Characteristics of participants and prevalence of multimorbidity (%), Manaus metropolitan region, Brazil, 2015 (n=4 001)*
| Variable | n (%) | Any chronic disease % (95% CI) | P values | Mean number of chronic health problems (95% CI) | Multimorbidity % (95% CI) | |||
| ≥2 | P values | ≥3 | P values | |||||
| Overall | 57.2 (55.6 to 58.7) | 1.17 (1.1 to 1.2) | 29.0 (27.6 to 30.5) | 15.2 (14.1 to 16.4) | ||||
| Sex | <0.001 | <0.001 | <0.001 | |||||
| Male | 1888 (47.2) | 52.1 (49.8 to 54.0) | 0.9 (0.8 to 0.9) | 21.5 (19.7 to 23.4) | 9.3 (8.1 to 10.7) | |||
| Female | 2113 (52.7) | 61.8 (59.7 to 63.8) | 1.39 (1.3 to 1.4) | 35.8 (33.8 to 37.8) | 20.5 (18.8 to 22.3) | |||
| Age (years) | <0.001 | <0.001 | <0.001 | |||||
| 18–24 | 838 (20.8) | 37.0 (33.8 to 40.3) | 0.5 (0.4 to 0.5) | 9.8 (7.9 to 12.0) | 3.5 (2.5 to 5.0) | |||
| 25–34 | 1152 (28.7) | 49.6 (46.7 to 52.5) | 0.8 (0.7 to 0.8) | 18.6 (16.4 to 20.9) | 6.9 (5.6 to 8.5) | |||
| 35–44 | 843 (21.1) | 61.0 (57.6 to 64.2) | 1.1 (1.0 to 1.2) | 30.0 (27.0 to 33.2) | 12.7 (10.6 to 15.1) | |||
| 45–59 | 772 (19.3) | 71.4 (68.0 to 74.4) | 1.7 (1.6 to 1.8) | 46.6 (13.1 to 50.2) | 28.1 (25.1 to 31.4) | |||
| ≥60 | 396 (9.9) | 86.1 (82.3 to 89.2) | 2.5 (2.3 to 2.7) | 63.5 (58.6 to 68.1) | 44.4 (39.6 to 49.3) | |||
| Marital status | <0.001 | <0.001 | <0.001 | |||||
| Single | 2173 (54.2) | 51.5 (49.3 to 53.5) | 0.9 (0.8 to 0.9) | 20.8 (19.1 to 22.6) | 10.3 (8.8 to 11.3) | |||
| Married | 1409 (35.2) | 62.0 (59.4 to 64.5) | 1.3 (1.2 to 1.4) | 35.3 (32.9 to 37.9) | 19.6 (17.6 to 21.8) | |||
| Separated/divorced | 260 (6.5) | 65.6 (59.6 to 71.2) | 1.5 (1.3 to 1.7) | 42.6 (36.8 to 48.7) | 19.9 (15.5 to 25.2) | |||
| Widower | 159 (4.0) | 79.3 (72.3 to 84.9) | 2.2 (1.9 to 92.5) | 63.1 (55.3 to 70.2) | 39.9 (32.5 to 47.7) | |||
| Skin colour | <0.001 | 0.0021 | 0.0016 | |||||
| White/yellow | 774 (19.3) | 51.7 (48.2 to 55.2) | 1.1 (1.0 to 1.2) | 27.1 (24.1 to 30.4) | 15.7 (13.3 to 18.5) | |||
| Black/brown/indigenous | 3227 (80.5) | 58.5 (56.8 to 60.2) | 1.2 (1.1 to 1.2) | 29.5 (27.9 to 31.1) | 15.1 (13.9 to 16.4) | |||
| Schooling level | <0.001 | <0.001 | <0.001 | |||||
| High education or above† | 158 (3.9) | 57.1 (49.3 to 64.6) | .2 (1.0 to 1.5) | 32.6 (25.7 to 40.4) | 16.1 (11.7 to 23.7) | |||
| High school | 1903 (47.5) | 51.0 (48.8 to 53.3) | 0.9 (0.8 to 1.0) | 22.5 (20.7 to 24.5) | 9.0 (7.8 to 10.4) | |||
| Middle school | 649 (16.2) | 50.0 (46.2 to 53.8) | 0.9 (0.8 to 1.0) | 21.1 (18.2 to 24.4) | 10.7 (0.8 to 13.3) | |||
| Elementary school or less | 1291 (32.2) | 69.9 (67.4 to 72.4) | <0.001 | 1.7 (1.6 to 1.8) | 42.1 (39.5 to 44.8) | 26.5 (24.1 to 28.9) | ||
| Economic classification‡ | <0.001 | <0.001 | ||||||
| A–B | 629 (15.7) | 51.2 (47.2 to 55.1) | 0.9 (0.8 to 1.1) | 24.6 (21.4 to 28.2) | 11.1 (8.8 to 13.8) | |||
| C | 2285 (57.1) | 55.5 (53.4 to 57.5) | 1.0 (1.0 to 1.1) | 26.1 (24.3 to 27.9) | 13.2 (11.9 to 14.7) | |||
| D–E | 1087 (27.2) | 64.3 (61.4 to 67.2) | 1.5 (1.4 to 1.6) | 37.7 (34.9 to 40.7) | 21.8 (19.4 to 24.3) | |||
| Occupation | <0.001 | <0.001 | <0.001 | |||||
| Formal job | 761 (19.0) | 52.7 (49.1 to 56.2) | 0.9 (0.8 to 1.0) | 22.7 (19.8 to 25.8) | 9.2 (7.3 to 11.5) | |||
| Informal job | 1149 (28.7) | 55.9 (53.0 to 58.7) | 1.0 (1.0 to 1.1) | 27.6 (25.1 to 30.3) | 12.9 (11.1 to 15.0) | |||
| Retired | 315 (7.9) | 79.2 (74.3 to 83.3) | 2.4 (2.2 to 2.6) | 60.5 (55.4 to 65.8) | 43.4 (38.0 to 49.0) | |||
| Student/housewife | 1199 (29.8) | 55.0 (52.2 to 57.8) | 1.1 (1.1 to 1.2) | 29.0 (25.5 to 31.6) | 15.8 (13.8 to 18.0) | |||
| Unemployed | 577 (14.4) | 58.3 (54.2 to 62.3) | 1.0 (0.9 to 1.1) | 23.1 (19.8 to 26.7) | 11.2 (8.9 to 14.1) | |||
| Private health insurance | 0.348 | 0.697 | 0.616 | |||||
| Yes | 523 (13.0) | 55.3 (51.0 to 59.5) | 1.0 (0.9 to 1.29 | 28.0 (24.6 to 32.3) | 14.5 (11.7 to 17.8) | |||
| No§ | 3478 (87.0) | 57.5 (55.8 to 59.1) | 1.2 (1.1 to 1.2) | 29.0 (27.6 to 30.7) | 15.3 (14.2 to 16.6) | |||
| Health status | <0.001 | <0.001 | <0.001 | |||||
| Very good | 471 (11.9) | 30.8 (26.8 to 35.2) | 0.4 (0.47 to 0.5) | 9.7 (7.3 to 12.7) | 3.1 (1.9 to 5.1) | |||
| Good | 2175 (54.3) | 50.4 (48.3 to 52.5) | 0.8 (0.8 to 0.9) | 20.3 (18.7 to 22.0) | 7.9 (6.8 to 9.1) | |||
| Fair | 1108 (27.7) | 75.1 (72.5 to 77.5) | 1.7 (1.6 to 1.8) | 45.2 (42.3 to 48.1) | 26.0 (23.5 to 28.6) | |||
| Bad | 193 (4.8) | 88.6 (83.2 to 93.3) | 2.6 (2.4 to 2.9) | 68.4 (61.6 to 74.6) | 50.3 (43.3 to 57.3) | |||
| Very bad | 54 (1.3) | 81.5 (68.9 to 89.7) | 3.6 (3.0 to 4.3) | 77.7 (64.8 to 86.9) | 70.3 (57.0 to 81.0) | |||
| City | <0.001 | <0.001 | <0.001 | |||||
| Capital | 3479 (86.8) | 58.4 (56.8 to 60.0) | 1.2 (1.1 to 1.2) | 30.2 (28.7 to 31.7) | 15.8 (14.6 to 17.1) | |||
| Countryside | 522 (13.1) | 49.2 (44.9 to 53.5) | 0.9 (0.8 to 1.0) | 21.5 (18.2 to 25.3) | 11.3 (0.8 to 14.3) | |||
| Health reference¶ | <0.001 | <0.001 | <0.001 | |||||
| Yes | 2434 (60.7) | 62.3 (60.3 to 64.2) | 1.3 (1.2 to 1.4) | 34.4 (31.5 to 36.3) | 18.7 (17.1 to 20.3) | |||
| No | 1567 (39.2) | 49.4 (46.9 to 51.9) | 0.9 (0.8 to 0.9) | 20.8 (18.9 to 22.9) | 9.8 (17.2 to 20.3) | |||
| Physician visit | <0.001 | <0.001 | <0.001 | |||||
| Yes | 3066 (76.5) | 60.8 (59.0 to 62.5) | 1.2 (1.2 to 1.3) | 32.1 (30.5 to 33.8) | 17.4 (16.1 to 18.8) | |||
| No | 935 (23.4) | 45.5 (42.3 to 48.7) | 0.8 (0.7 to 0.9) | 18.9 (16.5 to 21.5) | 8.2 (6.6 to 10.2) | |||
| Hospitalisation | <0.001 | <0.001 | <0.001 | |||||
| Yes | 273 (7.0) | 72.9 (67.3 to 77.8) | 1.2 (1.2 to 1.3) | 47.2 (41.4 to 53.2) | 28.1 (23.1 to 33.8) | |||
| No | 3728 (93.0) | 56.1 (67.3 to 77.8) | 0.8 (0.7 to 0.9) | 27.7 (26.3 to 29.2) | 14.3 (13.2 to 15.4) | |||
| Dengue | 0.002 | <0.001 | <0.001 | |||||
| Yes | 281 (7.0) | 65.9 (60.1 to 71.2) | 1.6 (1.4 to 1.8) | 44.2 (38.5 to 50.1) | 27.6 (22.7 to 33.1) | |||
| No | 3720 (93.0) | 56.5 (54.9 to 58.1) | 1.1 (1.0 to 1.1) | 27.9 (26.5 to 29.3) | 14.3 (13.2 to 15.5) | |||
| Malaria | 0.420 | 0.122 | 0.014 | |||||
| Yes | 234 (5.9) | 54.6 (48.2 to 60.9) | 1.3 (1.1 to 1.5) | 33.5 (27.7 to 39.8) | 20.8 (16.1 to 26.5) | |||
| No | 3767 (94.0) | 57.3 (0.55 to 0.58) | 1.1 (1.1 to 1.2) | 28.8 (27.3 to 30.2) | 14.9 (13.8 to 16.0) | |||
| Medical attention | <0.001 | 0.048 | 0.531 | |||||
| Primary | 1208 (30.2) | 60.8 (58.0 to 63.5) | 1.2 (1.1 to 1.3) | 29.9 (27.3 to 32.5) | 15.2 (13.3 to 17.3) | |||
| Secondary | 598 (14.9) | 62.3 (58.3 to 66.1) | 1.3 (1.2 to 1.5) | 33.0 (29.4 to 36.9) | 18.9 (15.9 to 22.2) | |||
| Tertiary | 1886 (47.2) | 54.0 (51.8 to 56.3) | 1.1 (1.0 to 1.2) | 27.7 (25.7 to 29.8) | 14.3 (12.8 to 15.9) | |||
| Others | 309 (7.7) | 52.7 (47.2 to 58.3) | 1.0 (0.9 to 1.2) | 26.2 (21.6 to 31.4) | 14.2 (10.7 to 18.5) | |||
Physician visit, hospitalisation, dengue and malaria in last 12 months.
*Descriptive statistics using simple frequency and Pearson’s χ2 test.
†Tertiary education or higher.
‡Average household income in 2015: A–B, US$6500–US$1419; C, US$463–US$772; D–E, US$205.
§People who use the public health service.
¶Seeking the same healthcare service when in need of attendance.