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Objective: Musculoskeletal disorders (MSDs) are a leading cause of healthy years lost due to premature mortality and disability. Our objective was to investigate whether MSDs were commensurably represented within the published health literature.Methods: MEDLINE bibliometric data were retrieved for 2011 and 2016. The 25 disease branches, including MSDs, were ranked according to published article counts, proportion of all publications, and increase in publications from 2011 to 2016. Rankings were also considered within 5 groupings of general health journals: geriatrics and gerontology, general and internal medicine, multidisciplinary sciences, primary health care, and public health.Results: There were 532,283 MEDLINE publications in 2016, a 16% increase over 2011. In 2016, MSDs ranked 13th in publication count, unchanged from 2011. The increase of 11% in MSD publications from 2011 was below the overall increase. Of 2016 publications, only 7% were MSD indexed, dropping from 7.3% in 2011. MSD-indexed publications had their highest ranking (8th) within geriatrics and gerontology, and lowest (19th) within public health.Conclusion: MSDs appear underrepresented in the published health literature generally, and specifically within public health, despite their significant population impact. A broader focus on noncommunicable diseases associated with mortality omits noncommunicable diseases such as MSDs that are leading contributors to high morbidity and high costs, and such omission likely contributes to the neglect of recognizing MSDs as a health priority. [ABSTRACT FROM AUTHOR]

Objectives Chronic conditions and multimorbidity are increasing worldwide. Yet, understanding longitudinal changes in multimorbidity over the lifecourse is limited. We compared the age-trajectory of multimorbidity by birth cohort and examined effects of socio-demographic (e.g. sex, income) and behavioral risk (e.g. obesity) factors in multimorbidity. Methods Using data from the Canadian Longitudinal National Population Health Survey (1994–2010), we examined 10,186 participants born 1925–1974 grouped in 5 birth cohorts. Data on the number of chronic conditions (up to 17), income, education, and behavioral risk factors were collected biannually. We used multilevel logistic growth modeling techniques for analyses of multimorbidity defined as the presence of 2+ chronic conditions versus 1 or none. Results We found significant cohort differences in the age-trajectory of multimorbidity: at corresponding ages, each succeeding recent cohort had higher odds of reporting multimorbidity than their predecessors. Access to healthcare did not fully explain these differences. Women, having lower income, being obese, smoking, and a sedentary lifestyle had increased odds of reporting multimorbidity. Obese individuals, particularly Gen Xers and younger boomers, reported multimorbidity at an earlier age than those of normal weight. We observed divergent trajectories of greater multimorbidity for lower than higher income individuals. Furthermore, after accounting for age and risk factors there was an apparent increase in reporting multimorbidity over time (period effect) across all ages. Discussion Our findings indicate that multimorbidity is not only becoming the norm, but is emerging earlier in the lifecourse and particularly for low income and obese individuals from more recent cohorts. The findings point to the importance of planning interventions and policies to deal with more recent birth cohorts entering into older age with worse health than their predecessors. [ABSTRACT FROM AUTHOR]

Background: There is a perception that the impacts of arthritis are greatest among older adults. However, the effect of age on health-related outcomes in individuals with arthritis has not been explicitly studied. This study examined whether the physical and mental health impacts of arthritis are greater in older (75+ years) versus younger (20-44, 45-64 and 65-74 years) Canadian adults. Methods: Data were from the arthritis component of the 2009 Survey on Living with Chronic Diseases in Canada. The responses were weighted to be representative of Canadians (≥20 years) with arthritis. Associations between age and the prevalence of severe/frequent joint pain, severe/frequent fatigue, sleep limitations, instrumental activities of daily living (IADLs) limitations, high levels of stress, suboptimal general and suboptimal mental health, were examined descriptively prior to conducting multivariate log-binomial regression analyses. Results: A total of 4565 respondents completed the survey (78 % response rate). Individuals with arthritis were mostly female (63 %), of working age (57 %) and overweight or obese (67 %). Upon adjusting for covariates, younger (20-44 years) and/or middle aged (45-64 years) adults were more likely than those older (75+ years) to report severe/frequent joint pain, sleep limitations, high levels of stress and suboptimal mental health. After adjusting for covariates, age was not associated with IADL limitations, severe/frequent fatigue or suboptimal general health. Conclusions: Contrary to the belief that older adults with arthritis experience more severe physical and mental health outcomes, we found that older adults were less likely to report worse outcomes than younger adults. In light of these findings, public health messaging should stress that arthritis does not just affect the elderly and emphasize the importance of timely diagnosis and management at all ages in order to prevent or, minimize arthritis-related impairment. [ABSTRACT FROM AUTHOR]

Objective: To examine the impact of access to primary care physicians (PCPs), geographic availability of orthopaedic surgeons, socioeconomic status (SES), proportion of older population (≥65 years) and proportion of rural population on orthopaedic surgeon office visits and orthopaedic surgery. Design: Population multilevel study. Setting: Ontario, Canada. Participants: Ontario residents 18 years or older who had visits to orthopaedic surgeons or an orthopaedic surgery for musculoskeletal disorders in 2007/2008. Primary and secondary outcomes: Office visits to orthopaedic surgeons and orthopaedic surgery. Results: Access to PCPs and the index of geographic availability of orthopaedic surgeons, but not SES, were significantly associated with orthopaedic surgeon office visits. There was a significant interaction between access to PCPs and orthopaedic surgeon geographic availability for the rate of office visits, with access to PCPs being more important in areas of low geographic availability of orthopaedic surgeons. After controlling for office visits with orthopaedic surgeons, the index of geographic availability of orthopaedic surgeons was no longer significantly associated with orthopaedic surgery. Conclusions: The findings suggest that, particularly, in areas with low access to PCPs or with fewer available orthopaedic surgeons, residents are less likely to have orthopaedic surgeon office visits and in turn are less likely to receive surgery. Efforts to address adequate access to orthopaedic surgery should also include improving and facilitating access to PCPs for referral, particularly in geographic areas with low orthopaedic surgeon availability. [ABSTRACT FROM AUTHOR]