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. 2020 Oct 15;20(1):1551.
doi: 10.1186/s12889-020-09599-0.

Geospatial patterns of comorbidity prevalence among people with osteoarthritis in Alberta Canada

Xiaoxiao Liu  1   2   3 , Rizwan Shahid  4   5 , Alka B Patel  1   5 , Terrence McDonald  6 , Stefania Bertazzon  4 , Nigel Waters  4 , Judy E Seidel  1   5 , Deborah A Marshall  7   8   9
Affiliations

Geospatial patterns of comorbidity prevalence among people with osteoarthritis in Alberta Canada

Xiaoxiao Liu et al. BMC Public Health. .

Abstract

Background: Knowledge of geospatial pattern in comorbidities prevalence is critical to an understanding of the local health needs among people with osteoarthritis (OA). It provides valuable information for targeting optimal OA treatment and management at the local level. However, there is, at present, limited evidence about the geospatial pattern of comorbidity prevalence in Alberta, Canada.

Methods: Five administrative health datasets were linked to identify OA cases and comorbidities using validated case definitions. We explored the geospatial pattern in comorbidity prevalence at two standard geographic areas levels defined by the Alberta Health Services: descriptive analysis at rural-urban continuum level; spatial analysis (global Moran's I, hot spot analysis, cluster and outlier analysis) at the local geographic area (LGA) level. We compared area-level indicators in comorbidities hotspots to those in the rest of Alberta (non-hotspots).

Results: Among 359,638 OA cases in 2013, approximately 60% of people resided in Metro and Urban areas, compared to 2% in Rural Remote areas. All comorbidity groups exhibited statistically significant spatial autocorrelation (hypertension: Moran's I index 0.24, z score 4.61). Comorbidity hotspots, except depression, were located primarily in Rural and Rural Remote areas. Depression was more prevalent in Metro (Edmonton-Abbottsfield: 194 cases per 1000 population, 95%CI 192-195) and Urban LGAs (Lethbridge-North: 169, 95%CI 168-171) compared to Rural areas (Fox Creek: 65, 95%CI 63-68). Comorbidities hotspots included a higher percentage of First Nations or Inuit people. People with OA living in hotspots had lower socioeconomic status and less access to care compared to non-hotspots.

Conclusions: The findings highlight notable rural-urban disparities in comorbidities prevalence among people with OA in Alberta, Canada. Our study provides valuable evidence for policy and decision makers to design programs that ensure patients with OA receive optimal health management tailored to their local needs and a reduction in current OA health disparities.

Keywords: Comorbidity; Disparities; Osteoarthritis; Rural; Spatial analysis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Standard geographic areas in Alberta. The authors created the map using ArcMap 10.8 through the University of Calgary Educational Site License
Fig. 2
Fig. 2
Global Moran’s I index by conceptualization of spatial relationships and by comorbidity group
Fig. 3
Fig. 3
Connectivity histograms of three weight matrices
Fig. 4
Fig. 4
Hot spots and outliers for people with OA and 1 comorbidity (left), 2 comorbidities (middle), and 3+ comorbidities (right). The authors created these maps using ArcMap 10.8 through the University of Calgary Educational Site License
Fig. 5
Fig. 5
Hot spots and outliers for people with OA and depression (left), hypertension (middle), and COPD (right). The authors created these maps using ArcMap 10.8 through the University of Calgary Educational Site License
See this image and copyright information in PMC

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