Multimorbidity: You’ve done too much, much too young

By Dave Lemon

So then, multimorbidity, what is it? Well first of all it doesn’t mean you get to die more than once – sorry…Wait, do I mean sorry here? Anyway, what it does mean is that anyone with a multimorbidity (sometimes called co-morbidity) is living with more than one condition at a time, basically all that fun you had when you were younger is catching up with you! For example, a person could have hypertension and diabetes, hearing loss and dementia, or maybe depression and heart disease. Clearly this isn’t exactly a brilliant state to be in as managing several conditions at once can make day-to-day life challenging to say the least. Not only that, but treating them becomes difficult too, as the ideal medication for helping one condition may cause problems with another one.

Because of the complexities involved in living with and treating multimorbidities it is important for us to understand where and in whom they are most likely to occur. If we can do this, we are better able to help the health and social care system target its resources towards communities where they are more common. Doing this will not only help people to manage their conditions but could help to prevent them occurring in the first place.

To do this we can look at a dataset recently produced by Public Health England (using a methodology from Barnet et al1) that identifies the proportion (prevalence) of people living with two or more (2+), three or more (3+), or a combintion of physical and mental health multimorbidites.

Using this we find that around 38% of people across Bournemouth, Dorset and Poole are living with 2 or more conditions. Whilst this sounds like a lot, it is similar to the England average. However, for all three types of mulitmorbidity there are differences across this combined authority area, with Bournemouth and Weymouth & Portland having the highest prevalence of multimorbidities and East Dorset the lowest. This is not that surprising as Bournemouth and Weymouth & Portland are home to some of the poorest communities in the area, and we know that health is related to prosperity. We also find that the prevalence of both physical and mental health conditions is higher in women, and that, as we might expect, the multimorbidity prevalence increases with age.

So then, what we are doing about it? Well, following the clinical service review, and in line with the sustainability and transformation plan, there is a programme of work looking to improve services for frail people, many of who will have multimorbidities. But, of course, this being a public health blog I can’t leave without saying that the best way to avoid the complications of multimorbidities is to not get any of the conditions in the first place: so, drink less alcohol, eat less sugar, and exercise more…blah, blah, blah, you know the drill.

If you want to know more about this then have a look at our multimorbidity dashboard here.

Thanks for reading!

1. Barnett, K. et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet 380, 37–43 (2012).

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