More, but less lethal diseases among younger generations in Catalonia
A recently published study conducted by the Centre for Demographic Studies (CED), the UAB and the Pompeu Fabra University detects that the rate of accumulation of chronic diseases tends to accelerate among younger generations, but that the lethalness of these diseases has decreased. The researchers wonder if the cause is the deterioration of health in young people, the healthcare system which has increased its capacity to detect chronic diseases, or if it is due to a change in individuals' attitudes towards health.
Among the younger generations, diseases related to mental health and those of the musculoskeletal system stand out in particular. The former are one of the factors that have contributed most to the increase in multimorbidity in Catalonia.
Catalonia is one of the regions with the highest life expectancy in the world. It currently stands at 86 years for women and 81 for men, the highest value ever achieved in the country. Despite this unprecedented success, after conducting this study researchers believe that there are a whole series of challenges associated with increasing longevity that are imperative to address. One of them is the increase in multimorbidity, that is, the fact that more and more individuals are affected by two or more chronic diseases simultaneously and who, therefore, may require and consume more healthcare resources than average.
The study Recent Multimorbidity Trends in Catalonia: Are Younger Generations Ageing Worse?, published in the latest edition of the journal Perspectives Demogràfiques and carried out by researchers Iñaki Permanyer, Jordi Gumà, Sergi Trias-Llimós and Aïda Solé Auró, from the UAB, the Centre for Demographic Studies and the Pompeu Fabra University, explores the extent to which improvements in survival have been accompanied by a decrease or increase in chronic diseases.
More specifically, the researchers analysed the trends in what is known as complex multimorbidity (the proportion of the population suffering from three or more chronic diseases simultaneously) among members of different generations in Catalonia over recent years.
Complex multimorbidity was measured by comparing the health status of different Catalan generations between 2010 and 2021 based on the extensive HEALIN Cohort database, created using Catalonia's health registries and which follows the evolution of more than 1.5 million individuals since 2005.
According to this study, younger generations tend to develop chronic diseases more quickly than their predecessors at the same age. For example, at age 25, 7.9% of women born between 1980 and 1989 suffered from complex multimorbidity, compared to 16.7% observed among women born a decade later (1990–1999) at the same age.
This pattern is not exclusive to these two generations but is repeated systematically for all generations and ages for which this type of comparison can be made.
The results show how people belonging to older generations are more affected by degenerative diseases. Metabolic diseases, those of the circulatory system and musculoskeletal diseases stand out in particular.
In contrast, among the younger generations, diseases related to mental health and those of the musculoskeletal system stand out. The former are one of the factors that have contributed most to the increase in multimorbidity in Catalonia.
These patterns have also been observed in other European Union countries, the United Kingdom and the United States of America, and are a cause for concern for societies that aspire to achieve healthy longevity. For CED researcher Iñaki Permanyer, one of the authors of the study, "unfortunately, we still do not have much knowledge about what social and/or biological factors prevent young people from reaching their maximum health potential."
What could be the causes?
The study points out that the causes of this phenomenon could be because, on the one hand, the health of certain population groups could be worsening, such as that of the immigrant population or that of individuals with fewer socioeconomic resources.
On the other hand, the apparent worsening of health in younger generations could be due to a growing tendency towards overdiagnosis by healthcare professionals, possibly spurred by technological advances, such as imaging diagnostics.
Finally, people's attitudes towards health may have changed in recent years and this may have made individuals more likely to access healthcare services when early or mild symptoms appear.
Although the presence of multimorbidity at increasingly younger ages is not good news, the results of the study suggest that the survival prospects of the multimorbid population have improved over time. In other words, although we are faced with a higher prevalence of multimorbidity, its lethality seems to have decreased.
Whatever the reasons, the results of this study point to an increase in the demand for care in public health systems. For the authors of the study, "this scenario poses a significant challenge that requires the design of public policies based on scientific evidence".
Article published in the journal Perspectives Demogràfiques: https://ced.cat/difusio/butlleti-perspectives-demografiques