Abstract
Objectives
To estimate and compare incidence/prevalence of rheumatoid arthritis (RA) in different geographic health regions and between urban/rural locations of residence within the province of Saskatchewan.
Methods
Saskatchewan Provincial Administrative Health Databases (2001–2014) were utilized as data sources. Two RA case-definitions were employed: (1) three physician billing diagnoses, at least one of which was submitted by a specialist (rheumatologist, general internist, or orthopedic surgeon) within 2 years; (2) one hospitalization diagnosis (ICD-9-CM code-714 and ICD-10-CA codes-M05, M06). Data from these definitions were combined to estimate annual RA incidence and prevalence. Annual incidence and prevalence rates across geographic regions and between rural and urban residences were examined.
Results
An increasing RA prevalence gradient was observed in a south to north direction within the province. In the 2014–2015 Fiscal Year, the southern region of Sun Country had a 0.57% RA prevalence and the Northern Health Regions a prevalence of 1.15%. Incidence rates fluctuated over time in all regions but tended to be higher in Northern Health Regions. A higher RA prevalence trend was observed in rural residents over the study period.
Conclusions
Higher prevalence rates were observed for RA in Northern Health Regions than elsewhere in the province. Rural prevalence rates were higher than for urban residents. Healthcare delivery strategic planning will need to ensure appropriate access for RA patients throughout the province.
Résumé
Objectifs
Estimer et comparer l’incidence et la prévalence de la polyarthrite rhumatoïde (PR) entre différentes régions sanitaires et entre les lieux de résidence urbains et ruraux de la province de la Saskatchewan.
Méthode
Nos données sont extraites des bases de données administratives sur la santé de la Saskatchewan (2001–2014). Nous avons employé deux définitions de cas pour la PR: 1) > trois factures de diagnostic médical, dont au moins une soumise par une ou un spécialiste (rhumatologue, interniste général(e) ou chirurgien(ne) orthopédiste) en l’espace de deux ans; 2) > un diagnostic d’hospitalisation (code CIM-9-MC 714 et codes CIM-10-CA M05 et M06). Nous avons combiné les données de ces définitions pour estimer l’incidence et la prévalence annuelles de la PR. Nous avons ensuite examiné les taux d’incidence et de prévalence annuels d’une région géographique à l’autre et entre les lieux de résidence urbains et ruraux.
Résultats
Un gradient de prévalence de la PR croissant du sud vers le nord a été observé dans la province. Durant l’exercice 2014–2015, le taux de prévalence de la PR était de 0,57% dans la région sanitaire de Sun Country, dans le sud de la Saskatchewan, et de 1,15% dans les régions sanitaires du nord. Les taux d’incidence ont fluctué dans le temps dans toutes les régions, mais ont eu tendance à être plus élevés dans les régions sanitaires du nord. Une prévalence supérieure de la PR a été observée chez les résidents des milieux ruraux au cours de la période de l’étude.
Conclusions
Les taux de prévalence observés pour la PR dans les régions sanitaires du nord étaient plus élevés qu’ailleurs dans la province. Les taux de prévalence des résidents des milieux ruraux étaient supérieurs à ceux des résidents des milieux urbains. Dans la planification stratégique, il faudra donc veiller à ce que les patients atteints de PR aient accès aux soins de santé appropriés dans toute la province.
Similar content being viewed by others
References
Romanow RJ (2002). Building on values: the future of health care in Canada. Final report. The Romanow Commission Report. Ottawa (ON): Health Canada 2002. ISBN 0–662–33043-92. (Accessed 12 June 2016).
Nair, B. V., Schuler, R., Stewart, S., & Taylor-Gjevre, R. M. (2016). Self-reported barriers to healthcare access for rheumatoid arthritis patients in rural and northern Saskatchewan: a mixed methods study. Musculoskeletal Care, 14(4), 243–251.
Ruderman, E. M., Nola, K. M., Ferrell, S., Sapir, T., & Cameron, D. R. (2012). Incorporating the treat-to-target concept in rheumatoid arthritis. J Manag Care Pharm, 18(9), 1–18.
Singh, J. A., Saag, K. G., Bridges Jr., S. L., Akl, E. A., Bannuru, R. R., Sullivan, M. C., et al. (2016). 2015 American College of Rheumatology Guideline for the treatment of rheumatoid arthritis. Arthritis and Rheumatology, 68, 1–26.
Statistics Canada (2011a). Focus on geography series, 2011 census-province of Saskatchewan. http://www12.statcan.gc.ca/census-recensement/2011/as-sa/fogs-spg/Facts-pr-eng.cfm?Lang=Eng&TAB=1&GK=PR&GC=47 (Accessed 10 Jan 2017).
Statistics Canada: Saskatchewan annual population report calendar year 2015 (http://www.stats.gov.sk.ca/pop/stats/population/APR2015.pdf) (Accessed 10 Jan 2017).
Statistics Canada: Saskatchewan aboriginal peoples 2011b national household survey: http://www.stats.gov.sk.ca/stats/pop/2011Aboriginal%20People.pdf (Accessed 10 Jan 2017).
Widdifield, J., Bernatsky, S., Paterson, J. M., Tu, K., Ng, R., Thorne, J. C., et al. (2013). Accuracy of Canadian health administrative databases in identifying patients with rheumatoid arthritis: a validation study using the medical records of rheumatologists. Arthritis Care and Res, 65(10), 1582–1591.
Statistics Canada: Census metropolitan area (CMA) and Census agglomeration (CA) http://www.statcan.gc.ca/pub/92-195-x/2011001/geo/cma-rmr/cma-rmr-eng.htm (Accessed 12 June 2016).
Bernatsky, S., Dekis, A., Hudson, M., Pineau, C. A., Boire, G., Fortin, P. R., et al. (2014). Rheumatoid arthritis prevalence in Quebec. BMC Res Notes, 19(7), 937.
Widdifield, J., Paterson, J. M., Bernatsky, S., Tu, K., Tomlinson, G., Kuriya, B., Thorne, J. C., & Bombardier, C. (2014). The epidemiology of rheumatoid arthritis in Ontario, Canada. Arthritis Rheumatol, 66(4), 786–793.
Myasoedova, E., Crowson, C. S., Kremers, H. M., Therneau, T. M., & Gabriel, S. E. (2010). Is the incidence of rheumatoid arthritis rising?: results from Olmsted County, Minnesota, 1955-2007. Arthritis Rheum, 62(6), 1576–1582.
Vieira, V. M., Hart, J. E., Webster, T. F., Weinberg, J., Puett, R., Laden, F., Costenbader, K. H., & Karlson, E. W. (2010). Association between residences in U.S. northern latitudes and rheumatoid arthritis: a spatial analysis of the nurses’ health study. Environ Health Perspect, 118(7), 957–961.
Taylor-Gjevre, R. M., Trask, C., King, N., & Koehncke, N. (2015). Prevalence and occupational impact of arthritis in Saskatchewan farmers. J Agromedicine, 20(2), 205–216.
Khuder, S. A., Peshimam, A. Z., & Agraharam, S. (2002). Environmental risk factors for rheumatoid arthritis. Rev Environ Health, 17(4), 307–315.
Parks, C. G., Hoppin, J. A., De Roos, A. J., Costenbader, K. H., Alavanja, M. C., & Sandler, D. P. (2016). Rheumatoid arthritis in agricultural health study spouses: Associations with pesticides and other farm exposures. Environ Health Perspect, 124(11), 1728–1734.
Klockars, M., Koskela, R. A., Jarvinen, E., Kolari, P. J., & Rossi, A. (1987). Silica exposure and rheumatoid arthritis: a follow up study of granite workers 1940-81. Br Med J (Clin Res Ed), 294(6578), 997–1000.
Yahya, A., Bengtsson, C., Larsson, P., Too, C. L., Mustafa, A. N., Abdullah, N. A., Muhamad, N. A., Klareskog, L., Murad, S., & Alfredsson, L. (2014). Silica exposure is associated with an increased risk of developing ACPA-positive rheumatoid arthritis in an Asian population: evidence from the Malaysian MyEIRA case-control study. Mod Rheumatol, 24(2), 271–274.
Hart, J. E., Laden, F., Puett, R. C., Costenbader, K. H., & Karlson, E. W. (2009). Exposure to traffic pollution and increased risk of rheumatoid arthritis. Environ Health Perspect, 117(7), 1065–1069.
Deering, K. N., Lix, L. M., Bruce, S., & Young, T. K. (2009). Chronic diseases and risk factors in Canada’s northern populations: longitudinal and geographic comparisons. Can J Public Health, 100(1), 14–17.
Di Giuseppe, D., Discacciati, A., Orsini, N., & Wolk, A. (2014). Cigarette smoking and risk of rheumatoid arthritis: a dose-response meta-analysis. Arthritis Res Ther, 16(2), R61.
Shen, T. C., Lin, C. L., Wei, C. C., Chen, C. H., Tu, C. Y., Hsia, T. C., et al. (2015). Previous history of tuberculosis is associated with rheumatoid arthritis. Int J Tuberc Lung Dis, 19(11), 1401–1405.
Long, R., Hoeppner, V., Orr, P., Ainslie, M., King, M., Abonyi, S., et al. (2013). Marked disparity in the epidemiology of tuberculosis among aboriginal peoples on the Canadian prairies: the challenges and opportunities. Can Respir J, 20(4), 223–230.
Barnabe, C., Elias, B., Bartlett, J., Roos, L., & Peschken, C. (2008). Arthritis in aboriginal Manitobans: evidence for a high burden of disease. J Rheumatol, 35(6), 1145–1150.
Parks, C. G., D’Aloisio, A. A., DeRoo, L. A., Huiber, K., Rider, L. G., Miller, F. W., et al. (2013). Childhood socioeconomic factors and perinatal characteristics influence development of rheumatoid arthritis in adulthood. Ann Rheum Dis, 72(3), 350–356.
Lix L, Yogendran M, Burchill C, Metge C, McKeen N, Moore D, Bond R. Defining and validating chronic diseases: an administrative data approach. Manitoba Centre for Health Policy. July 2006. http://mchpappserv.cpe.umanitoba.ca/reference/chronic.disease.pdf (Accessed 10 Jan 2017).
Doran, M. F., Pond, G. R., Crowson, C. S., O’Fallon, W. M., & Gabriel, S. E. (2002). Trends in incidence and mortality in rheumatoid arthritis in Rochester, Minnesota, over a forty-year period. Arthritis Rheum, 46(3), 625–631.
Funding
This work was supported by the Noreen Sutherland—Rheumatoid Arthritis—Royal University Hospital Foundation Endowment Fund.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
This study complies with the Declaration of Helsinki and was approved by the University of Saskatchewan Biomedical Research Ethics Board.
Conflicts of Interest
The authors declare that they have no conflicts of interest.
Disclaimer
This study is based in part on de-identified data provided by the Saskatchewan Ministry of Health. The interpretation and conclusions contained herein do not necessarily represent those of the Government of Saskatchewan or the Ministry of Health.
Rights and permissions
About this article
Cite this article
Taylor-Gjevre, R., Nair, B., Jin, S. et al. Geographic variation in incidence and prevalence rates for rheumatoid arthritis in Saskatchewan, Canada 2001–2014. Can J Public Health 109, 427–435 (2018). https://doi.org/10.17269/s41997-018-0045-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.17269/s41997-018-0045-6