Population attributable risk from obesity to arthritis in the Canadian Population Health Longitudinal Survey 1994-2006.

OBJECTIVES: To examine the relationship, potential associations, and determine the population attributable risk percent (PAR%) between obesity and arthritis in Canadians aged 40 to 79 from 1994 to 2006. METHODS: Our study population were the 17 276 respondents in the Canadian National Population Longitudinal Health Survey data, from 1994/1995 to 2006/2007. RESULTS: Respondents who were overweight and obese increased over time, with arthritis increasing from 20% to 30% over the study period. Women reported a 10% higher prevalence of arthritis than men. Men aged 70-79 and women aged 60-69 were most likely to report arthritis. PAR% calculations indicated that 3.8% of arthritis in 1994 and 7.5% in 2006 in the overall population could be attributed to overweight, while the proportion of arthritis attributable to obesity increased from 7.0% in 1994 to 10.2% in 2006. CONCLUSIONS: Increasing overweight/obesity of the population was positively associated with arthritis in Canada for both sexes. In addition to the many other beneficial health effects, reducing levels of excess weight may result in either less arthritis or fewer manifestations of symptoms of arthritis or both.

A cohort study for the impact of activity-limiting injuries based on the Canadian National Population Health Survey 1994-2006.

OBJECTIVE: To examine the prevalence and factors affecting activity-limiting injuries (ALI) in individuals and in the Canadian population; to estimate the short and long term impact on health status and well-being because of ALI in Canada from 1994 to 2006 using the Canadian National Population Health Survey (NPHS). DESIGN: The NPHS is a randomised longitudinal cohort study with biennial interviews, with information on age, sex, education, marital status, income, residence, height and weight to self-perceived health status, healthcare utilisation and medication use in addition to ALI. SETTING: The study population was a random sample of male and female participants 20 years and older from 10 provinces and three territories in Canada. PRIMARY AND SECONDARY OUTCOME MEASURES: Logistic regression models were used to assess the potential impact of ALI on individuals and on the Canadian population. The interviews 2 years before and 2 years after the ALI were compared to examine long-term effects, and the McNemar test option in SAS was used for the matched analysis. RESULTS: The immediate impacts of ALI were pain, disability and disruption of regular life. Long-term effects in patients were chronic pain and increased medical doctor visits. Population impact included a considerable increase in healthcare access and cost. The odds ratios (OR) for the 20-39 age group compared with those 60+ was 2.2; 95% CI 1.8 to 2.7, while the OR associated with male participants was 1.4; 95% CI 1.1 to 1.6. Individuals consuming nine or more alcoholic drinks per week were also significantly more likely to report an ALI (OR, 1.5; 95% CI 1.3 to 1.8). CONCLUSIONS: The findings from this study illustrated the immediate and long-term impact of individuals and population level injuries in Canada. Injury control policies should aim to prevent the number of injuries, fatalities as well as the consequences among survivors.

Road traffic accident risk related to prescriptions of the hypnotics zopiclone, zolpidem, flunitrazepam and nitrazepam.

BACKGROUND: Despite the high prescription rate of benzodiazepine-like hypnotics (z-hypnotics), there is limited information on the road traffic accident risk associated with the use of these drugs. We wanted to investigate whether filling a prescription for zopiclone or zolpidem was associated with increased risk of road traffic accidents at a national population level. Nitrazepam and flunitrazepam were used as comparator drugs. METHOD: All Norwegians 18-69 years (3.1 million) were followed-up from January 2004 until the end of September 2006. Information on prescriptions, road traffic accidents and emigration/death was obtained from three Norwegian population-based registries. The first week after the hypnotics had been dispensed was considered to be the exposure period. Standardized incidence ratios (SIRs) were calculated by comparing the incidence of accidents in the exposed person-time to the incidence of accidents in the unexposed person-time. RESULTS: During exposure, 129 accidents were registered for zopiclone, 21 for zolpidem, 27 for nitrazepam and 18 for flunitrazepam. The SIRs were (SIR for all ages and both sexes combined; 95% CI): z-hypnotics (zopiclone+zolpidem) 2.3; 2.0-2.7, nitrazepam 2.7; 1.8-3.9 and flunitrazepam 4.0; 2.4-6.4. The highest SIRs were found among the youngest users for all hypnotics. CONCLUSIONS: This study found that users of hypnotics had a clearly increased risk of road traffic accidents. The SIR for flunitrazepam was particularly high.

Factors Associated with Women's Medication Use.

HEALTH ISSUE: Research has consistently shown that while women generally live longer than men, they report more illness and use of health care services (including medication). In the literature, the reasons for women's elevated medication use are not clear. This paper investigates the associations between over-the-counter (OTC) and prescription (Rx) medication use and selected social and demographic variables in men and women. KEY FINDINGS: While a larger proportion of women than men used medication throughout the study, the proportion of people using medication did not increase. The use of OTC and Rx medication increased by number of physician visits for women and men.Medication use increased with age, chronic disease and number of physician visits, and decreased with the perception of good to excellent health. The relationship with other factors varied for women and men depending on their education level, income and social roles. For women, the social roles of being married or previously married, being employed or being a parent did not increase their likelihood of medication use. Reported income adequacy is not associated with the chances of mediation use among highly educated women, but for women with low levels, medication use increases as income adequacy decreases. DATA GAPS AND RECOMMENDATIONS: More complete data are needed about social roles and their relation to mediation use. Data that would allow an assessment of the appropriateness of OTC and Rx drug use or the reasons for such use need to be collected. More research is needed to better understand the distribution and determinants of specific medication use.