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Multimorbidity and multiple social disadvantage in a New Zealand high-needs free primary healthcare clinic population: a cross-sectional study

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Authors:
Summary:

Using EMR data for 375 patients registered as of 1 November 2017 with a Dunedin free ‘third sector’ primary healthcare clinic, these researchers sought to determine the prevalence of multimorbidity and multiple social disadvantage in relation to age, gender, deprivation and ethnicity. Multimorbidity affected around four-fifths (76.5%) of the cohort and half (49.9%) suffered from long-term physical and mental health comorbidities. Across all ethnicities and deprivation quintiles, the researchers found a high level of multimorbidity that increased with age. Of the 10 most prevalent long-term conditions, 7 were mental health conditions. Over half of the cohort (54.7%) had ≥1 multiple social disadvantage domain recorded.

Comment:
Some good evidence here about the issues for people being served by clinics in ‘highneeds’ communities. I suspect the majority of readers work in these services. As the authors suggest, the current health system is not achieving equity and a re-think on how to best manage the complex medical and social issues with our communities is underway. Hopefully, the review panel has access to these articles.
Reference: N Z Med J. 2019;132(1490):42-51
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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