O impacto da educação na ocorrência da multimorbidade.

Abstract

This study aimed to estimate the effect of educational attainment on the occurrence of multimorbidity in an adult population in the city Rio de Janeiro. A cross-sectional analysis of the Pró-Saúde Study baseline with 3092 participants was done and the prevalence of multimorbidity was estimated according to sex, age, tobacco exposure, obesity and educational level. The exposure was educational inequality between the participants and the outcome was the presence of multimorbididity, defined as the presence of two or more chronic conditions. The relationship between education and occurrence of multimorbidity was estimated by odds ratio and by relative and slope index of inequality, in order to quantify the degree of health inequality of multimorbidity in this population. Age, gender, tobacco use and obesity had a direct and positive relationship with the outcome, and tobacco use and obesity also showed a direct relationship with poorer educational level. There was a monotonic and inverse linear trend between educational level and the presence of multimorbididity in the general population, with a two fold chance for the occurrence of multimorbididity between the extremes of schooling in the general population. Posterior analyzes stratified by sex, this trend was seen only among women, in which multimorbididity was more prevalent. Excess of prevalence between the extremes of schooling measured in the general population by the slope index of inequality was 15% among those at the lowest level, with women being the main victims of this excess. These results provide important evidences in the field of multimorbididity, inequalities in health and the role it has on the development of multiple morbidities lifelong.