Country of birth, country of residence and multimorbidity

Chronic diseases tend to accumulate into multimorbidity, with severe implications for health care needs, costs, and economic productivity, as well as for quality and duration of life. The accumulation of diseases may result from exposures and experiences concurrently and earlier in life. Objectives: We investigated multimorbidity among immigrant and native-born people across Europe, examining the importance of country of birth and country of residence for multimorbidity. Methods: We used the Survey of Health, Aging, and Retirement in Europe (SHARE), a cross-national, multidisciplinary panel survey representative of older adults in Europe (n=112,612 native-born and 11,266 foreign-born in 2002-2017). Self-reported chronic conditions used to define multimorbidity were: heart attack, high blood pressure, high blood cholesterol, stroke, diabetes, chronic lung disease, cancer, stomach ulcer, Parkinson’s disease, cataracts, and hip fracture. We used multinomial logistic regression to identify patterns of multimorbidity and assessed interaction between country of birth and of residence. Results: More than a third of people living in Europe had multimorbidity, including 37.7% of migrants and 35.1% of native-born individuals. People living in Eastern Europe had the highest prevalence of multimorbidity. Across countries, compared to native-born people, multimorbidity was higher among migrants from Eastern Europe (OR:1.41) and Central and West Asia (OR:1.16), and lower among migrants from Asia (OR:0.66). Country of birth modified associations between county of residence and multimorbidity. Discussion: Country of birth and country of residence are each associated with multimorbidity, suggesting that early-life conditions can have different implications for health depending on later-life.