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Canadian Journal of Public Health

, Volume 95, Issue 3, pp 168–173 | Cite as

Proxy Reporting and the Increasing Prevalence of Arthritis in Canada

  • Anthony V. Perruccio
  • Elizabeth M. Badley
Article

Abstract

Background

Analyses of the 1994/95 to 1998/99 Canadian National Population Health Surveys (NPHS) reveal significant, and greater than projected, increases in the reported arthritis in the household population aged 15+ years, from 13.4 to 16.0%. The objectives of this study were to determine whether the increasing prevalence of arthritis can be explained by a) changes in the age and sex structure of the population, or b) the variation in the proportion of proxy respondents and whether proxy reporting affects the overall prevalence estimate.

Methods

Overall analyses of 1994/95, 1996/97 and 1998/99 cycles of the NPHS, for arthritis or rheumatism reported as a long-term health problem diagnosed by a health professional. Stratified analyses, by respondent type, to account for the decreasing proportion of proxy respondents over time (33% to 16%).

Results

Overall age-sex standardized prevalence estimates were similar to crude estimates. The crude prevalence of arthritis in proxy respondents was stable (approximately 8.5%), whereas in self-respondents it increased from 15.8 to 17.4% over the 3 cycles. Adjustment for the lower prevalence in proxy respondents increased the estimated overall prevalence of arthritis by at least 1 percentage point for each cycle year. The disparity between self- and proxy reporting was higher for younger people and females.

Conclusion

Significant disparity exists in age- and sex-specific prevalence estimates between self- and proxy respondents. The increase in prevalence of arthritis over time is a result of increased reporting by self-respondents. Proxy reporting affects overall prevalence. The findings have implications for the use of NPHS data.

Résumé

Contexte

L’analyse des Enquêtes nationales sur la santé de la population (ENSP) de 1994–1995 à 1998–1999 fait état d’une augmentation significative et plus importante que prévu, soit de 13,4 % à 16 %, du taux d’arthrite déclaré dans la population à domicile de 15 ans et plus. Notre étude visait à déterminer si la prévalence croissante de l’arthrite peut s’expliquer a) par les changements dans la structure par âge et par sexe de la population ou b) par la variation de la proportion d’enquêtéssubstituts et l’effet possible des déclarations par personne interposée sur l’estimation globale de la prévalence.

Méthode

Analyses globales de l’arthrite ou du rhumatisme déclarés dans les cycles 1994–1995, 1996–1997 et 1998–1999 de l’ENSP à titre de problèmes de santé durables diagnostiqués par un professionnel de la santé. Analyses stratifiées par type de répondant pour expliquer la proportion décroissante des enquêtés-substituts au fil du temps (de 33 % à 16 %). Résultats: Les estimations globales sur la prévalence, normalisées selon l’âge et le sexe, étaient semblables aux estimations non rectifiées. La prévalence non rectifiée de l’arthrite déclarée par les enquêtés-substituts est restée stable (à environ 8,5 %), tandis que chez les répondants directs, elle est passée de 15,8 % à 17,4 % au fil des trois cycles. Après ajustement pour la plus faible prévalence déclarée par les enquêtés-substituts, la prévalence estimative globale de l’arthrite a gagné au moins un point de pourcentage par année de cycle. La disparité entre les déclarations directes et par personnes interposées était plus prononcée chez les jeunes et chez les femmes.

Conclusion

Il existe une disparité significative entre les répondants directs et les enquêtéssubstituts dans les estimations sur la prévalence selon l’âge et le sexe. L’accroissement de la prévalence de l’arthrite au fil du temps résulte de sa déclaration accrue par les répondants directs. Les réponses par personnes interposées ont un effet sur la prévalence globale. Ces constatations ont des conséquences pour l’utilisation des données des ENSP.

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Copyright information

© The Canadian Public Health Association 2004

Authors and Affiliations

  1. 1.Arthritis Community Research and Evaluation Unit, Division of Outcomes and Population Health, Toronto Western Research InstituteUniversity Health NetworkTorontoCanada
  2. 2.Department of Public Health SciencesUniversity of TorontoTorontoCanada

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