Multimorbidity disease clusters in Aboriginal and non-Aboriginal Caucasian populations in Canada

Abstract

Patterns of multimorbidity, the co-occurrence of two or more chronic diseases, may not be constant across populations. Our study objectives were to compare prevalence estimates of multimorbidity in the Aboriginal population in Canada and a matched non-Aboriginal Caucasian population and identify the chronic diseases that cluster in these groups. We used data from the 2005 Canadian Community Health Survey (CCHS) to identify adult (≥ 18 years) respondents who self-identified as Aboriginal or non-Aboriginal Caucasian origin and reported having 2 or more of the 15 most prevalent chronic conditions measured in the CCHS. Aboriginal respondents who met these criteria were matched on sex and age to non-Aboriginal Caucasian respondents. Analyses were stratified by age (18-54 years and ≥ 55 years). Prevalence was estimated using survey weights. Latent class analysis (LCA) was used to identify disease clusters. A total of 1642 Aboriginal respondents were matched to the same number of non-Aboriginal Caucasian respondents. Overall, 38.9% (95% CI: 36.5%-41.3%) of Aboriginal respondents had two or more chronic conditions compared to 30.7% (95% CI: 28.9%-32.6%) of non-Aboriginal respondents. Comparisons of LCA results revealed that three or four clusters provided the best fit to the data. There were similarities in the diseases that tended to co-occur amongst older groups in both populations, but differences existed between the populations amongst the younger groups. We found a small group of younger Aboriginal respondents who had complex co-occurring chronic diseases; these individuals may especially benefit from disease management programs.