What is the impact of adolescent arthritis and rheumatism? Evidence from a national sample of Canadians.
OBJECTIVE
Adolescent arthritis or rheumatism (AAR) has been shown to influence the activities, mental health, and healthcare utilization of affected individuals. However, these effects have never been estimated in a population-based sample. We examined the association of AAR with health status, health services use, health behaviors, and activity limitations. We also investigated the effect of socioeconomic status and family background on respondents with AAR.


METHODS
The 1996 National Population Health Survey is a nationally representative survey exploring the health status and behaviors of Canadians. Among the 26,012 individuals aged 12 to 19 with complete responses on the presence of chronic illnesses, the 213 self-reporting arthritis or rheumatism (AAR) were compared to: (1) all other adolescents as a single group; or (2) the group of 9161 adolescents reporting other chronic diseases (OCD) but not AAR, and the group of 16,638 adolescents without chronic disease (WCD). Between-group differences were examined for the following variables: health status; use of health services; presence of activity limitations in school, work, or at home; and school enrollment and work status.


RESULTS
Compared to those without, respondents with AAR reported more diagnoses of non-AAR chronic illnesses. Depression among AAR individuals was more prevalent than among non-AAR individuals, as was suffering from moderate or severe pain. Those with AAR were more likely than WCD individuals to use physician services, hospital services, and pain relief medications. AAR patients were more likely to be limited in their activities, and less likely to be enrolled in school than OCD or WCD individuals.


CONCLUSIONS
This study indicates a broad range of effects of AAR in a nationally representative sample. Arthritis or rheumatism affected measures of mental health, health service use, and the school, work, and home activities of affected individuals, compared to individuals without chronic disease or with other chronic disease.
Adam
Viviane
V
Division of Clinical Epidemiology, McGill University Health Centre, The Montreal General Hospital, Montreal, Canada.
St-Pierre
Yvan
Y
Fautrel
Bruno
B
Clarke
Ann E
AE
Duffy
Ciarán M
CM
Penrod
John R
JR
D000203:Activities of Daily Living; D000293:Adolescent; D016497:Adolescent Health Services; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D002170:Canada; D002648:Child; D003863:Depression / Q000209:etiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D012720:Severity of Illness Index