Chronic Diseases in Canada

Volume 27, No. 1, 2006

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Titles of Feature Articles

1. Spatio-temporal distribution of hypothyroidism in Quebec - View Abstract
   Fabien Gagnon, Marie-France Langlois, Isabelle Michaud, Suzanne Gingras, Jean-François Duchesne and Benoît Lévesque

2. The epidemiology of self-reported fibromyalgia in Canada - View Abstract
   J Dayre McNally, Doug A Matheson and Volodko S Bakowsky

3. A population-based analysis of health behaviours, chronic diseases and associated costs - View Abstract
   Arto Ohinmaa, Donald Schopflocher, Philip Jacobs, Sandor Demeter, Anderson Chuck, Kamran Golmohammadi and Scott W Klarenbach

4. Multiple exposures to smoking, alcohol, physical inactivity and overweight: Prevalences according to the Canadian Community Health Survey Cycle 1.1 - View Abstract
   Julia E Klein-Geltink, Bernard CK Choi and Richard N Fry

Chronic Diseases in Canada (CDIC) is a quarterly scientific journal focussing on current evidence relevant to the control and prevention of chronic (i.e. non-communicable) diseases and injuries in Canada. Since 1980 the journal has published a unique blend of peer-reviewed feature articles by authors from the public and private sectors and which may include research fromsuch fields as epidemiology, public/community health, biostatistics, the behavioural sciences, and health services or economics. Only feature articles are peer reviewed. Authors retain responsibility for the content of their articles; the opinions expressed are not necessarily those of the CDIC editorial committee nor of the Public Health Agency of Canada.

Abstracts from Feature Articles in Chronic Diseases in Canada Volume 27, No 1, 2006

Article 1: Spatio-temporal distribution of hypothyroidism in Quebec

Authors: Fabien Gagnon, Marie-France Langlois, Isabelle Michaud, Suzanne Gingras, Jean-François Duchesne and Benoît Lévesque

Abstract:

This study estimates the incidence and prevalence of hypothyroidism in Quebec, based on a data bank produced by the Régie de l'assurance maladie du Québec (RAMQ) on the use of thyroid hormones by persons insured under RAMQ's public drug insurance plan between 1992 and 2001. In 2001, the prevalence of thyroid hormone use in women and men respectively was 10.8 and 2.9 percent. Prevalence increases with age, reaching, among those aged 65 and over, 21.9 percent in women and 8.0 percent inmen in 2001. Incidence is highest in women between the ages of 45 and 64 and in men aged 65 and over. Age-related incidence is relatively stable in women but tends to increase in men. On a regional and local basis (by Centre local de services communautaires [CLSC]), incidence rates up to 2.4 times higher than anticipated on the basis of provincial incidence rates were observed.

Article 2: The epidemiology of self-reported fibromyalgia in Canada

Authors: J Dayre McNally, Doug A Matheson and Volodko S Bakowsky

Abstract:

Fibromyalgia (FM) is a poorly understood condition characterized by chronic diffuse musculoskeletal pain. This study describes the self-reported epidemiology of FM in Canada using data collected from the Canadian Community Health Survey, Cycle 1.1 (2000). FM prevalence rates with corresponding 95 percent confidence intervals were calculated. The Canadian prevalence rate was 1.1 percent with a female-to-male ratio of six to one. In women, rates increased with age up to 65 years, declining thereafter. Data collected on-ageat- diagnosis is presented and demonstrates a surprising number of newly diagnosed FMcases among people in their 20s and 30s, signifying that FM is a problem for people of all ages. The association with FM and a number of sub-populations was also investigated. With respect to geography and environment, the FM prevalence rate in women was shown to be approximately two percent in all Canadian regions except Quebec, where it was 1.1 percent. Further analysis by language suggested that geographical and cultural differences might best explain this observation. Finally, an association with a number of behavioral and socioeconomic determinants of health, including weight, is presented.

Article 3: A population-based analysis of health behaviours, chronic diseases and associated costs

Authors: Arto Ohinmaa, Donald Schopflocher, Philip Jacobs, Sandor Demeter, Anderson Chuck, Kamran Golmohammadi and Scott W Klarenbach

Abstract:

Health behaviours influence the future incidence of certain common chronic diseases and thus have an impact on health status and utilization of health care services and costs.We analyzed person-level data of the Albertan adult population from the Canadian Community Health Survey, Cycle 1.1 (2000) to determine health care costs associated with specific health behaviours (smoking, sub-optimal diet, physical inactivity) and chronic disease states (heart disease, diabetes, COPD). We found that 74.7 percent of the population exhibited one ormore risk behaviours, while 10.5 percent had one or more of the chronic diseases of interest. Greater health care utilization and costs were noted in groups exhibiting risk behaviour and chronic disease states. Approximately 31 percent of health care costs in Alberta were attributable to people having one or more of the three chronic diseases. Our findings of higher health care costs incurred by those exhibiting unhealthy behaviour prior to development of disease, as well as by those with multiple co-existent diseases, are important indicators to guide future prevention and treatment strategies of chronic illness.

Article 4: Multiple exposures to smoking, alcohol, physical inactivity and overweight: Prevalences according to the Canadian Community Health Survey Cycle 1.1

Authors: Julia E Klein-Geltink, Bernard CK Choi and Richard N Fry

Abstract:

The objective of this study was to calculate the prevalence of multiple exposures to four modifiable risk factors (smoking, alcohol, physical inactivity and overweight) and to establish whether there are more Canadians with multiple risk factor exposures than those with singular ones. Weighted estimates of the prevalence of mutually exclusive risk factor clusters were calculated according to the Canadian Community Health Survey, Cycle 1.1 (2000). Confidence limits were estimated by bootstrap techniques. Findings indicate that 21.0 percent of Canadians have no risk factor exposures, 53.5 percent are physically inactive, 21.5 percent currently smoke, 44.8 percent are overweight, and 6.0 percent are high-risk drinkers. Compared to females, males are less physically inactive but more likely to smoke, have high alcohol intake and be overweight, across all age groups. At least one risk factor was present in 79.0 percent of Canadians and 39.0 percent have at least two coexistent exposures. The distribution of risk factor prevalences differed significantly by age, most peaking among those between age 35 and 64, with the exception of physical inactivity. Those who smoke and are physically inactive account for the highest proportion of the population with two or more coexistent risk factors. Canadians who are free of the four risk factors for chronic disease examined in this paper constitute the minority. Future studies are recommended to examine other risk factors, as well as interactions of multiple exposures in association with chronic disease.