How urban living can impact the health of early adolescents
Growing up in a city comes with multiple advantages. But could it also be the cause of multimorbidity – the coexistence of two or more adverse health conditions? The EU-funded URBANE project aimed to find out. “Although commonly associated with older adults, multimorbidity can already emerge during childhood, significantly impacting one’s physical and emotional development and having lasting consequences into adulthood,” says Susana Santos(opens in new window), a researcher at the University of Porto Institute of Public Health(opens in new window), the project’s coordinating partner. The project, which received support from the Marie Skłodowska-Curie Actions(opens in new window) programme, examined a broad range of urban environmental exposures, including air pollution, natural spaces, the built environment, meteorological factors, traffic, and social environment indicators. The exposures were assessed annually from birth through childhood. URBANE defined multimorbidity as being the presence of two or more adverse health conditions at age 13.
The associations between the urban environment and multimorbidity
Backed by an interdisciplinary team and using a range of advanced analytical approaches, the project explored the associations between the urban environment and multimorbidity. “While previous research has focused on specific health outcomes, ours is the first to examine the influence urban environmental exposures have on multimorbidity in early adolescence,” explains Santos. Santos says that URBANE’s research could help scientists better understand how complex urban environmental exposures influence disease accumulation during adolescence.
Multimorbidity in adolescence higher than expected
What researchers found is worrying. “With 43 % of our participants presenting two or more adverse health conditions, the prevalence of multimorbidity in early adolescence was higher than we expected,” notes Santos. Researchers also found that 35 % of participants had at least one disease, meaning that just 22 % of participants were disease-free. The most common health conditions at age 13 were obesity, dyslipidaemia, and respiratory and allergic disorders.
Urban environmental exposure not a good predictor of multimorbidity
In terms of being able to predict multimorbidity, the project’s model showed only moderate success. Despite considering a wide range of urban environmental exposures, Santos says none emerged as being a strong predictor of multimorbidity in adolescence. “Urban exposure may influence adolescent health, but its ability to predict multimorbidity is limited – underscoring the multifactorial nature of disease accumulation during this life stage,” she says.
An emerging public health and research priority
The URBANE project has established the study of multimorbidity in childhood and adolescence as an emerging public health and research priority. “Our work raises awareness that the accumulation of adverse health conditions can already begin in early life and thus needs to be investigated from a life-course perspective,” concludes Santos. Santos plans to continue her research on early-life environmental exposures and child health, extending the work done during URBANE to other environmental determinants of multimorbidity.
