Worsening trends in disease accumulation and health inequalities among middle-aged and older adults in Scotland: cross-cohort analysis using health-linked data from the Scottish Longitudinal Study

Eloi Ribe , University of Southampton
Genevieve Cezard, University of St Andrews
Alan D. Marshall, University of Edinburgh
Katherine Keenan, University of St Andrews

In the United Kingdom, rising prevalence of multimorbidity is coinciding with stagnation in life expectancy. We investigate patterns of disease accumulation and how they vary by birth cohort, social and environmental inequalities in Scotland, a country which has long suffered from excess mortality and poorer health outcomes relative to its neighbours. Using a dataset which links census data from 1991, 2001 and 2011 to disease registers and hospitalisation data, we follow cohorts of adults aged 30-69 years for 18 years. We model physical and mental disease accumulation using linear mixed effects models. Younger born cohorts experience higher levels of chronic disease accumulation compared to their predecessors at the same ages. Moreover, in more recently born cohorts we observe socioeconomic status disparities emerging earlier in the life course, which widen over time and with every successive cohort. Patterns of chronic conditions are also changing, and the most common diseases suffered by later born cohorts are cancer, hypertension, asthma, drug and alcohol problems and depression.

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 Presented in Session 29. Flash session Morbidity