Background: Multimorbidity, presence of two or more health conditions, is a widespread phenomenon affecting
populations’ health all over the world. It becomes a serious public health concern due to its negative consequences
on quality of life, mortality, and cost of healthcare services utilization. Studies exploring determinants of
multimorbidity are limited, particularly those looking at vulnerable populations prospectively over time. This study
aimed at identifying short and long term socioeconomic, psychosocial, and health behavioral determinants of
incident multimorbidity among a cohort of the 1988 Armenian earthquake survivors.
Methods: The study included a representative subsample of 725 from a larger initial cohort of the earthquake
survivors. Data on this subsample were collected via four phases of this cohort study during the period 1990–2012.
The final logistic regression analysis eliminated all those cases with baseline multimorbidity to investigate short and
long term determinants of incident multimorbidity; this subsample included 600 participants.
Results: More than 75% of the studied sample had multimorbidity. Perceived low affordability of healthcare
services, poor living standards during the post-earthquake decade, and lower education were independent
predictors of incident multimorbidity developed during the period 1990–2012. Stressful life events and poor social
support were among psychosocial determinants of incident multimorbidity. Participants’ baseline BMI reported in
1990 was independently associated with incident multimorbidity.
Conclusions: Most of the identified determinants of incident multimorbidity in our study population were markers
of social inequities, indicating that inequities pose a serious threat to both individual and public health-related
outcomes. Strategies targeting to decrease such inequities along with promotion of healthy lifestyle and
strengthening of social networks may considerably reduce multimorbidity among population groups with similar
socioeconomic and cultural profiles.