Sex and Gender-based Analysis of this topic
Definition
Arthritis and related conditions make up a large group of disorders affecting the joints, ligaments, tendons, bones and other components of the musculoskeletal system[1]. Arthritis commonly manifests as pain, swelling, or stiffness in or around a joint(s). Although arthritis is most prevalent among seniors, it is not solely confined to the elderly population. Nearly 4.5 million Canadians aged 12 years and older reported arthritis and related conditions as of 2005, two-thirds of these being women[2].
Sex Issues
Arthritis is the most common chronic condition that Canadian women report after non-food allergies[3]. Osteoarthritis is a common form of arthritis that breaks down the cartilage in the joint(s) and affects more women after the age of 50 compared to men in terms of hand, foot, and knee joints[4]. Men appear to have some inherent protective factors, such as significantly more cartilage in their knees, which may protect them from developing osteoarthritis in the knee[5]. Canadian women report a higher prevalence of disability related to arthritis in all age groups compared to men except less than 15 yrs of age. As well, women’s mortality rates are higher for arthritis and other related conditions in all age groups compared to men[6].
Gender Issues
Arthritis may be especially problematic for low-income women because arthritic individuals more often report taking more disability days compared to individuals with other chronic conditions[7]. Women are more disabled at the time of knee or hip replacements and require more assistance with daily living because they are more likely to live alone[8]. However, a recent study found that physcians were more likely to recommend total knee arthroplasty for male patients when both men and women present with similar levels of disability, which suggests that women are receiving differential treatment[9].
Diversity
Canadian women who have arthritis are more likely to be older, have lower incomes, have fewer years of education, and be out of the labour force[10]. Arthritis is the most prevalent chronic condition in the Aboriginal population; arthritis in the non-reserve Aboriginal population is twice the proportion compared to the total Canadian population. More specifically, Aboriginal women have higher prevalence rates in all age groups compared to men[11]. Individuals who live in British Columbia, Alberta, Manitoba, or Prince Edward Island receive poorer care compared to other Canadians because of restrictive provincial medication coverage.
Critique
Although arthritis is a leading cause of pain, physical disability, and health care utilization in Canada, arthritis research is severly underfunded compared to other diseases, surveillance activities are minimal, and national and provincial data is rarely integrated. The mortality burden of arthritis and related conditions has been underestimated, because data on contributing causes of death (such as complications of arthritis treatment) are not available.
National surveys need more detailed diagnostic questions about arthritis. For example, including questions on chronic joint symptoms or on the impact that arthritis has on day-to-day functioning would help provide a more complete picture of the burden of arthritis in Canada, especially in terms of women’s experience of arthritis.