Multimorbidity and equity in health

Two major challenges are at play in the design of current and future health care delivery: the growing diversity of patient populations and the increasing burden of multiple long-term conditions. The growing prevalence of multiple co-occurring conditions signifies a greater burden for patients and a resultant increasing need for health care resources [1,2]. Yet, health care systems are ill suited for the complex, frequently interacting needs of patients with multiple chronic conditions [3]. Guidelines and incentives are aligned in a way that acknowledge high quality treatment of single conditions [4,5] without recognizing the impact of multiple conditions on the commissioning of care and on patients’ self management capabilities [6-9]. For individuals from diverse socioeconomic and cultural backgrounds, these challenges are even greater, as multiple co-occurring life and social circumstances interact with their health and health related needs.