ArticleAging and disease2024
A longitudinal Analysis of the Association between Socioeconomic Position and Multimorbidity in the European Prospective Investigation into Cancer and Nutrition Study.
Article in Aging and disease, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Proteomics of multimorbidity progression across cardiometabolic diseases and cancer in a multinational cohort.Cardiovascular diabetology · 2026Article
- Does lifestyle explain the relationship between socioeconomic position and multimorbidity of cancer and cardiometabolic diseases? A mediation analysis applied to the European Prospective Investigation into Cancer and Nutrition.Journal of epidemiology and community health · 2025Article
Corrections and comments
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Authors and funding
33 authors.
Funding
Abstract
The association between socioeconomic position (SEP) and non-communicable diseases (NCDs) is well established, but its role in driving multimorbidity remains unclear. Multimorbidity, defined as the co-occurrence of more than one chronic condition, is linked to higher mortality and reduced quality of life. This study investigates the association between SEP and multimorbidity using data from the European Prospective Investigation into Cancer and Nutrition (EPIC). Incident cases of cancer, type 2 diabetes (T2D), and cardiovascular diseases (CVDs) were analysed alongside lifestyle factors such as smoking status, alcohol intake, body mass index (BMI), physical activity and diet. Multimorbidity was defined as the presence of at least two of the studied NCDs. SEP was assessed using the Relative Index of Inequality (RII) and categorized into high, medium, and low SEP. The cohort included 277 302 participants (60.7% women) from seven countries, enrolled between 1992-2000 and followed until the first diagnosis, end of follow-up (31/12/2007), or death. For transitions to multimorbidity, follow-up extended from the first diagnosis to the second diagnosis, end of follow-up, or death. Multistate models were used to examine the nine possible transitions to first diagnoses and multimorbidity combinations. Lifestyle factors were risk factors for all the transitions, except alcohol intake. In the main model, not stratified by sex, low SEP was associated with higher risks of progressing from cancer to CVD (Hazard Ratio (HR): 1.23, CI: 1.02-1.50), CVD to T2D (HR: 1.35, CI: 1.07-1.71), and cancer to T2D (HR: 1.37, CI: 1.10-1.69). These findings highlight the persistent influence of social inequalities on the risk of multimorbidity, even in individuals with an existing chronic condition.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.