Abstract
Background
There is limited understanding of socioeconomic inequality in multimorbidity in Iran. This study aims to investigate socioeconomic inequality in multimorbidity among adults in western Iran.
Methods
Data from the Ravansar Non-Communicable Disease (RaNCD) cohort study were used in this cross-sectional study. A sample of 10,047 adults aged 35–65 years was analyzed. Principal component analysis was utilized to determine socioeconomic status (SES). The normalized concentration index (CIn) was used to assess the extent of socioeconomic disparities in multimorbidity. Decomposition analysis was conducted to identify and calculate the factors contributing to multimorbidity inequality.
Results
In this study, the prevalence of having at least two NCDs was 9.07%, while the prevalence of having at least three NCDs was 2.87%, and four or more NCDs was 1.25%. The CIn for multimorbidity was − 0.061 (P < 0.001), indicating a higher concentration of multimorbidity among individuals with low SES. Age (52.5%), body mass index (BMI) (29.4%), gender (27.5%), physical activity (25.1%), and SES (15%) were identified as significant factors contributing to the increased inequality in multimorbidity.
Conclusion
The study findings demonstrate a pro-poor disparity in multimorbidity. Age, BMI, gender, physical activity, and SES were highlighted as key factors driving the heightened inequality in multimorbidity. Policy interventions targeting the reduction of socioeconomic disparities in multimorbidity should prioritize low-SES groups, particularly women, obese individuals, and older subjects.