Epidemiology of physical-mental multimorbidity and its impact among Aboriginal and Torres Strait Islander in Australia: a cross-sectional analysis of a nationally representative sample

Objectives This study aimed to examine the differences in multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and the effect of multimorbidity on health service use and work productivity. Setting Cross-sectional sample of the Household, Income and Labour Dynamics in Australia wave 17. Participants A nationally representative sample of 16 749 respondents aged 18 years and above. Outcome measures Multimorbidity prevalence and pattern, self-reported health, health service use and employment productivity by Indigenous status. Results Aboriginal respondents reported a higher prevalence of multimorbidity (24.2%) compared with non-Indigenous Australians (20.7%), and the prevalence of mental-physical multimorbidity was almost twice as high (16.1% vs 8.1%). Multimorbidity pattern varies significantly among the Aboriginal and non-Indigenous Australians. Multimorbidity was associated with higher health service use (any overnight admission: adjusted OR=1.52, 95% CI=1.46 to 1.58), reduced employment productivity (days of sick leave: coefficient=0.25, 95% CI=0.19 to 0.31) and lower perceived health status (SF6D score: coefficient=-0.04, 95% CI=-0.05 to -0.04). These associations were found to be comparable in both Aboriginal and non-Indigenous populations. Conclusions Multimorbidity prevalence was significantly greater among Aboriginal and Torres Strait Islanders compared with the non-Indigenous population, especially mental-physical multimorbidity. Strategies are required for better prevention and management of multimorbidity for the aboriginal population to reduce health inequalities in Australia.

Automated summary

This study examines the differences in multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and how it affects health service use and work productivity. The results show that Aboriginal respondents have a higher prevalence of multimorbidity, especially mental-physical multimorbidity. Multimorbidity is associated with increased health service use, reduced employment productivity, and lower perceived health status. These associations hold true for both Aboriginal and non-Indigenous populations.