;12:67.

Agborsangaya CB, Lau D, Lahtinen M, Cooke T, Johnson JA. Multimorbidity prevalence and patterns across socioeconomic determinants: a cross-sectional survey. BMC Public Health. 2012;12:201.

Foguet-Boreu Q, Violan C, Roso-Llorach A, Rodriguez-Blanco T, Pons-Vigues M, Munoz-Perez MA, et al. Impact of multimorbidity: acute morbidity, area of residency and use of health services across the life span in a region of south Europe. BMC Fam Pract. 2014;15:55.

Alaba O, Chola L. The social determinants of multimorbidity in South Africa. Int J Equity Health. 2013;12:63.

Banjare P, Pradhan J. Socio-economic inequalities in the prevalence of multi-morbidity among the rural elderly in Bargarh district of Odisha (India). PLoS One. 2014;9(6), e97832.

Schafer I, Hansen H, Schon G, Hofels S, Altiner A, Dahlhaus A, et al. The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. first results from the multicare cohort study. BMC Health Serv Res. 2012;12:89.

Van Minh H, Huong D, Wall S, Chuc N, Byass P. Multilevel analysis of covariation in socioeconomic predictors of physical functioning and psychological well-being among older people in rural Vietnam. BMC Geriatr. 2010;10:7.

Adler NE, Newman K. Socioeconomic disparities in health: pathways and policies. Health Aff (Millwood). 2002;21:60–76.

Ross CE, Wu C. The links between education and health. Am Sociol Rev. 1995;719–745.

Violan C, Foguet-Boreu Q, Roso-Llorach A, Rodriguez-Blanco T, Pons-Vigues M, Pujol-Ribera E, et al. Burden of multimorbidity, socioeconomic status and use of health services across stages of life in urban areas: a cross-sectional study. BMC Public Health. 2014;14:530.