List of figures: Life with arthritis in Canada: a personal and public health challenge
List of figures
Chapter 1
Figure 1-1 - Self-reported prevalence of specific chronic conditions by sex, household population aged 15 years and older, Canada, 2007-2008
Self-reported prevalence of specific chronic conditions by sex, among individuals aged 15 and older, in 2007-2008 are presented in Figure 1-1.
In 2007-2008, arthritis as a long-term health condition affected more than 4.2 million Canadians aged 15 years and older—or 16% of this population. Arthritis was the second and third most common chronic condition reported by women and men, respectively.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.Figure 1-2 - Self-reported prevalence and number of individuals with arthritis by age and sex, household population aged 15 years and older, Canada, 2007-2008
Self-reported prevalence and number of individuals with arthritis, by age and sex, among individuals aged 15 years and older, in 2007-2008 are presented in Figure 1-2.
The prevalence of arthritis increased with increasing age. In all age groups, prevalence of arthritis was higher among women than men. Overall, nearly two-thirds (64%) of those affected with arthritis were women, among whom the prevalence was 19%. Prevalence among men was 13%.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.Figure 1-3 - Proportion of total number of individuals with arthritis by age group, household population aged 15 years and older, Canada, 2007-2008
The proportion of the total number of individuals with arthritis, by age group, among individuals aged 15 years and older, in 2007-2008 is presented in Figure 1-3.
Nearly 3 in 5 people (58%) who reported having arthritis in 2007-2008 were younger than 65 years of age.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-4 - Crude self-reported prevalence of arthritis, by province/territory, household population aged 15 years and older, Canada, 2007-2008
The crude self-reported prevalence of arthritis, by province/territory, among individuals aged 15 years and older in 2007-2008 is presented in Figure 1-4.
The crude prevalence of arthritis varied considerably across Canada in 2007-2008. The highest percentage of individuals who reported having arthritis was found in Nova Scotia (23%), followed by Newfoundland and Labrador (21%), and New Brunswick and Prince Edward Island (20% and 19% respectively). The province of Quebec (12%) and the Territories (Yukon, Northwest Territories and Nunavut) (11%) had the lowest percentage of individuals who reported having arthritis.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada and 1991 Census population for age-standardization.Figure 1-5 - Age-standardized self-reported prevalence of arthritis, by rural and urban place of residence and sex, household population aged 15 years and older, Canada 2007-2008
Age-standardized self-reported prevalence of arthritis, by rural and urban place of residence and sex, among individuals aged 15 years and older, in 2007-2008 is presented in Figure 1-5.
Both men and women residing in rural areas reported statistically higher rates of arthritis compared to those residing in urban areas. In both rural and urban settings, prevalence of arthritis was higher among women than men. The highest prevalence of arthritis was among women living in rural settings (18%).
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-6 - Age standardized self-reported prevalence of arthritis, by health regions, household population aged 15 years and older, Canada 2007-2008
Age-standardized self-reported prevalence of arthritis (in quartiles), by health regions, among individuals aged 15 years and older, in 2007-2008 is presented in Figure 1-6.
The age-standardized prevalence of arthritis varied considerably across Canadian health regions. The highest prevalence of arthritis in the country was reported in Ontario’s Hastings and Prince Edward counties (27%) and the lowest was reported in Richmond, British Columbia (7%). More details can be found at: www12.statcan.gc.ca/health-sante/82-228/2009/06/index.cfm?Lang=E
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-7 - Age-standardized self-reported prevalence of arthritis, by marital status and sex, household population aged 15 years and older, Canada, 2007-2008
Age-standardized self-reported prevalence of arthritis, by marital status and sex, among individuals aged 15 years and older, in 2007-2008 is presented in Figure 1-7.
The age-standardized prevalence of arthritis was significantly lower among men and women who were married/common law, compared to those who were widowed/separated/divorced.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-8 - Age-standardized self-reported prevalence of arthritis for Caucasian, Black, Asian and other ethnic groups by sex, household population aged 15 years and over, Canada, 2007-2008
The age-standardized self-reported prevalence of arthritis for Caucasian, Black, Asian and other ethnic groups by sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 1-8. The ‘other’ ethnic category excludes First Nations, Inuit and Métis populations. For information about arthritis among First Nations, Inuit and Métis populations, see Chapter 4.
The prevalence rates of arthritis among people from Asian origins were statistically lower than in people of Caucasian origin.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-9 - Age-standardized self-reported prevalence of arthritis, by level of education and sex, household population aged 15 years and over, Canada 2007-2008
Age-standardized self-reported prevalence of arthritis, by level of education and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 1-9.
Men and women with less than secondary school education were more likely to report having arthritis compared to all other levels of education.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-10 - Age-standardized self-reported prevalence of arthritis, by income and sex, household population aged 15 years and over, Canada, 2007-2008
Age-standardized self-reported prevalence of arthritis, by income and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 1-10.
The prevalence of arthritis was significantly higher among women and men with low/ low middle income compared to all other income levels.
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-11 - Age-standardized self-reported prevalence of arthritis, by immigration status and sex, household population aged 15 years and over, Canada, 2007-2008
Age-standardized self-reported prevalence of arthritis, by immigration status and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 1-11.
The age-standardized prevalence of arthritis was significantly lower among immigrants than among people who were Canadian-born. Women reported a higher prevalence than men in both immigrant (14% versus 9%) and non-immigrant populations (17% versus 12%).
Source: Public Health Agency of Canada, using Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 1-12 - Age-standardized self-reported prevalence of arthritis, by time since immigration and sex, household population aged 15 years and over, Canada, 2007-2008
Age-standardized self-reported prevalence of arthritis, by time since immigration and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 1-12.
This figure illustrates the impact of time since immigration on the prevalence of arthritis among immigrants. The age-standardized prevalence of arthritis was much lower among recent immigrants (less than 15 years since immigration) than those who immigrated 15 years ago or more. The more time since immigration the more similar the prevalence rates of arthritis became to non-immigrant, particularly among women.
Source: Public Health Agency of Canada, using Canadian Community Health Survey 2007-2008, Statistics Canada.
Figure 1-13 - Number of people projected to have arthritis, by year and age group, Canada 2007-2031
The number of people projected to have arthritis, by year and age group, from 2007–2031 is presented in Figure 1-13.
It is estimated that by 2031, 6.7 million Canadians aged 15 years and older will have arthritis, with the largest increases in the older age groups, particularly among those aged 65 years and older due to an increasing number of older people. An increase is also noted in the working-age
population (35-64 years of age), particularly among those aged 55-64 years.
Sources: Arthritis Community Research and Evaluation Unit using Canadian Community Health Survey 2007, Statistics Canada.
Chapter 2
Figure 2-1 - Proportion of individuals who reported being physically inactive during their leisure time, by age and sex, household population aged 15 years and over, Canada, 2007-2008
| Age group | Men | Women |
|---|---|---|
| * Source: Public Health Agency of Canada using data from the Canadian Community Health Survey 2007-2008, Statistics Canada. * Physical activity is defined according to the total daily Energy Expenditure values (kcal/kg/day) expended during leisure time activities. Energy Expenditure is calculated using the frequency and duration per session of the physical activity as well as the MET value of the activity. The MET is a value of metabolic energy cost expressed as a multiple of the resting metabolic rate. Respondents are categorized as being “active” (≥ 3 MET), “moderate” (1.5 to ≤ 3 METS) or “inactive” (0 to < 1.5 METS) based on their total daily energy expenditure value. * Differences between men and women statistically significant at p<0.05 except among those aged 40-49 and 50-59 years. |
||
| 15-29 | 35.9 | 47.4 |
| 30-39 | 49.6 | 52.8 |
| 40-49 | 51.0 | 53.4 |
| 50-59 | 52.3 | 54.8 |
| 60-69 | 48.9 | 54.9 |
| 70+ | 52.6 | 66.5 |
Figure 2-2 - Proportion of individuals with and without arthritis who reported being physically inactive, by age and sex, household population aged 15 years and over, Canada, 2007-2008
| Age group | Men with arthritis | Men without arthritis | Women with arthritis | Women without arthritis |
|---|---|---|---|---|
| * Source: Public Health Agency of Canada using data from the Canadian Community Health Survey 2007-2008, Statistics Canada. | ||||
| 15-29 | 37.7 | 35.8 | 46.8 | 47.5 |
| 30-39 | 49.1 | 49.6 | 56.1 | 52.5 |
| 40-49 | 50.9 | 50.9 | 58.0 | 52.6 |
| 50-59 | 55.1 | 51.6 | 58.4 | 53.5 |
| 60-69 | 53.0 | 47.4 | 60.1 | 51.4 |
| 70+ | 56.2 | 50.6 | 70.3 | 62.1 |
Figure 2-3 - Proportion of individuals aged 12-17 years who were overweight or obese (based on body mass index), by sex, Canada, 2007-2008.
| Weight classification | Boys | Girls |
|---|---|---|
| * Source: Public Health Agency of Canada, using data from the Canadian Community Health Survey 2007-2008, Statistics Canada. * Differences between boys and girls statistically significant at p<0.05. |
||
| Overweight | 17.6 | 11.4 |
| Obese | 6.3 | 2.8 |
Figure 2-4 - Proportion of individuals aged 18 years and older, who were overweight or obese (based on body mass index), by age and sex, Canada, 2007-2008
| Age groups | Overweight men | Obese men | Overweight women | Obese women |
|---|---|---|---|---|
| * Source: Public Health Agency of Canada, using data from the Canadian Community Health Survey 2007-2008, Statistics Canada. | ||||
| 18-29 | 29.6 | 11.6 | 16.7 | 9.9 |
| 30-39 | 41.8 | 18.9 | 23.6 | 15.1 |
| 40-49 | 44.2 | 19.1 | 27.4 | 16.2 |
| 50-59 | 44.1 | 23.0 | 32.5 | 19.4 |
| 60-69 | 44.9 | 22.6 | 35.3 | 21.9 |
| 70+ | 43.1 | 15.1 | 34.4 | 15.8 |
Figure 2-5 - Proportion of individuals with and without arthritis aged 18 years and over who were overweight or obese (body mass index ≥ 25), by age and sex, Canada, 2007-2008
| Age group | Men with arthritis | Men without arthritis | Women with arthritis | Women without arthritis |
|---|---|---|---|---|
| * Source: Public Health Agency of Canada, using the Canadian Community Health Survey, 2007-2008. * Differences between individuals with and without arthritis significantly at p<0.05, except men 30-49 years of age. |
||||
| 18-29 | 56.2 | 40.9 | 41.5 | 26.2 |
| 30-39 | 62.5 | 60.6 | 50.4 | 38.0 |
| 40-49 | 66.4 | 62.8 | 52.1 | 42.4 |
| 50-59 | 71.5 | 66.0 | 61.6 | 48.7 |
| 60-69 | 74.9 | 64.8 | 65.6 | 51.7 |
| 70+ | 64.5 | 54.7 | 56.4 | 43.0 |
Chapter 3
Figure 3-1 - Proportion of individuals with arthritis and with no chronic conditions who rated their health as fair or poor
The proportion of individuals with arthritis and with no chronic conditions who rated their health as fair or poor, by age and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-1.
Overall, 30.4% of men and 29.1% of women living with arthritis reported their health as fair or poor. The proportion of individuals who rated their health as fair or poor was much higher among those living with arthritis than those with no chronic conditions. Men and women with arthritis aged 75 years and older were more likely to report fair to poor health than the other age groups (approximately 37% among 75 years and older versus between 21% and 32% for the other age groups).
Source: Public Health Agency of Canada, using the Canadian Community Health Survey 2007-2008, Statistics Canada.
Figure 3-2 - Proportion of individuals with arthritis who rated their health as somewhatworse or much worse than a year earlier
The proportion of individuals with arthritis who rated their health as somewhat worse or much worse than a year earlier, by age and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-2.
The proportion of men and women with arthritis who rated their health as worse than a year earlier was 21.7% and 23.0% respectively. The greatest proportion of individuals with arthritis that rated their health worse than a year earlier was within the oldest age group (75+). A statistically significant difference between men and women was shown only among those aged 45–64 years: women with arthritis were more likely than men with arthritis to rate their health as worse than the previous year.
Source: Public Health Agency of Canada, using the Canadian Community Health Survey 2007-2008, Statistics Canada.
Figure 3-3 - Proportion of individuals with arthritis who perceived their mental health as fair or poor
The proportion of individuals with arthritis who perceived their mental health as fair or poor, by age and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-3.
The overall proportion of men and women with arthritis that perceived their mental health as fair or poor was 9.6% and 8.2% respectively. Women less than 44 years of age were as likely as women in the 45-64 age group to report fair or poor mental health and men less than 44 years of age were more likely to report fair or poor mental health than all other age groups.
Source: Public Health Agency of Canada, using the Canadian Community Health Survey 2007-2008, Statistics Canada.Figure 3-4 - Proportion of individuals with arthritis who reported being dissatisfied or very dissatisfied with life
Proportion of individuals with arthritis who reported being dissatisfied or very dissatisfied with life, by age and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-4.
Overall, a small proportion of individuals with arthritis (5.7% and 6.0% of men and women respectively) reported being dissatisfied with life. However, working age men and women with arthritis were as likely as those aged over 65 years to report being dissatisfied with life. A statistically significant difference between men and women was shown only among those aged 75 years and over: women with arthritis were more likely than men with arthritis to report being dissatisfied with life.
Source: Public Health Agency of Canada, using Canadian Community Health Survey 2007-2008, Statistics Canada.Figure 3-5 - Individuals with arthritis with no chronic conditions who reported life to be quite a bit or extremely stressful
Proportion of individuals with arthritis and with no chronic conditions who reported life to be quite a bit or extremely stressful, by age and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-5. The value for “no chronic conditions” for men aged 75 years and over was not reportable.
Overall, close to one quarter (22%) of individuals with arthritis reported life to be “quite a bit” or “extremely” stressful compared to approximately one fifth (18%) for those without chronic conditions. A higher proportion of women with arthritis of all ages reported life to be “quite a bit” or “extremely” stressful compared to women with no chronic conditions. The same was found for men aged 15-44 years and 65-74 years with arthritis. Men and women with arthritis between 15 and 44 years of age were more likely to find life a bit or extremely stressful compared to the other age groups.
Source: Public Health Agency of Canada, using Canadian Community Health Survey 2007-2008, Statistics Canada.
Figure 3-6 - Prevalence of top six chronic conditions among individuals with arthritis
The prevalence of the top six chronic conditions among individuals with arthritis, by sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-6.
The six chronic conditions most frequently reported among men with arthritis were back problems (42.5%), high blood pressure (34.7%), heart disease (14.7%) diabetes (14.4%), mood or anxiety disorder (13.3%) and asthma (10.5%). Among women with arthritis, the most frequently reported conditions were back problems (41.6%), high blood pressure (39.1%), mood or anxiety disorder (19.5%), migraines (17.4%), diabetes (13.3%) and heart disease (12.3%).
Source: Public Health Agency of Canada, using Canadian Community Health Survey 2007-2008, Statistics Canada.
Figure 3-7 - Proportion of individuals with arthritis for whom pain prevents a few, some or most activities
The proportion of individuals with arthritis for whom pain prevents a few, some or most activities, by age and sex, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-7.
Overall, 34.4% of men and 39.4% of women with arthritis reported having pain that prevented activities. People aged 15-44 years were more likely than the other age groups to report having activities prevented by pain, particularly women. Men and women of working age (less than 65 years of age) were also more likely to report activities prevented by pain than those aged over 65 years.
Source: Public Health Agency of Canada, using Canadian Community Health Survey 2007-2008, Statistics Canada.Figure 3-8 - Proportion of individuals with arthritis reporting at least one disability day in the previous 14 days
Proportion of individuals with arthritis reporting at least one disability day in the previous 14 days, by age and sex, among individuals aged 15 years and over, in 2005 is presented in Figure 3-8.
The proportion of men and women with arthritis that reported disability days in the previous two weeks was greatest among those aged 15-44 years compared to the other age groups. Women were more likely than men in all age groups to report disability days. Again, people of working age (less than 65 years) were more likely than those aged 65 and over to report at least one disability day in the past 14 days.
Source: Arthritis Community Research and Evaluation Unit, using data from the Canadian Community Health Survey (CCHS) 2005, Statistics Canada. The 2005 CCHS was used as this variable was not available in the 2007-2008 CCHS.
Figure 3-9 - Proportion of individuals reporting activity limitations sometimes or often, by chronic condition
Proportion of individuals reporting activity limitations sometimes or often, by chronic condition, among individuals aged 15 years and over, in 2007-2008 is presented in Figure 3-9. Chronic condition categories are not mutually exclusive.
Over two thirds (67.3%) of individuals with arthritis aged 15 years and over, reported activity limitations, a proportion similar to individuals with heart disease (67.6%). A significantly greater proportion of individuals with stroke reported activity limitations (81.4%) compared to those with arthritis. In contrast, a significantly lower proportion of individuals with diabetes and asthma reported activity limitations compared to those with arthritis (56.1% and 45.3%, respectively).
Source: Public Health Agency of Canada, using Canadian Community Health Survey 2007-2008, Statistics Canada.
Figure 3-10 - Top ten causes of disability among men and women aged 15 years and over
Top ten causes of disability among men and women, aged 15 years and over, in 2001 is presented in Figure 3-10.
Among the top ten causes of disability, arthritis was the most frequently reported cause of disability among women and second most frequently mentioned condition as a direct cause of disability among men.
Source: Arthritis Community Research and Evaluation Unit, using data from the Participation and Activity Limitation Survey 2001, Public Use File, Statistics Canada.Figure 3-11 - Individuals with disability due to arthritis who reported limitations in specific life domains
Proportion of individuals aged 15 years and over, with disability due to arthritis who reported limitations in five daily life domains (i.e., mobility, self-care, domestic life, participation in the labour force and community, social and civic life), in 2001 is presented in Figure 3-11.
Arthritis affects many dimensions of every day life for a large proportion of people living with the disease. Over half of individuals with activity limitations due to arthritis faced difficulty with the following tasks: climbing stairs (57.1%); standing for 20 minutes (64.8%); moving room-to-room or walking ½ km (62.1%); reach, grasp and/or carry (68.5%); bend over and pick up an object from the floor (53.9%); use of distance transportation (51.6%); cutting toenails (53.7%); heavy housework (65.6%); household tasks (56.3%); leisure activities outside the home less than weekly (72%.0) and; exercise/physical activity less than daily (57.1%).
Source: Arthritis Community Research and Evaluation Unit, using data from the Participation and Activity Limitation Survey 2001, Public Use File, Statistics Canada.Figure 3-12 - Individuals with a disability due to arthritis who reported limitations in domestic life due to arthritis
Proportion of individuals aged 15 years and over with a disability due to arthritis who reported limitations in domestic life due to arthritis, by age group and sex, in 2001 is presented in Figure 3-12.
Men and women living with arthritis reported facing considerable difficulty in domestic life activities. Differences between men and women were evident, as the proportions of women who reported difficulties were up to 1.8 times higher than men.
High proportions of women aged 15-44 years with a disability related to arthritis reported difficulties in domestic life activities: 76% needed help with heavy housework and 62% needed assistance with household tasks. These proportions are similar to those reported by women aged 65 years and over (71% and 69%, respectively).
Source: Arthritis Community Research and Evaluation Unit using data from the Participation and Activity Limitation Survey 2001, Public Use File, Statistics Canada.
Figure 3-13 - Individuals with disability due to arthritis who reported limitations in participation in the labour force
Proportion of individuals aged 25–64 years with disability due to arthritis who reported limitations in participation in the labour force, by age group and sex, in 2001 is presented in Figure 3-13.
Many men and women with arthritis are still in the labour force however, 44% are working with job limitations and 33% required job modifications. Over 70% of those aged between 55-64 years reported not being in the labour force. Of concern is the proportion of young people with arthritis who report not being in the labour force. On average, over a quarter of men and women aged between 25 and 44 years with arthritis are not in the labour force because of their arthritis.
Source: Arthritis Community Research and Evaluation Unit, using data from the Participation and Activity Limitation Survey 2001, Public Use File, Statistics Canada.
Chapter 4
Figure 4-1 - Figure 4-1: Prevalence and number of individuals with arthritis/rheuma-tism, on-reserve First Nations - 20 and older
Self-reported prevalence and number of individuals with arthritis/rheumatism, in the on-reserve First Nations population aged 20 years and older, by age group and sex, in 2002-2003 is presented in Figure 4-1.
In 2002-2003, 19% of First Nations adults aged 20 years and older living on-reserve (79,400 people) reported having been diagnosed with arthritis/rheumatism. The percentage of individuals with arthritis/rheumatism increased with increasing age and arthritis was more common among women than men in every age group. Close to two-thirds (64%) of First Nations adults living on-reserve who had arthritis/rheumatism were 30–59 years of age.
Source: First Nations Regional Longitudinal Health Survey (RHS) Phase 1 2002-2003, custom tabulations by The RHS National team, Assembly of First Nations.Figure 4-2 - Prevalence and number of individuals with arthritis, off-reserve First Nations population - 20 and older
Self-reported prevalence and number of individuals with arthritis in the off-reserve First
Nations population aged 20 years and older, by age group, in 2007-2008 is presented in Figure 4-2. The 15 to 19 year age group was not reportable.
In 2007-2008, 17.7% of First Nations adults aged 15 years and older living off-reserve (71,704 people) reported having been diagnosed with arthritis. The percentage of individuals with arthritis increased with increasing age and overall arthritis was more commonly reported in women (19.9%) compared to men (15.3%). Close to two-thirds (61%) of First Nations adults living off-reserve who had arthritis were between 30 to 59 years of age.
Source: Public Health Agency of Canada, using the Canadian Community Health Survey, 2007-2008, Statistics Canada.
Figure 4-3 - Prevalence of arthritis/rheumatism diagnosed by a health professional, Métis and total population of Canada
Self-reported prevalence of arthritis/rheumatism diagnosed by a health professional in the Métis and total population of Canada, by age group, in 2005 and 2006 respectively, is presented in Figure 4-3.
Métis women were more likely than men to report arthritis/rheumatism (24% and 18%, respectively). The prevalence of arthritis/rheumatism increased with increasing age.
Source: Statistics Canada. Aboriginal Peoples Survey, 2006: An Overview of the Health of the Métis Population. Ottawa: Statistics Canada, February 2009, Catalogue no. 89-637-X no. 004.
Chapter 5
Figure 5-1 - Number of deaths and crude mortality rates (per 100,000) attributed to arthritis
Number of deaths and crude mortality rates (per 100,000) attributed to arthritis, by age and sex, in 2005 are presented in Figure 5-1.
In 2005, 777 women and 296 men in Canada were recorded as having died from arthritis. Mortality rates among men ranged from 0.2 deaths for every 100,000 men aged 54 years or less to 48 deaths per 100,000 men aged 85 years and over. Among women in the same age groups, rates ranged between 0.7 deaths per 100,000 to 74 deaths per 100,000. Mortality rates were higher among women than men in every age group, with approximately 2.6 female deaths for every male death.
The number of deaths increased with age, except among men, where the number of deaths declined after the age of 84 years. Over one fifth (21%) of the deaths occurred in men and women of working age (0–64 years).
Source: Public Health Agency of Canada, using 2005 Canadian annual mortality data, Statistics Canada.
Figure 5-2 - Age-specific mortality rates (per 100,000) for arthritis, by year
Age-specific mortality rates (per 100,000) for arthritis, by year, from 1999–2005 are
presented in Figure 5-2.
Age-specific mortality rates due to arthritis remained relatively stable from 1999–2005. For those 65 years of age and over, there was a noticeable peak in the year 2000.
Source: Public Health Agency of Canada, using 2005 Canadian annual mortality data, Statistics Canada.Chapter 7
Figure 7-1 - Estimated total number of NSAID prescriptions written for individuals with arthritis - 2007
The estimated total number of non-steroidal anti-inflammatory drug (NSAID) prescriptions written for individuals with arthritis, by age and sex, in 2007 are presented in Figure 7-1.
In 2007, more NSAID prescriptions were written for women than men with arthritis for all age groups with the exception of those between the ages of 15 and 34 years. The number of NSAID prescriptions peaked among men 45–54 years of age and among women aged 55–64 years, and then declined.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-2 - Estimated total number of GI protective agent prescriptions written for people with arthritis - 2007
The estimated total number of gastrointestinal (GI) protective agent prescriptions written for people with arthritis, by age group and sex, in 2007 are presented in Figure 7-2.
More GI protective agent prescriptions were written for men than women with arthritis, with the exception of those aged 45–54 years and 65–74 years. There was an increase in the number of prescriptions for GI protective agents for men up to age 64 years. Whereas, there was a sharp increase in GI protective agent prescriptions among women between the ages of 35 and 54 years, followed by a steady decline thereafter.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-3 - Estimated total number of NSAID prescriptions written for people with arthritis - 2002-2007
Estimated total number of non-steroidal anti-inflammatory (NSAID) prescriptions written for individuals with arthritis, by sex and year, from 2002–2007 are presented in Figure 7-3.
The number of prescriptions written for NSAIDs declined over time among women and men. For women, the number of prescriptions written peaked in 2004, followed by a steep decline.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-4 - Estimated total number of GI protective agent prescriptions written for people with arthritis - 2002-2007
The estimated total number of gastrointestinal (GI) protective agent prescriptions for individuals with arthritis, by sex and year, from 2002–2007 are presented in Figure 7-4.
The number of GI protective agent prescriptions written for men and women increased greatly between 2004 and 2005, and 2005 and 2006, respectively.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-5 - Estimated total number of GI protective agent prescriptions for arthritis 2002–2007
The estimated total number of disease modifying anti-rheumatic drug (DMARD) prescriptions written for individuals with arthritis, by age group and sex, in 2007 is presented in Figure 7-5.
The number of DMARD prescriptions written for women with arthritis was higher than for men in all age groups. The peak number of DMARD prescriptions was among women aged 45–54 years, after which the number began to decline; men’s prescriptions peaked between 55 and 64 years of age.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-6 - Estimated total number of DMARD prescriptions written for people with arthritis 2002–2007
The estimated total number of disease modifying anti-rheumatic drug (DMARD) prescriptions written for people with arthritis, by sex and year, from 2002–2007 are presented in Figure 7-6.
The time trends for DMARDs prescriptions varied according to sex. The number of prescriptions written for women with arthritis increased between 2002 and 2007 while the number for men remained stable until 2006, followed by a decrease in 2007.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-7 - Estimated total number of corticosteroid prescriptions written for individuals with arthritis 2007
The estimated total number of corticosteroid prescriptions written for individuals with arthritis, by age group and sex, in 2007 is presented in Figure 7-7.
In every age group, the number of corticosteroid prescriptions (oral and injected combined) written for women with arthritis was greater than that for men. The number of prescriptions written for women with arthritis increased with age.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-8 - Estimated total number of corticosteroid prescriptions written for people with arthritis 2002–2007
The estimated total number of corticosteroid prescriptions written for people with arthritis, by sex and year, from 2002–2007 is presented in Figure 7-8.
A similar trend in the number of corticosteroid prescriptions (oral and injected combined) was found among women and men: the number prescriptions written decreased between 2002 and 2004, followed by an increase from 2004 to 2006, and a subsequent decrease in 2007.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-9 - Estimated total number of biologic response modifier prescriptions written for individuals with arthritis 2007
The estimated total number of biologic response modifier prescriptions written for individuals with arthritis, by age group and sex, in 2007 is presented in Figure 7-9. There were no prescriptions reported by surveyed physicians for men aged 15–34 years in 2007.
Women received a higher number of written prescriptions for biologic response modifiers than men. The number of prescriptions written for women increased with age until 64 years whereas the number decreased among men within the same age groups.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Figure 7-10 - Estimated total number of biologic response modifier prescriptions written for people with arthritis 2002-2007
The estimated total number of biologic response modifier prescriptions written for people with arthritis, by sex and year, from 2002–2007 is presented in Figure 7-10.
The number of biologic response modifier prescriptions written for women increased sharply between both 2002 and 2003, and 2006 and 2007. There was a sharp increase in biologic response modifier prescriptions between 2006 and 2007 for both men and women.
Source: Public Health Agency of Canada, using data from the Canadian Disease and Therapeutic Index (CDTI), IMS Health Canada.Chapter 8
Figure 8-1 - Person-visit rates to all physicians for all types of arthritis conditions, by age and sex
Person-visit rates to all physicians for all types of arthritis conditions, by age and sex, in 2005-2006 are presented in Figure 8-1.
Overall, person-visit rates i.e., persons visiting per 1,000 of the Canadian population, for all types of arthritis increased with age. Rates among women were greater than among men within all age groups except the youngest age group (i.e. 15-24 years).
Source: Public Health Agency of Canada using provincial physician billing data (Alberta, Manitoba, Ontario, Quebec, Nova Scotia).Figure 8-2 - Person-visit rates to all physicians for osteoarthritis, by age and sex
Person-visit rates to all physicians for osteoarthritis, by age and sex, in 2005-2006 are presented in Figure 8-2.
Overall, person-visit rates i.e., persons visiting per 1,000 of the Canadian population, for osteoarthritis increased with age. Rates among women were greater than among men within all age groups except the youngest age group (i.e. 15-24 years).
Source: Public Health Agency of Canada using provincial physician billing data (Alberta, Manitoba, Ontario, Quebec, Nova Scotia).
Figure 8-3 - Person-visit rates to all physicians for rheumatoid arthritis, by age and sex
Person-visit rates to all physicians for rheumatoid arthritis (RA), by age and sex, in 2005-2006 are presented in Figure 8-3.
Person-visit rates for RA increased with age, and then declined in women 75 years and older. Rates among women were greater than among men within all age groups.
Source: Public Health Agency of Canada using provincial physician billing data (Alberta, Manitoba, Ontario, Quebec, Nova Scotia).Figure 8-4 - Percentage of adults with arthritis conditions who saw primary care, medical and surgical specialists
Percentage of adults aged 15 years and older with all types of arthritis conditions, who saw primary care, medical and surgical specialists, in 2005-2006 are presented in Figure 8-4. Percentages do not add to 100% because an individual can visit more than one type of physician in a year.
In 2005-2006, 80% of the individuals who visited a physician with arthritis was listed as the reason for the visit, saw a primary care physician. Approximately 19% saw a surgical specialist and fewer (14%) visited a medical specialist. Of all the surgical specialists, orthopaedic surgeons (85%) were the most commonly consulted.
Source: Public Health Agency of Canada using provincial physician billing data (Alberta, Manitoba, Ontario, Quebec, Nova Scotia).Figure 8-5 - Percentage of adults aged 15 years and older with osteoarthritis and rheumatoid arthritis who saw primary care, medical and surgical specialists
Percentage of adults aged 15 years and older with osteoarthritis and rheumatoid arthritis, who saw primary care, medical and surgical specialists, in 2005-2006 are presented in Figure 8-5. Percentages do not add to 100% because an individual can visit more than one type of physician in a year.
Of those who visited a physician for osteoarthritis (OA), 79% saw a primary care physician. A greater percentage of people with OA visited a surgical specialist (20.5%) compared to a medical specialist (11.5 %). Of all the surgical specialists, orthopaedic surgeons were the most commonly consulted (97%).
While over half of individuals who visited a physician for rheumatoid arthritis (RA) visited a primary care physician (60%), a large proportion also visited a medical specialist (53%). Of all the medical specialists consulted, rheumatologists were the most commonly consulted (67%), followed by general internists (37%). Fewer individuals with RA visited a surgical specialist (7%) and of those who did, over half consulted an orthopaedic surgeon.
Chapter 9
Figure 9-1 - Number of hospitalizations for arthritis and non-arthritis conditions
The number and age- and sex-standardized rates (per 100,000 population) of hospitalizations for arthritis and non-arthritis conditions, from 2001/02–2005/06 are presented in Figure 9-1.
The number of hospitalizations for arthritis conditions were relatively stable between 2001/02 and 2004/05 with a minor increase in 2005/06, while non-arthritis conditions remained relatively stable during this time period. While the age- and sex-standardized rate of hospitalizations for arthritis conditions decreased between 2001/02 and 2004/05 and increased slightly between 2004/05 and 2005/06, the rate of hospitalizations for non-arthritis conditions decreased during this period of time.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB)/Canadian Institute for Health Information (CIHI).Figure 9-2 - Medical hospitalizations, surgical hospitalizations and day surgeries for arthritis and non-arthritis conditions
Age- and sex-standardized rates (per 100,000 population) of medical hospitalizations, surgical hospitalizations and day surgeries for arthritis and non-arthritis conditions, from 2001/02–2005/06 are presented in Figure 9-2. Day surgery data were not available for Alberta and Quebec.
Between 2001/02 and 2005/06, the age-standardized rates for medical and day surgery hospitalizations for arthritis decreased. The rates of surgical in-patient hospitalizations for arthritis increased during the same time period.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB), Discharge Abstract Database (DAD) and National Ambulatory Care Reporting System (NACRS), Canadian Institute for Health Information (CIHI).Figure 9-3 - Medical hospitalizations, surgical hospitalizations and day surgeries by arthritis- diagnostic groupings
Age- and sex-standardized rates of medical hospitalizations, surgical hospitalizations and day surgeries by arthritis- diagnostic groupings, from 2001/02–2005/06 are presented in Figure 9-3. Day surgery data were not available for Alberta and Quebec.
Among the five types of arthritis, medical hospitalizations rates were higher for the more common soft tissue disorders (e.g., synovitis and bursitis), inflammatory arthritis and ‘other arthritis’ (e.g., internal joint derangements) than for osteoarthritis (OA) or systemic connective tissue disorders (e.g., lupus). Medical hospitalization rates decreased after 2001/02, with the exception of the soft tissue disorders, which showed a slight increase in 2005/06.
Between 2001/02 and 2005/06, surgical hospitalizations for all types of arthritis remained stable with the exception of OA whose rate increased particularly between 2004/05 and 2005/06.
Day surgeries were more common for individuals with ‘other arthritis’, soft tissue disorders and OA. The rate of day surgeries decreased between 2001/02 and 2003/04 for most of the diagnostic groups and then levelled off thereafter.
Overall, OA accounted for most of the hospitalizations related to arthritis, particularly surgical hospitalizations.
Inflammatory types of arthritis accounted for about one in four of all arthritis-related medical hospitalizations.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB), Discharge Abstract Database (DAD) and National Ambulatory Care Reporting System (NACRS), Canadian Institute for Health Information (CIHI).Figure 9-4 - Rates of arthritis-related hospitalizations and day surgeries
Rates of arthritis-related hospitalizations and day surgeries per 100,000 population, by age and sex, in 2005-2006 are presented in Figure 9-4. Day surgery data were not available for Alberta and Quebec.
The rate of medical hospitalization increased with age and was more than twice as high in the 75 and over age group than in the 65 to 74 year old age group. The rate of surgical hospitalizations increased to age 65 to 74 then decreased for both men and women. The rate of day surgeries peaked in the 55 to 64 year old age group for both men and women and then declined.
The rate of surgical hospitalizations was higher than the rate of medical hospitalizations for men and women in every age group. In general, the rate of hospitalizations was slightly higher for women than men, with the exception of day surgeries. Young men (aged 15-44 years) had higher day surgery rates than young women.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB), Discharge Abstract Database (DAD) and National Ambulatory Care Reporting System (NACRS), Canadian Institute for Health Information (CIHI).Figure 9-5 - Age and sex distribution of arthritis-related hospitalizations, by diagnostic groupings
Age and sex distribution of arthritis-related hospitalizations, by diagnostic groupings, in 2005-2006 is presented in Figure 9-5.
The highest proportion of all arthritis-related hospitalizations was attributed to osteoarthritis for men and women in all age groups, with the exception of those between 15 and 44 years of age. In contrast, the proportion attributed to soft tissue disorders or ‘other arthritis’ was higher in men and women under 45 years of age.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB), Canadian Institute for Health Information (CIHI).Figure 9-6 - Arthritis-related hip and knee replacements
Number and age- and sex-standardized rates per 100,000 population of arthritis-related hip and knee replacements, from 2001/02–2005/06 are presented in Figure 9-6.
In 2005-2006, 59,200 joint replacements for arthritis were performed in Canada. Nearly all of these (57,300) were hip or knee replacements. In each year between 2001/02 and 2005/06, the number of knee replacements exceeded the number of hip replacements, and this gap widened over time. The number of knee replacements increased by 59% and the number of hip replacements increased by 47%. After adjusting for the older age group who have hip replacements and the aging of the population over that time period, knee replacements still increased 1.3 times more than hip replacements.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB), Canadian Institute for Health Information (CIHI).Figure 9-7 - Number of arthritis-related hip and knee replacements, by age
The number of arthritis-related hip and knee replacements, by age, from 2001/02–2005/06 is presented in Figure 9-7.
The number of joint replacement procedures increased in every age group between 2001/02 and 2005/06.
Source: Arthritis Community Research Evaluation Unit using, Hospital Morbidity Database (HMDB), Canadian Institute for Health Information (CIHI).Figure 9-8 - Number and rates of arthritis-related hip replacements by age and sex
The number and rates of arthritis-related hip replacements per 100,000 population, by age and sex, in 2005-2006 are presented in Figure 9-8.
The rate of hip replacements in Canada increased with age in 2005-2006, peaking among both men and women aged 65–74 years. Adults aged 65 years and older had the largest number of hip replacements.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB), Canadian Institute for Health Information (CIHI).Figure 9-9 - Number and rates of arthritis-related knee replacements by age and sex
The number and rates of arthritis-related knee replacements per 100,000 population, by age and sex, in 2005-2006 are presented in Figure 9-9.
The rate of knee replacements increased with age in 2005-2006, peaking among women aged 65–74 years and among men over 75 years of age. Adults aged 65 years and older had the largest number of knee replacements.
Source: Arthritis Community Research Evaluation Unit using Hospital Morbidity Database (HMDB), Canadian Institute for Health Information (CIHI).
Figure 9-10 - Distribution of BMI categories among individuals who underwent total hip or knee replacement
The distribution of body mass index (BMI) categories among individuals who underwent total hip or knee replacement, in 2005-2006 is presented in Figure 9-10.
In 2005-2006, 74% of those who underwent hip replacement and 87% of those who underwent knee replacement were overweight or obese.
Source: Canadian Joint Replacement Registry (CJRR), Canadian Institute for Health Information (CIHI).
Figure 9-11 - Distribution of BMI categories among individuals undergoing hip replacement, by age and sex
The distribution of BMI categories among individuals undergoing hip and knee replacement, by age and sex, in 2005-2006 are presented in Figures 9-11 and 9-12 respectively
More men than women who had a hip or knee replacement were overweight or obese (85% and 80%, respectively). The proportion of individuals that were obese was higher among those undergoing knee replacement compared to those having a hip replacement among men and women, in all age groups.
A large proportion of individuals who were obese and who had either knee or hip replacements were of working age i.e., less than 65 years old (66% and 44%, respectively). Knee and hip replacements occurred at an earlier age for those individuals who were overweight or obese whereas, they occurred at an older age for those of normal or underweight.
Source: Canadian Joint Replacement Registry (CJRR), Canadian Institute for Health Information (CIHI).Figure 9-12 - Distribution of BMI categories among individuals undergoing knee replacement, by age and sex
The distribution of BMI categories among individuals undergoing hip and knee replacement, by age and sex, in 2005-2006 are presented in Figures 9-11 and 9-12 respectively
More men than women who had a hip or knee replacement were overweight or obese (85% and 80%, respectively). The proportion of individuals that were obese was higher among those undergoing knee replacement compared to those having a hip replacement among men and women, in all age groups.
A large proportion of individuals who were obese and who had either knee or hip replacements were of working age i.e., less than 65 years old (66% and 44%, respectively). Knee and hip replacements occurred at an earlier age for those individuals who were overweight or obese whereas, they occurred at an older age for those of normal or underweight.
Source: Canadian Joint Replacement Registry (CJRR), Canadian Institute for Health Information (CIHI).Figure 9-13 - Average length of stay for hip and knee replacements, by sex
Average length of stay for hip and knee replacements, by sex, in 2005-2006 is presented in Figure 9-13.
The average length of stay for individuals with hip replacements was slightly longer than for those with knee replacements. For hip replacements, the average length of stay for women was higher than for men; no sex difference was observed for knee replacements.
Source: Arthritis Community Research Evaluation Unit using Canadian Joint Replacement Registry (CJRR), Canadian Institute for Health Information (CIHI).
Figure 9-14 - Average length of stay for hip and knee replacements
Average length of stay for hip and knee replacements, from 2000/01–2005/06 is presented in Figure 9-14.
Between 2000/01 and 2005/06, the average length of stay for hip replacements declined from 10 to 8 days and from 8 to 6 days for knee replacements.
Source: Arthritis Community Research Evaluation Unit using Canadian Joint Replacement Registry (CJRR), Canadian Institute for Health Information (CIHI).Page details
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