Abstract
Background: Multimorbidity, the presence of ≥2 chronic conditions, is a major contributor to health inequalities, with significant impact on health care costs. This study aims to examine the differences in chronic physical and mental health multimorbidity between Aboriginal and Torres Strait Islander people and non-Indigenous Australians, and the effect of multimorbidity on health service use and work productivity amongst Aboriginal and non-Indigenous Australians.Methods: This study conducted cross-sectional analyses of the Household, Income, and Labour Dynamics in Australia Wave 17, examining a nationally representative sample of 16,749 respondents aged 18 years and above. We applied multivariable linear and logistic regressions to examine the association between multimorbidity and self-reported health, health service use, and employment productivity.Results: Aboriginal respondents reported a higher prevalence of multimorbidity (24.2%) compared to non-Indigenous Australians (20.7%), and the prevalence of co-existing mental and physical multimorbidity was almost twice as high (16.1% vs 8.1%). Multimorbidity was associated with higher health service use (any overnight admission: AOR 1.52), reduced employment productivity (days sick leave: coef. 0.25), and lower perceived health status (SF6D score: coef. -0.04). These associations are similar in both Aboriginal and non-Indigenous populations.Conclusions: Multimorbidity prevalence was greater among Aboriginal and Torres Strait Islanders compared to the non-Indigenous population, likely driven by the greater prevalence of mental health conditions reported by the Aboriginal sample. Strategies for better management of mental and physical multimorbidity would not only reduce health care costs among those affected but may contribute to a reduction in health inequalities in Australia.
Modelling mental health service needs of Aboriginal and Torres Strait Islander peoples: a review of existing evidence and expert consensus
