Multimorbidity and the inverse care law in primary care

Multimorbidity, usually defined as the coexistence of two or more long term conditions within an individual, is rapidly becoming the norm among people with chronic disease. Although often seen as a problem of elderly people, it affects large numbers of younger people too. Multimorbidity is not simply a problem of chronological ageing, but neither is it randomly distributed.1 In a recent Scottish study of almost 1.8 million people, more people with multimorbidity were aged below 65 years than above,2 and similar findings have been reported outside the United Kingdom.3 The level of deprivation influences not just the amount but also the type of multimorbidity that people experience. Multimorbidity is more common and occurs 10-15 years earlier in the most deprived areas than in the most affluent ones.2 4 A greater mix of mental and physical problems …