Putting a population health lens to multimorbidity in Ontario

Almost all Ontarians die with multimorbidity, and most accumulate more than five conditions over their lifetime. Our health system is still largely focused on specialties and treating one disease at a time – an approach that is incompatible with the healthcare needs of patients with multiple and often complex chronic conditions. This burden requires a health system that recognizes that patients will more likely live and die with multiple chronic conditions than not (i.e., multimorbidity management versus specialized care). There are important and meaningful differences in the types and numbers of conditions that patients die with. In particular, increases in the most preventable conditions are greater among the most deprived members of our society. To address the worrying trends seen here, chronic disease prevention – not only management – must be a priority, with a strong focus on health equity. Chronic disease prevention and a strong focus on equity are signatures of a population health approach. This work echoes calls for a stronger emphasis on population health in the health system.