Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis
Abstract
:1. Introduction
2. Methods
2.1. Ethics Approval
2.2. Statistical Analysis
3. Results
3.1. Description of the Social Vulnerability Index in Participants with Multimorbidity
3.2. The Relationship between Social Vulnerability and Number of Chronic Health Conditions
3.3. The Relationship between Chronic Condition Types with the Most Socially Vulnerable State
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variables | N = 301 |
---|---|
Age (years) | 61.0 ± 10.5 |
Female | 160 (53.2) |
BMI (kg/m2) | 31.55 ± 6.41 |
Number of chronic health conditions | 5.01 ± 1.82 |
Prevalence of chronic health conditions: | |
Hyperlipidemia | 235 (78.1) |
Hypertension | 209 (69.4) |
Obese (BMI ≥ 30) | 162 (54.2) |
Chronic musculoskeletal conditions causing pain or limitation | 154 (51.2) |
Diabetes | 149 (49.5) |
Stomach problem (reflux, heartburn, or gastric ulcer) | 111 (36.9) |
Asthma, COPD, or chronic bronchitis | 96 (31.9) |
Depression/anxiety | 91 (30.2) |
Cardiovascular disease (angina, myocardial infarction, atrial fibrillation, poor circulation | 64 (21.3) |
in the lower limbs) | |
Colon problem (irritable bowel, Crohn’s disease, ulcerative colitis, diverticulosis) | 43 (14.3) |
Thyroid disorder | 37 (12.3) |
Arthritis and/or rheumatoid arthritis | 26 (8.6) |
Osteoporosis | 26 (8.6) |
Any cancer in the previous 5 years (including melanoma, but excluding other skin cancer) | 22 (7.3) |
Kidney disease or failure | 20 (6.6) |
Stroke/Transient ischemic attack | 17 (5.6) |
Chronic urinary problem | 14 (4.7) |
Heart failure (including valve problems or replacement) | 11 (3.7) |
Chronic hepatitis | 1 (0.3) |
N = 301 | |
---|---|
Communication to engage in wider community: | |
1. Can speak English or French: | |
No (1 point) | 0 (0) |
Yes (0 point) | 301 (100) |
Living situation: | |
2. Marital status: | |
Single/divorced/widower (1 point) | 104 (34.6) |
Married (0 point) | 197 (65.4) |
Social support: | |
3. If I need help, I have plenty of people I can rely on | |
Answers of “strongly disagree” or “disagree” (1 point) | 21 (7.0) |
Answers of “strongly agree” or “agree” (0 point) | 280 (93.0) |
4. When I feel ill, my family and carers really understand what I am going through | |
Answers of “strongly disagree” or “disagree” (1 point) | 40 (13.3) |
Answers of “strongly agree” or “agree” (0 point) | 260 (86.7) |
5. I have enough friends who help me cope with my health problems | |
Answers of “strongly disagree” or “disagree” (1 point) | 53 (17.7) |
Answers of “strongly agree” or “agree” (0 point) | 247 (82.3) |
6. Overall, I feel well looked after by friends or family | |
Answers of “strongly disagree” or “disagree” (1 point) | 16 (5.3) |
Answers of “strongly agree” or “agree” (0 point) | 285 (94.7) |
Social engagement and leisure: | |
7. During the past four weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)? | |
all of the time (1 point) | 5 (1.7) |
most of the time (0.75 point) | 21 (7.0) |
some of the time (0.50 point) | 57 (18.9) |
a little of the time (0.25 point) | 65 (21.6) |
none of the time (0 point) | 153 (50.8) |
8. I feel like I am actively involved in life | |
Answers of “strongly disagree” or “disagree” (1 point) | 22 (7.3) |
Answers of “strongly agree” or “agree” (0 point) | 278 (92.7) |
9. On most days of the week, I do at least one activity to improve my health | |
Answers of “strongly disagree” or “disagree” (1 point) | 66 (21.9) |
Answers of “strongly agree” or “agree” (0 point) | 235 (78.1) |
10. I do at least one type of physical activity every day for at least 30 minutes | |
Answers of “strongly disagree” or “disagree” (1 point) | 106 (35.2) |
Answers of “strongly agree” or “agree” (0 point) | 195 (64.8) |
11. I have plans to do enjoyable things for myself during the next few days | |
Answers of “strongly disagree” or “disagree” (1 point) | 4 (1.3) |
Answers of “strongly agree” or “agree” (0 point) | 297 (98.7) |
12. On most days of the week, I set aside time for healthy activities | |
Answers of “strongly disagree” or “disagree” (1 point) | 95 (31.6) |
Answers of “strongly agree” or “agree” (0 point) | 206 (68.4) |
13. I walk for exercise, for at least 15 minutes per day, most days of the week | |
Answers of “strongly disagree” or “disagree” (1 point) | 140 (46.5) |
Answers of “strongly agree” or “agree” (0 point) | 161 (53.5) |
Empowerment, life control: | |
14. I try to make the most of my life | |
Answers of “strongly disagree” or “disagree” (1 point) | 5 (1.7) |
Answers of “strongly agree” or “agree” (0 point) | 296 (98.3) |
15. I am doing interesting things in my life | |
Answers of “strongly disagree” or “disagree” (1 point) | 13 (4.3) |
Answers of “strongly agree” or “agree” (0 point) | 288 (95.7) |
16. I feel I have a very good life even when I have health problem | |
Answers of “strongly disagree” or “disagree” (1 point) | 16 (5.3) |
Answers of “strongly agree” or “agree” (0 point) | 285 (94.7) |
17. I do not let my health problems control my life | |
Answers of “strongly disagree” or “disagree” (1 point) | 23 (7.6) |
Answers of “strongly agree” or “agree” (0 point) | 278 (92.4) |
Socioeconomic status: | |
18. Income level | |
Low income (<20000) (1 point) | 56 (19.4) |
Income ≥20000 (0 point) | 232 (80.6) |
19. Education level | |
Did not complete secondary school (1 point) | 68 (22.6) |
Complete secondary school or higher (0 point) | 233 (77.4) |
Variables | Univariate | Multivariable | ||
---|---|---|---|---|
Odds Ratio for Being the Most Socially Vulnerable (95% CI) | p | Adjusted Odds Ratio for Being the Most Socially Vulnerable (95% CI) | p | |
Age | 0.99 (0.97–1.02) | 0.735 | – | – |
Female gender | 1.35 (0.76–2.38) | 0.305 | – | – |
Hypertension | 1.45 (0.76–2.76) | 0.258 | – | – |
Hyperlipidemia | 1.05 (0.53–2.08) | 0.896 | – | – |
Obesity | 2.31 (1.26–4.25) | 0.007 | 2.74 (1.43–5.27) | 0.002 |
Diabetes | 1.16 (0.66–2.04) | 0.605 | – | – |
Cardiovascular disease (angina, myocardial infarction, atrial fibrillation, poor circulation in the lower limbs) | 1.59 (0.83–3.02) | 0.160 | 2.38 (1.17–4.84) | 0.017 |
Heart failure (including valve problems or replacement) | 2.34 (0.66–8.25) | 0.188 | – | – |
Stroke/transient ischemic attack | 1.23 (0.39–3.90) | 0.731 | – | – |
Chronic lung diseases | 1.65 (0.93–2.95) | 0.090 | – | – |
Depression/anxiety | 2.38 (1.34–4.26) | 0.003 | 2.28 (1.25–4.15) | 0.007 |
Thyroid disorder | 1.31 (0.58–2.95) | 0.513 | – | – |
Chronic musculoskeletal conditions causing pain or limitation | 1.07 (0.61–1.87) | 0.821 | – | – |
Arthritis and/or rheumatoid arthritis | 1.20 (0.46–3.13) | 0.709 | – | – |
Osteoporosis | 2.27 (0.96–5.38) | 0.062 | – | – |
Any cancer in the previous 5 years (including melanoma, but excluding other skin cancer) | 0.37 (0.08–1.64) | 0.192 | – | – |
Kidney disease or failure | 0.98 (0.32–3.05) | 0.976 | – | – |
Chronic urinary problem | 1.08 (0.29–3.99) | 0.912 | – | – |
Stomach problem (reflux, heartburn, or gastric ulcer) | 0.96 (0.53–1.72) | 0.883 | – | – |
Colon problem (irritable bowel, Crohn’s disease, ulcerative colitis, diverticulosis) | 0.88 (0.39–2.02) | 0.770 | – | – |
Chronic hepatitis | N/A due to small number (n = 1) | – | – |
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Share and Cite
Nguyen, T.N.; Ngangue, P.; Bouhali, T.; Ryan, B.L.; Stewart, M.; Fortin, M. Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis. Int. J. Environ. Res. Public Health 2019, 16, 1244. https://doi.org/10.3390/ijerph16071244
Nguyen TN, Ngangue P, Bouhali T, Ryan BL, Stewart M, Fortin M. Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis. International Journal of Environmental Research and Public Health. 2019; 16(7):1244. https://doi.org/10.3390/ijerph16071244
Chicago/Turabian StyleNguyen, Tu N., Patrice Ngangue, Tarek Bouhali, Bridget L. Ryan, Moira Stewart, and Martin Fortin. 2019. "Social Vulnerability in Patients with Multimorbidity: A Cross-Sectional Analysis" International Journal of Environmental Research and Public Health 16, no. 7: 1244. https://doi.org/10.3390/ijerph16071244