Canadian Journal of Public Health

, Volume 104, Issue 7, pp e450–e455 | Cite as

The Rising Burden of Rheumatoid Arthritis Surpasses Rheumatology Supply in Ontario

  • Jessica WiddifieldEmail author
  • J. Michael Paterson
  • Sasha Bernatsky
  • Karen Tu
  • J. Carter Thorne
  • Vandana Ahluwalia
  • Noah Ivers
  • Debra Butt
  • R. Liisa Jaakkimainen
  • George Tomlinson
  • Claire Bombardier
Quantitative Research



Accurate data on the burden of rheumatoid arthritis (RA) are scarce, but critical in helping health care providers and decision makers to optimize clinical and public health strategies for disease management. We quantified the burden of RA in Ontario from 1996 to 2010 by age, sex and health planning region.


We used the Ontario Rheumatoid Arthritis administrative Database (ORAD), a validated population-based cohort of all Ontarians with RA, to estimate the crude prevalence and incidence of RA among men and women, and by age group from 1996 to 2010. Burden by area of patient residence and rheumatology supply also were determined.


The number of RA patients increased over time, from 42,734 Ontarians (0.5%) in 1996 to 97,499 (0.9%) in 2010. On average 5,830 new RA patients were diagnosed each year. In 2010, the burden was higher among females (1.3%) than males (0.5%) and increased with age, with almost half of all RA patients aged 65 years and older. The burden was higher in northern communities (1.0%) than in southern urban areas (0.7%). During the study period, the number of rheumatologists practicing in Ontario remained unchanged (approximately 160).


Over a 15-year period, the number of RA patients more than doubled with no concomitant increase in the number of practicing rheumatologists. We observed considerable regional variation in burden, with the highest rates observed in the north. Our findings highlight the need for regional approaches to the planning and delivery of RA care in order to manage the growing burden.

Key words

Rheumatoid arthritis prevalence incidence health services 



Les données précises sur le fardeau de la polyarthrite rhumatoïde (PR) sont rares mais essentielles pour aider le personnel soignant et les décideurs à optimiser les stratégies cliniques et de santé publique en gestion des soins thérapeutiques. Nous avons chiffré le fardeau de la PR en Ontario de 1996 à 2010 selon l’âge, le sexe et la région de planification sanitaire.


Nous avons utilisé la base de données administratives sur la polyarthrite rhumatoïde de l’Ontario (ORAD), une cohorte populationnelle validée de tous les Ontariens atteints de PR, pour estimer la prévalence et l’incidence brutes de la PR selon le sexe et le groupe d’âge de 1996 à 2010. Nous avons aussi déterminé le fardeau de la maladie selon la région de résidence des patients et l’offre en rhumatologie.


Le nombre de patients atteints de PR a augmenté avec le temps, passant de 42 734 Ontariens (0,5%) en 1996 à 97 499 (0,9%) en 2010. En moyenne, 5 830 nouveaux patients par année ont reçu un diagnostic de PR. En 2010, le fardeau était plus lourd chez les femmes (1,3%) que chez les hommes (0,5%), et il augmentait avec l’âge: près de la moitié des patients atteints de PR avaient 65 ans et plus. Le fardeau était plus lourd dans les communautés nordiques (1,0%) que dans les agglomérations urbaines du Sud (0,7%). Sur la période de l’étude, le nombre de rhumatologues exerçant en Ontario est resté inchangé (environ 160).


Sur une période de 15 ans, le nombre de patients atteints de PR a plus que doublé, sans augmentation comparable du nombre de rhumatologues en exercice. Nous avons relevé des écarts régionaux considérables dans le fardeau de la maladie, les plus hauts taux étant observés dans le Nord. Nos constatations soulignent le besoin d’approches régionales en matière de planification et de prestation des soins de la PR afin de composer avec l’alourdissement du fardeau.

Mots clés

polyarthrite rhumatoïde prévalence incidence services de santé 


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Copyright information

© The Canadian Public Health Association 2013

Authors and Affiliations

  • Jessica Widdifield
    • 1
    • 2
    Email author
  • J. Michael Paterson
    • 1
    • 2
    • 3
  • Sasha Bernatsky
    • 4
  • Karen Tu
    • 1
    • 2
  • J. Carter Thorne
    • 5
  • Vandana Ahluwalia
    • 6
  • Noah Ivers
    • 1
    • 2
    • 7
  • Debra Butt
    • 1
  • R. Liisa Jaakkimainen
    • 1
    • 2
    • 8
  • George Tomlinson
    • 1
  • Claire Bombardier
    • 1
  1. 1.University of TorontoTorontoCanada
  2. 2.Institute for Clinical Evaluative SciencesTorontoCanada
  3. 3.McMaster UniversityHamiltonCanada
  4. 4.McGill UniversityMontrealCanada
  5. 5.Southlake Regional Health CentreNewmarketCanada
  6. 6.William Osler Health CenterBramptonCanada
  7. 7.Women’s College HospitalTorontoCanada
  8. 8.Sunnybrook Health Sciences CentreTorontoCanada

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