Gender as a Determinant of Multimorbidity: Findings from the Migrant Health Follow-Up Study (MHFUS)
1
Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), University of the Witwatersrand (School of Public Health), Johannesburg, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
South Africa is experiencing an increase in chronic illness multimorbidity (MM)1, with detrimental individual and public health implications2. Social factors influence the development of MM; and can be leveraged to design healthcare interventions3. South Africa has high rates of rural/urban migration which may impact health outcomes4. However, there is a dearth of studies on internal mobility and health5. This study aims to ascertain the prevalence and determinants of MM in a mobile population.
METHODS:
The study uses panel data from the first four waves of the Migrant Health Follow-Up Study (MHFUS) cohort, which was based on a simple random sample of 18–40-year-olds selected from the Agincourt Health and socio_Demographic Surveillance System platform6. The cohort includes participants residing in the Agincourt study area and those who migrated to destinations outside of it. Following descriptive and bivariate analyses, generalized linear mixed models were used to ascertain the social determinants of multimorbidity.
RESULTS:
At baseline (2018), 3092 participants with a median age of 28 years (IQR=24 – 33) took part in the study, with an almost equal number of male (50.19%) and female (49.81%) participants. Over half of the participants were Agincourt residents (56.95%). At Wave 4 (2022), 6.67 % of participants were multimorbid, with obesity (16.73 %), HIV (13.55%), and hypertension (4.02%) being the most prevalent illnesses in the cohort. Agincourt residents were more likely to become multimorbid than migrants AOR=2.15 (1.54 – 4.05) p<0.001 and gender emerged as a key determinant of MM as women (8.38%) had a higher prevalence of MM than men (4.98%) with 9.72 (4.83 – 19.55) times the odds of MM (p<0.001).
CONCLUSIONS:
Results indicate that women are at a disproportionately higher risk of MM than men. Future interventions should target rural-origin women. Additionally, patients presenting with hypertension or HIV should be screened for other illnesses.
South Africa is experiencing an increase in chronic illness multimorbidity (MM)1, with detrimental individual and public health implications2. Social factors influence the development of MM; and can be leveraged to design healthcare interventions3. South Africa has high rates of rural/urban migration which may impact health outcomes4. However, there is a dearth of studies on internal mobility and health5. This study aims to ascertain the prevalence and determinants of MM in a mobile population.
METHODS:
The study uses panel data from the first four waves of the Migrant Health Follow-Up Study (MHFUS) cohort, which was based on a simple random sample of 18–40-year-olds selected from the Agincourt Health and socio_Demographic Surveillance System platform6. The cohort includes participants residing in the Agincourt study area and those who migrated to destinations outside of it. Following descriptive and bivariate analyses, generalized linear mixed models were used to ascertain the social determinants of multimorbidity.
RESULTS:
At baseline (2018), 3092 participants with a median age of 28 years (IQR=24 – 33) took part in the study, with an almost equal number of male (50.19%) and female (49.81%) participants. Over half of the participants were Agincourt residents (56.95%). At Wave 4 (2022), 6.67 % of participants were multimorbid, with obesity (16.73 %), HIV (13.55%), and hypertension (4.02%) being the most prevalent illnesses in the cohort. Agincourt residents were more likely to become multimorbid than migrants AOR=2.15 (1.54 – 4.05) p<0.001 and gender emerged as a key determinant of MM as women (8.38%) had a higher prevalence of MM than men (4.98%) with 9.72 (4.83 – 19.55) times the odds of MM (p<0.001).
CONCLUSIONS:
Results indicate that women are at a disproportionately higher risk of MM than men. Future interventions should target rural-origin women. Additionally, patients presenting with hypertension or HIV should be screened for other illnesses.
| eISSN: | 2654-1459 |
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