Evidence map›Paper›PMID 33158940›Full record

SynthesisJournal of epidemiology and community health2021

Household and area-level social determinants of multimorbidity: a systematic review.

Elizabeth Ingram, Sarah Ledden, Sarah Beardon, Manuel Gomes, Sue Hogarth, Helen McDonald, David P Osborn, Jessica Sheringham

Open access · hybridAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of epidemiology and community health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 6 pooled it
6.4field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 6 syntheses or guidelines pooled it, 106 citations in OpenAlex.

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  20. Beyond Isolation: Social Determinants of Mental Health among Single-Person Households in Urban Contexts.Journal of urban health : bulletin of the New York Academy of Medicine · 2025
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14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Elizabeth IngramDepartment of Applied Health Research, University College London, London, UK e.ingram.17@ucl.ac.uk.ORCID 0000-0002-0354-4551
Sarah LeddenDivision of Psychiatry, University College London, London, UK.
Sarah BeardonDepartment of Applied Health Research, University College London, London, UK.
Manuel GomesDepartment of Applied Health Research, University College London, London, UK.
Sue HogarthLondon Boroughs of Camden and Islington, London, UK.
Helen McDonaldLondon School of Hygiene and Tropical Medicine, London, UK.
David P OsbornDivision of Psychiatry, University College London, London, UK.
Jessica SheringhamDepartment of Applied Health Research, University College London, London, UK.
University College London · GBLondon Borough of Camden · GBLondon School of Hygiene & Tropical Medicine · GB

Funding

Department of Health PD-SPH-2015-10025
6 · The paper itself

Abstract

backgroundNo clear synthesis of evidence examining household and area-level social determinants of multimorbidity exists. This study aimed to systematically review the existing literature on associations between household and area-level social determinants of health (SDoH) and multimorbidity prevalence or incidence in the general population.

methodsSix databases (MedLine, EMBASE, PsychINFO, Web of Science, CINAHL Plus and Scopus) were searched. The search was limited to peer-reviewed studies conducted in high-income countries and published in English between 2010 and 2019. A second reviewer screened all titles with abstracts and a subset of full texts. Study quality was assessed and protocol pre-registered (CRD42019135281).

results41 studies spanning North America, Europe and Australasia were included. Household income and area-level deprivation were the most explored with fairly consistent findings. The odds of multimorbidity were up to 4.4 times higher for participants with the lowest level of income compared with the highest level. Those living in the most deprived areas had the highest prevalence or incidence of multimorbidity (pooled OR 1.42, 95% CI 1.41 to 1.42). Associations between deprivation and multimorbidity differed by age and multimorbidity type. Findings from the few studies investigating household tenure, household composition and area-level rurality were mixed and contradictory; homeownership and rurality were associated with increased and decreased multimorbidity, while living alone was found to be associated with a higher risk of multimorbidity and not associated.

conclusionImproving our understanding of broader social determinants of multimorbidity-particularly at the household level-could help inform strategies to tackle multimorbidity.

Indexed as

MultimorbiditySocial Determinants of HealthHumansIncomePrevalenceSocial FactorsDeprivationEpidemiology of chronic non communicablenon-communicable diseasesHealth inequalitiesPublic healthSocial inequalities

Identifiers

PMID33158940
PMCPMC7892392
OpenAlexW3097781180

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.