Variable/
Indicator 

Definition/Description 

Chronic Conditions 

For the chronic conditions presented in Figure 2-1, the respondent was asked about specified chronic health conditions*, defined as long-term conditions that had lasted or were expected to last 6 months or more and that had been diagnosed by a health professional. In order to assess the differential impact of arthritis, the comparison groups used in the chapter are as follows: 

1.    With arthritis - individuals who reported having arthritis/rheumatism with or without other chronic conditions. 

2.    Other chronic conditions - individuals who reported not having arthritis/rheumatism but reported having at least one chronic condition other than arthritis, and 

3.    No chronic condition - individuals who did not report any chronic conditions. 

*    Chronic health conditions: Food allergies, any other allergies, asthma, fibromyalgia, arthritis or rheumatism (excluding fibromyalgia), back problems (excluding fibromyalgia and arthritis), high blood pressure, migraine headaches, chronic bronchitis, emphysema or chronic obstructive pulmonary disease (asked of those aged 30+), diabetes, epilepsy, heart disease, cancer, stomach or intestinal ulcers, effects of a stroke, urinary incontinence, bowel disorder such as Crohn's disease or colitis, Alzheimer's disease or any other dementia (asked of those aged 18+), cataracts (asked of those aged 18+), glaucoma (asked of those aged 18+), thyroid condition, Parkinson's disease, multiple sclerosis, chronic fatigue syndrome, multiple chemical sensitivities, any other long-term condition. 

Income 

A 5-level total household income variable designated by Statistics Canada was grouped into two categories. The lowest/lower middle/middle income category was defined as a household income of <= $29,999, <= $39,999 or <= $59,999 if there were 1-2, 3 or 4, or 5+ people in the household respectively. Otherwise, the household income was categorized as upper middle/highest income. 

Education 

Highest level of education attained, coded as less than secondary school graduation, secondary school graduation, some post-secondary or post-secondary graduation. 

Body Mass
Index (BMI) and Overweight 

BMI is calculated as weight in kg divided by height in m². BMI was recoded as not overweight (BMI < 27) or overweight (BMI >= 27). The index was calculated for those aged 20-64 only excluding pregnant women and people less than 3 ft. (0.914 m)
or greater than 6 ft.11 in. (2.108 m) in height. The BMI cut-offs used here were the accepted Canadian standards at time of analysis. Since then, however, Health Canada has revised its standards with a BMI of >= 25 indicating overweight. 

Disability Days 

The number of days in the last 14 days in which the respondent had to spend all or part of the day in bed or had to reduce activities normally performed during the day because of illness or injury. Three categories were used: 1-5 days, 6-10 days, and 11-14 days. 

Pain 

Respondents were asked to identify which of the following four categories best described their situation with respect to pain: no pain or discomfort, mild pain, moderate pain, or severe pain. Moderate and severe pain were grouped 

Health Utilities Index (HUI) 

A generic health status measure designed to assess both quantitative and qualitative aspects of life, with scores ranging from 0.0 (worst health state, death) to 1.0 (best state, full health). HUI provides a description of an individual's overall functional health based on eight attributes: vision, hearing, speech, mobility (ability to get around), dexterity (use of hands and fingers), cognition (memory and thinking), emotion (feelings), pain and discomfort. The responses are weighted, and the derived score describes the individual's overall functional health status: a score < 0.830 was taken to indicate disability.⁴ 

Activity Limitations 

Respondents were asked, “Because of a long-term physical or mental condition or a health problem, are you limited in the kind or amount of activity you can do: at home? at school? at work? in other activities?” (Yes/No). 

Help with Daily Activities 

Recoded as needing help with at least one domestic activity (preparing meals and/or shopping for groceries and/or other necessities and/or housework), personal care (washing, dressing or eating and/or moving about in the house) or heavy household chores, versus needing no help. 

Physical Activity Index 

The energy expenditure (EE) in leisure activities** was estimated using the frequency and time per session of the physical activity as well as its MET value, a value of metabolic energy cost expressed as a multiple of the resting metabolic rate. The index was recoded with EE < 1.5 identified as “inactive” versus all other levels. 

** Walking for exercise, gardening or yard work, swimming, bicycling, popular or social dance, home exercises, ice hockey, ice skating, in-line skating or rollerblading, jogging or running, golfing, exercise class or aerobics, downhill skiing or snowboarding, bowling, baseball or softball, tennis, weight-training, fishing, volleyball, basketball and other. 

Sleep Problems 

a)    The time spent sleeping each night was recoded as <= 6 hours vs. > 6 hours. 

b)    How often do you have trouble going to sleep or staying asleep? This variable was recoded as problems sleeping most of the time versus all others. 

Depression 

A subset of items from the Composite International Diagnostic Interview (CIDI) that measure major depressive episode, where the score is translated in a probability of “caseness” of depression.⁵ A score >= 0.25 is considered to be indicative of a case depression. 

Stress 

The perceived amount of stress in daily life (not at all stressful, not very stressful, a bit stressful, quite a bit stressful, and extremely stressful). 

Self-rated Health 

Rated as either “excellent”, “very good”, “good”, “fair” or “poor”. The first three and the last two categories were grouped. Respondents were also asked to rate their health as compared with one year earlier (better, same, or worse). 

Health Care Provider Visits 

The number of times in the previous 12 months that the respondent had seen or talked on the telephone about physical, emotional or mental health with: 

•    A family doctor or general practitioner; 

•    Any other medical doctor (such as a surgeon, allergist, orthopedist, gynecologist or psychiatrist) (referred to as specialist); 

•    A nurse for care or advice; 

•    A chiropractor, a physiotherapist; 

•    A social worker or counsellor; or 

•    A psychologist. 

Social worker, counsellor and psychologist were grouped. Data are presented as at least four visits for family doctors and at least one visit for all others. 

Alternative or Complementary Medicine 

Respondents were asked whether in the previous 12 months they had seen or talked to an alternative health care provider such as 

•    An acupuncturist; 

•    A homeopath; or 

•    A massage therapist 

about physical, emotional or mental health. (Yes/No). 

Self-perceived Unmet Health Care Needs 

Respondents were asked “During the past 12 months, have you felt that health care was needed but not received?” (Yes/No). 

Medication Use 

Information on medication use was taken from the National Population Health Survey (NPHS) 1998/99.⁶ The target population for the NPHS included all household residents in each Canadian province excluding populations on Indian reserves, Canadian Forces Bases and some remote areas. Analyses and results are based on individuals 15 years of age and older, with weighted estimates representative of the general household population aged 15+. The NPHS used a survey methodology similar to the CCHS. 

The NPHS had a sample size of 14,682 respondents and a response rate of 98.5%. Data are presented for people who reported taking in the past month: 

a)    pain relievers such as Aspirin or Tylenol (including arthritis medicine and anti- inflammatories); 

b)    antidepressants; and 

c)    codeine, Demerol or morphine.