Epidemiology of physical-mental multimorbidity and its impact among Aboriginal and Torres Strait Islander in Australia: a cross-sectional analysis of a nationally representative sample

Abstract

Objectives: This study aimed to examine the differences in multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and the effect of multimorbidity on health service use and work productivity.

Setting: Cross-sectional sample of the Household, Income and Labour Dynamics in Australia wave 17.

Participants: A nationally representative sample of 16 749 respondents aged 18 years and above.

Outcome measures: Multimorbidity prevalence and pattern, self-reported health, health service use and employment productivity by Indigenous status.

Results: Aboriginal respondents reported a higher prevalence of multimorbidity (24.2%) compared with non-Indigenous Australians (20.7%), and the prevalence of mental-physical multimorbidity was almost twice as high (16.1% vs 8.1%). Multimorbidity pattern varies significantly among the Aboriginal and non-Indigenous Australians. Multimorbidity was associated with higher health service use (any overnight admission: adjusted OR=1.52, 95% CI=1.46 to 1.58), reduced employment productivity (days of sick leave: coefficient=0.25, 95% CI=0.19 to 0.31) and lower perceived health status (SF6D score: coefficient=-0.04, 95% CI=-0.05 to -0.04). These associations were found to be comparable in both Aboriginal and non-Indigenous populations.

Conclusions: Multimorbidity prevalence was significantly greater among Aboriginal and Torres Strait Islanders compared with the non-Indigenous population, especially mental-physical multimorbidity. Strategies are required for better prevention and management of multimorbidity for the aboriginal population to reduce health inequalities in Australia.

Keywords: Epidemiology; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; Health economics; Health policy; Public health.

Figure 1

The prevalence of multimorbidity by age and Indigenous status.

Figure 2

Impact of multimorbidity on health service use, work productivity and self-reported health by Indigenous status. All regression models were adjusted for sex, income quantiles, education level, employment, country of birth, marital status, state, residential location, age and private health insurance. GP, general practitioner.