Abstract
Background: Health issues among school-age children have emerged as a global public health concern. These conditions often do not occur in isolation but tend to cluster, indicating a widespread issue of multimorbidity among this population. This study examined the prevalence and clustering of multimorbidity among school-aged school students in the Yangzhou district. Methods: A repeated cross-sectional analysis was conducted from 2019 to 2024, including 22,512 students aged 6-18 years. Common diseases, under national key monitoring, including myopia, dental caries, obesity, elevated blood pressure, and growth disorders, were assessed. Multimorbidity patterns were identified using association rule mining (Apriori algorithm) with predefined thresholds (support ≥ 2.0%, confidence ≥ 20.0% and lift > 1). Results: The multimorbidity prevalence among school-age students in the Yangzhou district is 53.95%. The most frequent multimorbidity was found in dental caries and myopia, while the most common ternary pattern was found in obesity, dental caries, and myopia. The following gender differences were observed: boys had a higher multimorbidity prevalence (56.4%) compared to girls (51.2%), with boys more likely to exhibit obesity and dental caries, while girls showed a higher prevalence of myopia-related multimorbidity. By educational stage, primary school students showed a multimorbidity rate of 50.3%, junior high showed a rate of 54.6%, and senior high showed a rate of 57.9%, indicating a rising trend across age groups. Patterns of multimorbidity varied but were interrelated. Conclusions: From 2019 to 2024, the prevalence of multimorbidity among school-aged children in Yangzhou remained relatively high, primarily manifesting as co-occurring myopia and other health issues. Patterns of multimorbidity across gender and educational stage varied but were interrelated.