Examining the Effect of SNAP-Multibehaviours on Multimorbidity Risk: A Cross-Sectional Study in Three General Practices’ Electronic Health Records

Konstantinos Spyropoulos (), Naomi J. Ellis and Christopher J. Gidlow
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Konstantinos Spyropoulos: Centre for Health and Development (CHAD), University of Staffordshire, Stoke-on-Trent ST4 2DF, UK
Naomi J. Ellis: Centre for Health and Development (CHAD), University of Staffordshire, Stoke-on-Trent ST4 2DF, UK
Christopher J. Gidlow: School of Medicine, Keele University, University Road, Staffordshire ST5 5BG, UK

IJERPH, 2025, vol. 22, issue 8, 1-19

Abstract: Background: The growing challenge of multimorbidity for healthcare systems worldwide demands a dual prevention framework, targeting both primary and secondary prevention. Multimorbidity–multibehaviours can provide such a theoretical and clinical framework to explore new aetiological evidence for multimorbidity risk. While the role of single health risk behaviours, such as smoking, nutrition, alcohol, and physical activity (SNAP), in chronic disease prevention is well-documented, their synergistic effect on multimorbidity has received relatively little attention. Methods: Using retrospective observational data from electronic health records of 21,079 patients from a convenience sample of three general practices in Staffordshire, UK (2015–2018), we examined the association between SNAP-multibehaviours and multimorbidity risk, defined as follows: MM2+ (≥2 morbidities), MM3+ (≥3 morbidities), and complex multimorbidity (accumulated morbidities affecting ≥3 body systems). Multiple logistic regression models, stratified by sex and adjusted for age and area, were applied to analyse the associations between both combined and accumulative SNAP-health risk behaviours (HRBs) and all multimorbidity operational definitions. Results: A dose–response association was observed, indicating increased multimorbidity risk with greater accumulation of SNAP-HRBs. Additionally, sex-specific patterns were identified, which varied according to the operational definitions of multimorbidity. These findings underscored both the clinical significance of the identified outcomes for promoting tailored multimorbidity guidelines and the need for further sex-sensitive research. Conclusion: These findings support the importance of transcending traditional silos in healthcare and public health research by integrating preventive and curative medicines under a multimorbidity–multibehaviour framework. Embracing the complexity of coexisting morbidities and health risk behaviours, healthcare systems can move beyond disease-specific and behaviour-specific paradigms. This approach has the potential to enhance clinical outcomes and to address the complex needs of individuals with multimorbidity in real-world healthcare settings.

Keywords: multimorbidity; multibehaviours; multivariate analysis; primary care; sex specific multimorbidity patterns (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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