EPIDEMIOLOGY OF MULTIMORBIDITY OF CHRONIC NONCOMMUNICABLE DISEASES WITHIN THE BRAZILIAN ADULT GENERAL POPULATION

Introduction and objective: Multimorbidity incrementally worsens health compared with one disease. People in low- and middle-income countries develop diseases at younger ages and suffer for longer, but epidemiology of multimorbidity in those countries remains under-researched. The present study aimed to explore the multimorbidity of self-reported chronic noncommunicable diseases (NCDs) in Brazil. Methods: The National Health Survey 2013 data from adults in macro-regions of Brazil was used. Based on 60,202 individuals who responded the individual questionnaire, we calculated prevalence rates of physical-physical (≥2 physical diseases) and physical-mental (≥1 mental and ≥1 physical disease) multimorbidities. Multivariate Poisson regression analyses were conducted to explore demographic and lifestyle factors associated with the two types of multimorbidity. Results and conclusions: 49.8% (95%CI 48.9-60.5) of the sample had one or more morbidities, and 25.0% (95%CI 24.3-25.8) were multimorbid. 22.9% (95%CI 22.2-23.5) and 6.1% (95%CI 5.7-6.6) had physical-physical and physical-mental multimorbidities respectively. Being female, increasing age and body mass index, living in the South /Southeast, previously smoking, frequently watching television, exercising in the past 3 months were positively associated with physical-physical multimorbidity. Higher educational levels, not living with a spouse/partner and eating fruits/vegetables were negatively associated with physical-physical multimorbidity. Physical-mental multimorbidity was most likely in females, obese people, aged 45-84 years, those not living in the North, those who smoke(ed) and who watch television frequently or not at all. Multimorbidity of NCDs is common in Brazil and associated with demographic and lifestyle factors. Our findings have implications for resource allocation for research and primary healthcare in Brazil.