Data from the

NATIONAL HEALTH SURVEY

.

BasicDataon Arthritis

Knee,Hip, andSacroiliacJoints

in Adults Ages 25-74 Years

United States, 1971-1975

This report presents basic data on the prevalence of arthritis in the

knee, hip, and sacroiliac joints.

DHEW Publication No. (PHS) 79-1661

Series 11

Number 213

U.S. DEPARTMENT OF HEALTH, EDUCATION; AND WELFARE

Public Health Service

Office of Health Research, Statistics, and Technology

National Center for Health Statistics

Hyattsvil Ie, Md. August 1979
NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Deputy Director

JACOB J. FELDMAN, ph.D., Associate Director for Amdysis

GAIL F. FISHER, Ph. D., Associate Direc tor for the Cooperative Health S tatistics System

ROBERT A. ISRAEL, Acting Associate Director for Data Systems

JAMES T. BAIRD, JR., Ph.D., Associate Director for international Statistics

ROBERT C. HUBER, Associate Director for Management

MONROE G. SIRKEN, Ph.D., Associate Director for Mathematical Statistics

PETER L. HURLEY, Associate Director for Operations

JAMES M. ROBEY, Ph.D., Associate Director for Program Development

PAUL E. LEAVERTON, Ph. D., Associate Director for Research

ALICE HAYWOOD, Information Officer

DIVISION OF HEALTH EXAMINATION STATISTICS

ROBERT S. MURPHY, Director

JEAN ROBERTS, Chiej Medicd S tatistics Branch

COOPERATION OF THE BUREAU OF THE CENSUS

In accordance with specifications established by the Nationrd Health Survey, the Bureau

of the Census, under a contractual agreement, participated in the design and selection of the

sample, and earned out the first stage of the lfieldinterviewing and certain parts of the statistical processing.

Vital and Health Statistics-Series 11-No. 213

DHEW Publication No. (PHS) 79-1661

Library of Congress Cat~zlog Card No. 79-607006
—

/“

Library of Congress Cataloging in Publication Data

Maurer, Kurt

Basic data on arthritis.

(Vital and health statistics : Series 11, Data from the National Health Surt,ey ; no. 213)

(DHEW publication ; no. (PHS) 79-1661.

Bibliography

Supt. of Dots. no.: HE 20.6209: 11/213

1. Arthritis–United States–Statistics. 2. Knee–Diseases-United States–Statistics.

3. Hip joint–Diseases–United States–Statistics. 4. Sacroiliac joint-Diseases-United

States–Statistics. I. Title. II. Series: United States. National Center for Health Statistics.

Vital and health statistics : Series 11, Data from the National Health Survey, Data from the

health examination survey ; no. 213. III. Series: United States. Dept. of Health, Education, and Welfare. DHEW publication ; no. (PHS) 79-1661.

RA407.3.A347 no. 213 [RC933] 312’.0973s

ISBN 0-8406 -0158-1 [312’.37’200973] 79-607006
PREFACE

The National Center for HeaIth Statistics has as its mission the collection,

analysis, and dissemination of data on the health of the population of the United

States. One of the major programs is the Health Examination Survey, in which

are conducted extensive examinations of a sampIe of the U.S. population. Data

from this survey have been pubIished periodically in Series 11 reports of Vital

and Health Statistics.

Historically the published documents in Series 11 present only a small fraction of the available data. In order to make additionzd data avaiIable for users, the

Center has for many years had a policy of preparing public use tapes for purchase

by persons interested in more detailed analysis or analysis of additional variables

not published in Series 11 reports. These data, however, are only easiIy accessible

to persons with computers and support staff who can read, interpret, and analyze

the data. In order to make these data more generally accessible to many users,and,

in particular, to persons not able to directly use data tapes, the Division of Health

Examination Statistics, in the autumn of 1977, initiated a program to release,

along with the data tapes, basic descriptive summary tables of data contained in

those tapes.These tabular summaries have been termed “basic data publications,”

of which this report is one.

These basic data publications present findings of the Health and Nutrition

Examination Survey of 1971-75. For each of the data sets, these publications

include information on the methods used to collect the data, a descriptive summary of the tables included, an index to the tables, and the tables themselves.

An appendix describes the basic format of the associated data tape. More detailed

information on use of the data for additional analysis is available on request from

the staff of the Division of Health Examination Statistics.

...

Ill
CONTEI’)JTS

Foreword ............................................................................................................................................. ..

... m

Introduction .......................................................................................................................................... . 1

Sources and Limitations of the Data ...................................................................................................... 2

Arthritis Assessment ......................................................................................................................... 2

Arthritis History Supplement ............................................................................................................ 2

Highlights ...................................................................................................................................... ......... 3

Knees ........................................................................................................... .................................... 3

Hips .................................................................................................................................................. 4

Sacroiliac Joints ................................................................................................................................ 4

Joint Pain .......................................................................................................................................... 4

Treatments, Accidents, and Injuries .................................................................................................. ~

Limitation of Activity .......................................................................................................................

References ...................................................................................................................................... ........ 5

Lkt of Detailed Tables ........................................................................................................................... 6

Appendixes

I. Statistical Notes ........................................................................................................................ ~~

IL Demographic Terms .................................................................................................................. ~~

III. Summary of Arthritis Microdata Tape (HANES Catalog No. 4121) ..........................................

TEXT TABLE

I

A. Estimated percent of the noninstitutionalized U.S. population ages 55-74 with severe-moderate

osteoarthrosis of the knees or hips or severe-moderate sacroiliitis, by overall grade of condition,

sex, and age: HANES, 1971-75 ...................................................................................................... 3

v
SYMBOLS

Data not available -------------------------------------- ---

Category not applicable --------------------------- . . .

Quantity zero ------------------------------------------ -

Quantity more than Obut less than 0.05 ----- 0.0

Figure does not meet standards of

reliabilityy or precision ---------------------------

*

vi
BASIC DATA ON ARTHRITIS

KNEE, HIP, AND SACROILIAC JOINTS

IN ADULTS AGES 25-74 YEARS

Kurt Maurer, Division of Health Examination Statistics

INTRODUCTION

In this report the arthritis findings from the

first Health and Nutrition Examination Survey

of the civilian noninstitutionalized 25-74-yearoId population of the United States are summarized. These findings are based upon assessments

of X-rays of the hips and knees by expert rheumatologists and upon medicaI histories. The microdata tapes, including the one from which the

findings in this report were prepared, are available for purchase by persons interested in more

detailed analysis including analysis of additional

variables not presented in this report. The sample distribution of all the variables on the microdata tapes can be found in the respective tape

documentation. The plan and operation of this

survey are described in publications Series 1,

Nos. 10al and 142 and the forms used to collect

the data are published in Series 1, Nos. 10b 1

and 14.2 Other data from HANES I pertinent

to arthritis were ako collected on the General

Medical History Supplement, Ages 25-74, the

GeneraI Medical Examination (generally referred

to as the ““detailed examination”) and the

Goniometry Examination. In addition, data on

arthritis have been published by the National

Center for Health Statistics based on the Health

Examination Survey of 1960-62.

The Center has also published reports on

arthritis based on some of its other surveys: the

Health Interview Survey, the National Nursing

Home Survey, and the Health Resources Utilization Surveys. The Health Interview Survey is a

survey of the civilian noninstitutiorudized population of the United States, but unlike the

Health and Nutrition Examination Survey

(HANES I) includes those persons older than 74

years of age. Information on personal and demographic characteristics, illnesses, injuries, impairments, chronic conditions, and other health

topics is collected in the survey. In the National

Nursing Home Surveys information is gathered

relating to the health characteristics of the residents, and their medicaI, nursing, and personal

care, based on national samples of establishments providing these services and samples

of the residents or patients. In the Health Resources Utilization Surveys information is collected on the utilization of health manpower

and facilities providing long-term care, ambulatory care, hospital care, and family planning

services. If the reader is interested in acquiring

any pubIished reports from the surveys conducted by the National Center for Health

Statistics (NCHS), the “Current Listing and

TopicaI Index to the Vital and Health Statistics

Series 1962-1977”3 should be consulted.

The age, sex, and race distribution of the

civilian noninstitutionalized U.S. population at

the midpoint of the survey and distribution of

the probability sample drawn from it are presented in appendix I. Also in appendix I, the statistical design of HANES I and the reliability of

the estimates are discussed. Standard error estimates have been presented in tables 1-3, 7, and

1
13. An illustration of the use of the standard

error estimates and a formula for approximating

standard errors for estimates shown in other

tables of this report are also presented in appendix I. The definitions of demographic terms in

this report are found in appendix II. A summary

of the contents of the microdata tape used in

preparation of this report is found in appendix

III.

SOURCES AND LIMITATIONS

OF THE DATA

One of the major components of HANES I

was a detailed arthritis examination composed

of a physician’s examination, X-ray films of the

hip area and knees, and medical histories. The

findings in this report summarize the data from

evaluation of X-ray films of the hip area and

knees and the medical histories; findings based

on the physician’s examination will be summarized in another report.

Perhaps the greatest problem encountereci

in a large examination survey such as HANES [

is persuading those persons selected :for the sample to participate. The efforts made to persuade

sample persons to participate are best describec[

as intensive. In spite of these efforts, some o:F

those selected for the sample cannot be persuaded to participate. Of those invited to participate in the survey, 98.6 percent were interviewed and 70.0 percent were subsequently

examined. Because 30 percent of those persons

selected for the sample were not examined,

there is the possibility that the estimates contained in this report are biased. That is, they

may be too low because those with ]more severe

forms of arthritis were not able to participate

in the survey or, as indicated in table O of 21

report4 from the first Health Examination

Survey of 1960-62, they may be too high. How.

ever, it should be noted that a nonresponse

adjustment has been made within ealch primary

sampling unit for each of five income groups,

as described in appendix I in an attempt to minimize any bias that may result because of

Arthritis Assessment

X-ray films of the hip

on all examinees receiving

2

nonresponse.

area were to be taken

the detailed examination except on women less than 50 years old;

however, 6.0 percent of the X-ray films of the

hips were not taken. Unlike the X-ray fiIms

taken of the hip area, X-ray films of the knees

were to be taken on all examinees receiving the

detailed examination; only 2.6 percent of the

X-ray films of the knees were not taken,

Each X-ray film was read independently by

two rheumatologists for any evidence of abnormality. The X-ray films were read on an ordinal

scale generally based on the scale described in

the Atlas of Standard Radiographs. 5 ~f an abnormality was found on one of the first two

readings, a final adjudicated reading was made

by a third rheumatologist in the presence of the

two other readers. A final adjudicated reading

was not generally made if no abnormality was

found on either of the first two readings. As a

check, 1 out of every 20 examinees (343 people)

whose X-ray films were read as normal on the

first two readings had their X-ray films read

once again during a final adjudication session. Of

those, only 1 was found to have a severe abnormality and 2 more were found to have lesions of

questionable certainty. These reassessments have

been incorporated into the findings presented in

this report.

The only assessments of the X-ray films presented in this report are the “overall” @ades of

osteoarthrosis which were subjectively synthesized by the rheumatoIogists from several items.

If an alternative overall grade of osteoarthrosis was constructed from the individual

items, it is quite possible that differen$ prevalence estimates of osteoarthrosis COUIC1be derived from the data.

Arthritis History Supplement

The Arthritis History Supplement was administered to the detailed sample exarnihees by

the examining physicians in the same session as

the physical examination. The Supplement was

only administered to those examinees who had

answered positively to one or more screening

questions asked at the household interviqw dealing with significant history of pain, aching,

swelling, or stiffness in any of their joints. After

an initial period of operation at the beginning of

the survey, the examining physician was instructed not to administer the arthritis supplement if requestioning of the examinee warranted
changing all positive screening questions to negative. This procedure was followed for most of

the survey operation. Consequently, all of those

not asked to respond to the Arthritis History

Supplement are assumed for the purposes of this

report to have had no history of significant joint

problems.

Since those without a history of significant

joint problems were not asked to respond to the

questions in the Arthritis History Supplement,

it is quite possible that some of the estimates

presented in this report would be higher if those

persons had been asked to respond.

HIGHLIGHTS

As can be seen in tables 1-3, the prevalence

of severe-moderate osteoarthrosis of the knees

and hips and the prevalence of severe-moderate

sacroiliitis are less than 0.5 percent for men and

women under 55 years of age. The sampling

errors for such low prevalence are large relative

to the estimates themselves. However, the absolute errors are small. Table 1 shows, for example,

that an estimate of 0.2 percent of the population 45-54 years of age had severe osteoarthrosis

of the knees. The standard error of this estimate

is 0.17 percent, or 85 percent of the estimate.

The true prevalence is likely to be slightly

greater than zero but less than 0.5 percent. Interpretations of differences between very small

rates or proportions should be made with caution. More discussion of the statistical reliability

of the estimates in this report is presented in

appendix I.

The prevzdence of severe-moderate osteoarthrosis of the knees and hips and the prevalence of severe-moderate sacroiliitis are summarized in table A (abstracted from tables 1-3) for

men and women ages 55-74 years. The estimates

presented in table A are generally less than 3

percent, the only exception being for severemoderate osteoarthrosis of the knees in women

ages 65-74 years (6.6 percent). Although these

estimates are small and the standard errors of

these estimates would likely be relatively large

(standard errors of the severe and moderate

grades are presented separately in tables 1-3), an

estimate of 2.0 percent for men ages 65-74 years

with severe-moderate osteoarthrosis of the knees

(table A), when multiplied by the number of

men ages 65-74 years (nearly 5.7 million from

table I in appendix I), corresponds to approximately 114,000 people, a substantial number of

people with the condition in that particular agesex group.

Additional findings are presented below but

do not constitute an exhaustive attempt to describe the 27 detailed tables of this report. AIl

estimates presented in this report refer to the

civiIian noninstitutiomdized U.S. population

ages 25-74 years, unless otherwise stated.

Knees

In the population, 0.9 percent have severe or

moderate and an additional 2.9 percent have

minirmd osteoarthrosis of the knees; 63 percent

of those persons who have moderate osteoarthrosis of the knees report pain in their knees on

Table A. Estimated percent of the noninstitutionalized U.S. population ages 55-74 with severe-moderate osteoarthrosis of the knees or

hips or severe-moderate sacroiliitis, by overall grade of condition, sex, and age: HANES, 1971-75

Overall grade of condition

Sex and age Severe-moderate Severeinoderate Severe+noderate

osteoarthrosis osteoarthrosis

of the knees

sacroiliitis

of the hips

—Men Percent of population

55-64 years ..................................................... .............................................. 1.0 0.7 2.7

65-74 years ................................................................................................... 2.0 2.3 0.6

Women

55-64 years ................................................................................................... 0.9 1.6 0.3

65-74 years ................ ................................ ................................................... 6.6 1.2 0.4

3
most days for a period of at least 1 month; 39

percent of those persons who have moderate

osteoarthrosis report never having been treated

for any kind of joint problems (tables 1, 4,

and 7).

Hips

The following results are based upon the

most severe grade of osteoarthrosis in either hip

for men ages 25-74 years and women ages 50-74

years; for example, if an examinee has severe

osteoarthrosis in one hip and minimal osteoarthrosis in the other, then he has been coded as

having severe osteoarthrosis for the purpose of

this report. The prevalence of severe or moderate osteoarthrosis of the hips increases from

about 0.2 percent among men ages 25-34 years

to about 2.3 percent among men ages 65-74

years and is about 1.2 percent among women

ages 65-74 years; 2.3 percent of men ages 65-74

years and about 1.5 percent of women ages

65-74 years have minimal osteoarthrosis of the

hips; 28 percent of those with moderate osteoarthrosis of the hips report having pain in their

hips on most days for at least 1 month; 57 percent of those with moderate osteoarthrosis of

the hips report never having been treated for any

kind of joint problem (tables 2,5, and 8).

Sacroiliac Joints

The prevalence of severe or moderate sacroiliitis is about 0.4 percent among men ages 25-34

years, about 0.6 percent among men ages 65-74

years, and about 0.4 percent among women ages

65-74 years; about 1.0 percent of men ages

65-74 years and about 0.2 percent of women

ages 65-74 years have minimal sacroiliitis; 54

percent of those who have moderate sacroiliitis

report never having been treated for any kind of

joint problem (tables 3,6, and 9).

Joint Pain

In the population, 16 percent have had back

or neck pain on most days for at least 1 month

(9 percent currently); 7 percent have had pain

in or around their hips most days for at least 1

month (3 percent currently); 10 percent have had

pain in or around their knees most days for at

least 1 month (4 percent currently); 11 percent

have had pain in their fingers, wrists, elbows,

shoulders, ankles, or feet on most days for at

least 6 weeks; 6 percent have had swelling and

pain upon touching of the fingers, wrists,

elbows, shoulders, ankles, or feet on most days

for at least 1 month; 14 percent have had joint

or muscIe stiffness when first getting out of bed

in the morning for at least 1 month (11 percent

currently) (tables 10, 12-14 and 16-18).

Treatments, Accidents, and 1njuries

Three percent have had an operation for the

treatment of hip, knee, or back disease; 12 ~percent report that their pain, swelling, or stiffness

was caused by either an accident or an injury,

and 8 percent say that is the cause of their firesent pain; more people (16 percent) have been

treated for joint trouble by a general practitioner than by any other kind of practitioner;

hot pack or heating pad (12 percent) and aspirin

(14 percent) seem to be the most common t~eatments used for significant joint troubIe (tables

15, 19,20, and 22).

Limitation of Activity

Between 1 percent and 2 percent of the civilian noninstitutionalized population ages 25-74

years report that they are unable, without the

help of someone else or some special devicq, to

do one or more of the following: go up or dbwn

stairs, get into or out of a car, use washing facilities, dress or feed themselves, or get into or’ out

of bed; the percent increases from about 1 percent at ages 25-34 to approximately 4 percent

at ages 65-74 years; 5 percent report that their

physiczd activity is restricted either “quite a bit”

or “a whole lot” because of a joint problem; 9

percent report having moderate or severe joint

trouble; 5 percent report a change in job status

as a result of a joint condition (tables 23, 24,

27, and 28).

000
REFERENCES

lNational Center for Health Statistics: PIan andoperation of the Health and Nutrition Examination Survey:

United States, 1971-1973, by H. W. Miller. Vital and

Health Statistics. Series I-Nos. 10a and 10b. DHEW Pub.

No. (HRA) 77-1310. Health Resources Administration.

Washington. U.S. Government Printing Office, Feb.

1973.

2National Center for Health Statistics: Plan and operation of the HANES I Augmentation Survey of adults

25-74 years: United States, 1974-1975, by A. Engle,

R. Murphy, K. Maurer, and E. Collins. Vital and Health

Statistics. Series l-No. 14. DHEW Pub. No. (PHS) 78-

1314. Public Health Service. Washington. U.S. GovernmentPrinting Office, June 1978.

3 Nation~ center for He~th Statistics: CuVent List.

irzg and Topical Index to the Vital and Health Statistics

Series 1962-1977. DHEW Pub. No. (PHS) 78-1301.

Public Health Service. Washington. U.S. Government

Printing Office, May 1978.

4National Center for Health Statistics: Cycle I of the

Health Examination Survey: Sample and response, by

T. Gordon and H. W. Miller. Vital and Health Statistics.

PHS Pub. No. 1000-Series 1 l-No. 1. Public Health Service. Washington. U.S. Government Printing Office, Apr.

1964.

~Atlas of Standard Radiographs. Vol 2. The Epidemiology of Chronic Rheumatism. Oxford. B1ackwell

Scientific Publications, 1963.

5
LIST OF DETAIILED TABLES

1. Percent distribution of U.S. population ages 25-74 years by whether they have osteoarthrosis of the knees and overall grade

of the condition, according to sex and age, with standard errors: H, ANES, 1971-75 ............................... ..................................

2. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U.S. population by whether they have osteoarthrosis of the hips and overall grade of the condition, according to sex and age, with standard errors: HAN ES, 1971 -75 .......

3. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U.S. population by whether they have

sacroiliitis and overall grade of the condition, according to sex and age, with standard errors: HAN ES, 1971 -75 ............... .......

4. Percent distribution of U.S. population ages 25-74 years by whether they have significant pain in their knees on most days

for at least 1 month, according to whether they have osteoarthrosis, of the knees and overall grade of the condition: HANES,

1971-75 ......................................................................... ...........................................................................................................

5. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U.S. population by whether they have significant pain in their hips on most days for at least 1 month, accc,rding to whether they have osteoarthrosis of the hips and

overall grade of the condition: HAN ES, 1971.75 ........................................................................ ...............................................

6. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U.S. population by whether they have significant pain in their lower backs on most days for at least 1 month, according to whether they have sacroiliitis and overall

grade of the condition: HAN ES, 1971 -75..... ... ......................................................................................................... .................

7. Percent distribution of U.S. population ages 25-74 years by whether currently or ever been treated for joint trouble, according to whether they have osteoarthrosis of the knees and overall grade of the condition, with standard errors: HAN ES,

1971-75 ........................................................................... ............................. ............................................................................

8. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U.S. population by whether currently or

ever been treated for joint trouble, according to whether they have osteoarthrosis of the hips and overaIl grade of the condition: HAN ES, 1971-75 ............................. .............................................................................. .......................... ................ .........

9. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U..% population by whether currently or

ever been treated for joint trouble, according to whether they have sacroiliitis and overall grade of the condition: HANES,

1971-75 ................................... .................................. ...............................................................................................................

10. Estimated percent of U.S. population ages 25-74 years ever having significant back or neck pain on most days for at least 1

month, by sex, racer and age: HAN ES, 1971.75 ............................................................................. .................... ...... .................

11. Estimated percent of U.S. population ages 25-74 years ever having back or neck injuries or medical treatment of the back or

neck or ever been hospitalized for back or neck pain, by sex, rata, and age: HAN ES, 1971.75 ..................................... ............

12. Estimated percant of U.S. population ages 25-74 yews ever having significant pain in their hips on most days for at least 1

month, by sex, race, and age: HAN ES, 1971.75 ................... ...................................................... .......................................... .....

13. Estimated percent of U.S. population ages 25-74 years ever having significant pain in their knees on most days for at least 1

month, by age and sex, with standard errors: HAN ES, 1971-75 ......... ..................... ...... ........ ...................... ...... .......................

14. Estimated percent of U.S. population ages 25-74 year: ever having significant pain and other symptoms in their knees on

most days for at least 1 month, by sex, race, and age: HAN ES, 1971 .75 ..... ....... .......................................................................

15. Estimated percent of U.S. population ages 25-74 years ever having had hip, knee, or back disease treated by an operation,

by sex, race, and age: HANES, 1971.75 ......... ............... ............ ......... ...... ........................... ...................... .................................

16. Estimated percent of U.S. population ages 25-74 years ever having significant pain in their joints on most days for at least

6 weeks, by sex, race, and age: HAN ES, 1971.75 ................ .................................... .................................. .................... ......... ...

8

8

9

9

10

10

11

12

12

13

13

14

14

?kl

15
17. Estimated percent of U.S. population ages 25-74 years ever having significant swelling of joints and pain present when joints

touched, on most days for at least 1 month, by sex, race, and age: HAN ES, 1971.75 ...............................................................

18. Estimated percent of U.S. population ages 25-74 years ever having significant stiffness in joints and muscles when first

getting out of bed in morning, for at least 1 month, by sex, race, and age: HANES, 1971.75 ..... ............ ..................... ..............

19. Estimated percent of U.S. population ages 25-74 years ever having pain, swelling, or stiffness in a joint because of an accident or injury, by sex, race, and age: HANES, 1971.75 .. ...... ................................................ ...... .............................. ...... ...........

20. Estimated percent of U.S. population ages 25-74 years ever having been treated by selected practitioners for joint trouble,

by sex, race, and age: HANES, 1971.75 .. .. .......... ........................... ............................................................... ..... ...... ..................

21. Estimated percent of U.S. population ages 25-74 years currently being treated by selected practitioners for joint trouble, by

sex, race, and age: HAN ES, 1971.75 .............. ...... ...... ........................ ........................ .................................... ............................

22. Estimated percent of U.S. population ages 25-74 years, by use and effectiveness of selected types of treatments for joint

trouble: HAN ES, 1971.75 ................................................................ ............ ...... .......................................................................

23. Estimated percent of U.S. population ages 25-74 years unable to perform various activities without the help of someone else

or the help of some special device, by sex, race, and age: HAN ES, 1971.75 .......................................................... ....................

24. Estimated percent of U.S. population ages 25-74 years currently having their physical activity restricted because of a joint

condition, by sex, race, and age: HAN ES, 1971.75 ................ ..... ...................... ............. ................. ...........................................

25. Estimated percent of U.S. population ages 25-74 years ever having stayed in bed at home for long periods or overnight in

a hospital because of joint trouble, by sex, race, and age: HAN ES, 1971.75 ..... ................................................... ...... ................

26. Estimated percent of U.S. population ages 25-74 years ever having mild, moderate, or severe joint trouble, by sex, race, and

age: HAN ES, 1971.75 ......... ............ ............ ........ .................. ...... .... ............ ...................... .. .......................................................

27. Estimated percent of U.S. population ages 25-74 years whose joint condition has necessitated a change in job status, by sex,

race, and age: HANES, 1971.75 .......................................... ...... ................... ...... ...... ....................................... ...........................

16

17

17

18

18

19

19

20

20

20

21

7
Table 1. Percent distribution of U.S. mmulat ion aaes 25-74 vears bv whether thev have osteoanhrosis of the knees and overall grade of the condition, according to

sex and age, “with standard” errorx HAN ES, 1971-75

Overall grade of oateoarthrosis of the knees

Severe Moderate Minimal QuestiOn- Normal

able

Sex and age

Both sexes, 25-74 vears ...

25-34 years..,,..,......,..,,...,,...,...,,..,,,..

35-44 years ...... ..... ..... .......................

45-54 years ... .......... ........ .......... ........

55-64 vears ... .... . . .. . .. . .. . .. ....

65-74 vears . .. .... .... .... .... .. . .. . ..

Men, 25-74 veals .... ..... ..... ..... .

25-34 years .......... ............... ..............

35-44 years ..,.,...,,..,...,,.,.., ................

45-54 years..,.,....,..,.,..,,,,,,.,..,....,..,,,.

55-64 y’ears .... . . .... .. . .. . ..... . ....

65-74 vears ........ ... .. . .... . . .... . .

Women, 25-74 years ..... ..... .....

25-34 Vears . ..... .......... ..... ..... ........ .....

35-44 years . . .... .. . .... ... .. . .. .... ..

45-54 Vears ... .... .... . .. .... .. ...... .. ..

55-64 vears .. .. .. . .. . .. .... . ... .....

65-74 Vears . .. ... .... .. . .. ... . . .

Total

100.0

100,0

100,0

100.0

100.0

100.0

100,0

I

QuestiOn- 3evere Moderate Minimal Normal

able

Percent distribution Standard error in percentage points

O.B

0.3

0.2

0.s

4.2

0.4

2.9

0.0

1.3

2.6

4.8

9.2

2.1

2.0

0.2

0.7

1.6

3.8

6.2

1.9

0.06 0.18

0.32

0.15

0.46

1.03

0.41

0.05

0.74

0.79

1.20

1.73

0.41

1.20

0.97

1.00

1.96

0.68

94.2

99.s

97.s

95.4

90.5

BO.O

95.5

99.7

97.6

96.3

91.7

B6.3

93.1

0.1

0.0

0.2

0.1

0.4

0.1

0!17 ~ 0.19

0.48 0.84

0.56 0.98

1.14 1.67

1.37 1.97

0.54 0.59

0.35 0.35

0.71 1.20

0.66 1.15

2.00 2.21

1.75 2.46

0.43 0.76

0.14

0.71 1.11

0.78 1.36

1.12 2.24

1.76 2.s1

0.03

0.17

0.16

0.26

0.20

.

0.07

0.3

0.7

1.4

4.2

5.3

2.1

100,0

100.0

100.0

100.0

100.0

100.0

0.3

0.2

0.2

0,1

0,2

0,7

1,8

1.1

1.6

2,1

3,1

6.3

3.6

0.17

0.27

0.63

1.05

0.35

0.20

0.10 0.30

100.0

100.0

100.0

100.0

100,0

0.0

0.3

0.6

0.1

1.0

3.1

6.4

11.4

99.9

97.9

94.6

B9.3

75.1

0.06 0.08

0.74

1.23

1.98

2.33

0.5

0.2

0.9

6.0

0.6

1.8

3.5

6.9

0.60

0.17

0.69

1.74

—

0,33

0,43

NOTE: Three expert rheumatologists made the assessments of the Overall grade of osteoarthrd.s from X-ray films of the knees. The overalI grade is a subjective

synthesis of several items.

Table 2. Percent distribution of men ages 25-74 vears and women ages 50-74 ve:ws in the U.S. population bv whether they have osteoarthrosis of the hips and

overall grade of the condition, according to sex artd age, with standard errors: HAN ES, 1971-75

Overall grade of osteoarthrosis of the hips

Severe Moderate I‘inima’ ISex and age

Severe I Moderate Minimal

Percent distribution Standard error in percentage points

0.3

0.1

0.8

0.6

1.6

0.9

0.9

1.2

0.40

0.14

0.59

0.44

0.87

0.61

0.86

0.83

0.49

0.29

0.78

1.28

1.59

1.13

1.39

1.73

99.4

99.8

98.5

96.8

93.B

98.3

96.3

96.1

0,22

0.26

0.79

0.17

0.48

0.61

0.14

0.15

0.45

1.00

1.15

0.70

0.88

1.06

0.2

0.3

1.2

0.1

O.B

0.6

0,1

0.4

f.1

0.8

0,6

0.2

0.1

0.6

1.9

2.3

0.7

1.2

1.5

0.14

0.35

0.67

0.53

0.51

NOTE: Three exoert rheumatologists made the assessments of the overall made of osteoarthrosis from X-ray fdms of the hips. The overall grade is a subjective

synthesis of several i(ems. X-rays of tie hips were not done on women less than <0 years old.

8
Table 3. Percent distribution of men ages25-74 years and women ages 50-74 years in the U.S. population by whether they have sacroiliitis and overall grade of the

condition, according to sex and age, with standard errors: HAN ES, 1971-75

Sex and age

—Men

25-34 years . ... ..... ..... ..... ....................

35-44 years ...... ............. ..... ........ ..... ..

45-54 years . ..... ..... ... .. ........ .............. .

55-64 years ........ ... ..... ..... ................ ..

65-74 years ..................... ... ..... ..... .....

Women

50-54 years ..... .......................... ........

55-64 yeara ..... ..... ....... ...... ............. ...

65-74 years ..... ..... ... .. ... ..... ..... ........ ...

II Overall grade of sacroiliitis

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

0.2

1.0

0.1

0.2

0.2

0.0

Percent distribution

0.4

0.1

1.7

0.5

0.1

0.4

0.6

E

0.2

1.0

0.5

0.2

0.1

0.7

0.8

1.6

0.4

1.0

0.7

1.4

98.9

98.5

99.2

95.5

98.0

98.8

98.6

97.9

Severe

0.17

0.77

0.12

0.28

0.22

0.06

Moderate

Standard error in percentage points

0.33

0.15

0.88

0.41

0.13

0.40

0.63

0.52

0.05

0.33

0.67

0.48

0.23

0.21

0.53

0.68

1.04

0.28

0.96

0.68

0.97

0.70

0.81

0.68

1.62

0.81

1.01

0.70

1.08

NOTE: Three expert rheumatologists made tbe assessment of the overall grade of aacroiliitis from X-ray films of the hips. The overall grade is a subjective

synthesis of several items. X-raya of the hips were not done on women less than 50 years old.

Table 4. Percent distribution of U.S. population ages 25-74 years by whether they have significant pain in their knees on most days for

at least 1 month, according to whether they have osteoarthrosis of the knees and overall grade of the condition: HAN ES, 1971-75

Pain in or

around

Overall grade of osteoarthrosis of the knees Total knees

I I’=1=

I

Percent distribution

Severe ......

All

......

grades

..........

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

..

..

..

..

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

..

..

.

.

.

.

..

..

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

..

..

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

..

..

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

..

..

...........

................................

........... .......... Ww

Moderate

100.0 48.2 51.8

................................. ........................................................................................................ ...................... 100.0 62.6 37.4

Minimal .. ............................................................ ............................................................................ .............. ......... 100.0 38.0 62.0

Questionable ................................................. ...................................... .......................... ....................................... ., 100.0 17.8 82.2

Normal ............ ............................................ ...................... ................................ ...... .................................. ............ 100.0 8.8 91.2

NOTES: This table is based upon the Arthritis History Supplement which v.as given only tothose in the detailed sumple who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or hod indicated that they hada

history of arthritis orgout. Allofthose notasked torespond tothe Arthritis History Supplement reassumed tohavehad nohistoryuf

significant joint problems.

Three expert rheumatologists made the assessments of the overall grade of osteoarthrosis from X-ray films of the knees. The overall

grade is a subjective synthesis of several items.

9
Table 5. Percent distribution of men ages 25-74 years and women ages 50-74 years in tha U.S. population by whether they have

significant pain in their hips on most days for at least 1 month, according to whether they have osteoarthrosis of the hips and

overall grade of the condition: HAN ES, 1971-75

Pain in or

around

Overall grade of osteoarthrosis of the hips Total hips

Yes No

Percent distributi~n

All grades ........................ ...... ...... ........ .. ....................................................... .......................................... 100.0 6.6 q3.4

*

Severe ....................................... ........ .. ........................................ ...................... ......... .................................. .......... 100.0 56.6 43.4

Moderate .................................... ................................................................ ................ ........................................... 100.0 27.8 72.2

Minimal ........... ............................................ ...... ................ .......................................... .......................................... 100.0 11.2 $8.8

Questionable .................................. .. ............................ .......................................................................................... 100.0 7.2 92.8

Normal ...................................... ................... ......................................................................................................... 100.0 7.0 93.0

NOTES: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Three expert rheumatologists made the assessments of the overall grade of osteoarthrosis from X-ray films of the hips. The overall

grade is a subjective synthesis of several items. X-rays of the hips were not done on women less than 50 yeara old.

Table 6. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U.S. population by whether they hive

significant pain in their lower backs on most davs for at least 1 mcmth, according to whether they have sacroiliitis and overall grdde

o;the condition: HAN ES, 1971-75

Overall grade of sacroiliitis

All grades ......................................... ......................................................................................................

=

L

Pain in

lower

Total back

Yes No

Parcent distribution

I

100.0 10.5

100.0 2.0

100.0 10.5

100.0 4.8

100.0 18.2

100.0 11.1

98.0

8ti,.5

9$2

81~.8

8~.9

NOTES: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Three expert rheumatoIogists made the assessments of the overall grade of osteoarthrosis from X-ray films of the hips. The overall

grade is a subjective synthesis of several items. X-rays of tire hips were not done on women less than 50 years old.

10
Table 7. Percent distribution of U.S. population ages25-74 years by whether currently or ever been treated for joint trouble, according

to whether they have osteoarthrosis of the knees and overall grade of the condition, with standard errors: HAN ES, 1971-75

Overall grade of osteoarthrosis of the knees

All grades............................................................

Severe .................................................................................

Moderate .............................................................................

Minimal ...............................................................................

Questionable .......................................................................

Normal ................................................................................

II Have you ever been treated for joint trouble?

Total

Yes, now

Yes, Never Yes, now

Yes, Never

not now not now

I

Percent distribution I

Standard error in percentage

points

100.0II 6.6 I 17.7 [ 75.7 0.66 I 1.36 I 1.60

100.0 10.8 34.2

100.0 29.3 31.8

100.0 14.9 27.0

100.0 12.5 24.4

100.0 6.0 17.2

55.0 18.13 27.40 28.11

39.0 9.89 10.28 11.05

58.1 4.43 5.25 5.85

63.2 4.44 7.02 7.47

76.8 0.65 1.33 1.57

NOTES: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Three expert rheumatologists made the assessments of the overalt grade of osteoarthrosis from X-ray films of the knees. The overall

grade is a subjective synthesis of several items.

Table 8. Percent distribution of men ages 25-74 years and women ages50-74 years in the U.S. population by whether currently or ever

been treated for joint trouble, according to whether they have osteoarthrosis of the hips and overall grade of the condition:

HAN ES, 1971-75

Overall grade of osteoarthrosis of the hips

All grades ................................................................................................................

Severe......................................................................................................................................

Moderate .................................................................................................................................

Minimal ...................................................................................................................................

Questionable ...........................................................................................................................

Normal ................................................................................................................................ ....

IIYes, now I

Yes,

I

Never

not now

11 1 1

Percent distribution

l=

100.0 6.7

100.0 39.1

100.0 18.0

100.0 21.2

100.0

100.0 7.1 T

17.6 75.7

17.2 43.6

24.9 57.1

20.8 58.0

28.1 71.9

19.3 73.6

NOTES: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritia or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Three expert rheumatologists made the assessments of the overall grade of osteoarthrosis from X-ray films of the hips. The overall

grade is a subjective synthesis of several items. X-rays of the hips were not done on women less than 50 years old.

11
Table 9. Percent distribution of men ages 25-74 years and women ages 50-74 years in the U.S. population by whether currently or ever

been treated for joint trouble, according to whether they have sacroiliitis and overall grade of the condition: HAN ES, 1971-75

Overall grade of sacroil iitis

IIYes, now

Yes,

I

Never

not now

I

Percent distribution

All grades ................................... .............................................................................

l-n

100.0 6.7 17.6 75.7

-

-

100.0 26.5 23.1 50.4

100.0 45.9 54.1

100.0 8.0 12.0 80.0

100.0 12.9 20.2 66.9

100.0 7.2 19.3 73.4

NOTES: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the ,krthritis History Supplement are assumed to have had no history of

significant joint problems.

Three expert rheumatologists made the assessments of the overall grade of osteoarthrosis from X-ray films of the hips. The overall

grade is a subjective synthesis of several items. X-rays of the hips were not done on women less than 50 years old.

Table 10. Estimated parcent of U.S. population ages 25-74 years ever having significant back or neck pain on most days for at h~ast 1

month, by sex, race, and aga: HAN ES, 1971-75

Location and time of pain in back

or neck

Total 1 ........................... ........ .................

Location of pain

Neck ............................................... ............

Upper back .................................................

Midback ....... ...............................................

Lower back .................................................

Time of pain

When resting at night ...................... ............

Awaken from sleep at night ........................

Pain present now .........................................

~

Age in years

25-34 35-44 45-54 55-64 65-74

Percent of population

15.6 13.9 17.2 15.9 14.2 7.8 13.9 19.4 20.8 21.3

5.9

2.6

1.9

10.5

9.3

7.1

8.7

4.8

1.8

1,3

9,4

8.0

5.9

7.1

7.0

3.41

2.5

11.4

10.4

8.1

10.2

6.1

2.7

1.9

10.5

9.3

7.0

8.8

4.8

2.1

2.4

10.1

8.9

7.6

9.0

2.6

0.9

0.8

5.4

4.7

2.8

3.2

5.0

1.8

1.1

9.6

7.6

6.4

7.0

6.8

3.2

2.4

13.3

12.7

9.2

11.4

8.4

4.6

2,9

13,5

11.8

10.2

11.6

9.6

3.9

3.8

13.3

12.1

8.8

14.6

lThe ~ercent5 in the ~o]umns of the table do not add u~ to the total due to the fact that ~ersons were allowed to designate more

than 1 re~ponse to the question.

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

12
Table 11. Estimated percent of U.S. population ages 25-74 years ever having back or neck injuries or medical treatment of the back or

neck or ever been hospitalized for back or neck pain, by sex, race, and age: HANES, 1971-75

Injury or treatment of back or neck

Type of injury

Sprained back due to physical activity ....... .

Whiplash injury of neck .......... ....................

Ruptured disc in back or neck ....................

Type of treatment

Traction ....................................... ...............

Surgery ................... ............... .....................

Hospitalized for back or neck pain ..............

Sex Race Age in years

Total

Male Female White Black 25-34 35-44 45-54 55-64 65-74

4.3

2.3

2.5

1.1

1.0

3.7

5.1

1.8

3.1

1.3

1.2

4.1

3.6

2.8

2.0

0.9

0.8

3.4

4.5

2.5

2.8

1.2

1.1

3.7

2.5

0.9

1.0

0.4

0.6

3.7

2.3

1.3

0.5

0.1

0.1

0.8

3.6

2.2

3.0

1.3

1.5

4.5

5.3

3.0

3.6

1.5

1.6

4.6

6.3

3.2

3.8

2.0

1.3

6.6

5.0

2.1

2.5

0.7

0.7

2.8

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Table 12. Estimated percent of U.S. population ages 25-74 years ever having significant pain in their hips on most days for at least 1

month, by sex, race, and age: HAN ES, 1971-75

Sex Race Age in years

Pain in or around hips Total

Male Female White Black 25-34 35-44 45-54 55-64 65-74

Percent of population

1===11 Totall ....................... .................. 6.6 5.6 7.5 [ 6.7 I 5.9

I I 1

Pain at rest .................................................. 4.2 3.3

Pain present now ......................................... 3.5 2.8

2.7 5.5 I 6.9 I 10.7 I 10.1

1 I I 1

1.5 3.2 4.6 7.5 5.7

1.2 3.0 4.1 5.3 5.3

1The percents in the columns of the table do not add up to the total due to the fact that persons Were allowed to designate more

than 1 response to the question.

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

13
Table 13. Estimated percent of U.S. population ages 25-74 years ever having significant pain in their knees on most days for at least 1

month, by age and sex, with standard errors: HAN ES, 1971-75

Age in years

Sex Total

25-34 3544 45-54 55-64 65-74

I Percent of population

Total ................ .....................................................................................pm.

Men ......................................................................................................................

Women .................. .......................................... ................... ..................................

I

Standard error in percentage points

Total ............ ......................................................................................... 0.88 1.14 1.17 1.50 1.73 2.12

Men ................. ................ ...... .. ........ ................ .. .. .................... ............................. 1.11 1.42 1.95 2.37 2.54 3.21

Women ............................................ ..................................................................... 1.03 1.49 1.68 1.88 2.18 3.07

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. AII of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Table 14. Estimated percent of U.S. population ages 25-74 years ever having significant pain and other symptoms in their knees on

most days for at least 1 month, by sex, race, and age: HAN ES, 1971-75

pain in or around knees and other

symptoms

Total . .....................................

Pain at rest .................. ................................

Swelling with pain .......................................

Locking with pain .......................................

Knees given way ... .......................................

Pain present now .........................................

Severely twisted knees ................. ...............T

10.2 9.6

5.6 4.4

4.4 3.9

1.3 1.0

3.5 3.4

4.4 3.9

2.1 2,5

Percent of population

III

10.9 10.0 12.4 5.5

6.6 5.3 8.0 3.2

4.8 4.1 6.4 2.0

1.7 1.3 1.5 0.9

3.5 3.2 6.1 2.0

4.9 4.2 7.0 146

1.8 2.0 2.6 1.6

7.8 I 11.7

-L4.6 6.5

3.3 5.2

1.1 1.1

2.9 4.2

3.’I 5.5

2.4 2.4

13.3

7.7

6.7

1.4

4.3

5.8

1.8

17.6

7.4

6.7

3.1

5.1

8.9

~ 2.6

l’fhe percents in the ~o]~mns of the table do not add Up to the total due to the fact that persons were allowed to designate more

than 1 response to the question.

NOTE: This table is based upon the Arthritis History Supplem(?nt which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

14
Table 15. Estimated percent of U.S. population ages 25-74 years ever having had hip, knee, or back disease treated by an operation, by

sex, race, and age: HAN ES, 1971-75

Operation for hip, knee, or Sex Race

back disease

Total

Male Female White IBlack

Age in years

25-34 I 35-44 I 45-54 I 55-64 / 65-74

I

Percent of population

Total 1 ............................. .. .......... 2.6 2.9 2.2 2.7 1.4 1.2 2.8 3.1 3.1 3.4

Hip operation ............................ .................. 0.4 ().3 0.6 0.5 0.0 0.3 0.4 0.1 0.7 1.1

Knee operation ........................................... 0.8 1.1 0.5 0.8 0.7 0.6 0.8 1.1 0.7 1.0

Back operation ................................... ......... 1.2 1.4 1.1 1.3 0.7 0.2 1.4 1.9 1.8 1.3

lThe ~ercent~ in the columns of the table do not add up to the total due to the fact that persons were aIlowed to desimate more

than 1 response to the question.

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detaiIed sample who had

indicated that they had pain, aching, sweIling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Table 16. Estimated percent of U.S. population ages 25-74 years ever having a significant pain in their joints on most days for at least 6

weeks, by sex, race, and age: HAN ES, 1971-75

Location of joint pain

‘eta’ ~

Total . .................................... .

Fingers .................................................... ....

Wrists ..........................................................

Elbows ........................................ .......... ......

Shoulders ............... .....................................

Ankles ................... ....... ...............................

Feet ............................................................ I

11.4 10.2

4.1 2.6

1.8 1.5

2.9 2.7

4.7 4.6

2.2 1.9

1.8 1.3

Age in years

25-34 35-44 45-54 55-64 65-74

5.5 4.2

2.1 1.8

3.1 2.9

4.9 4.7

2.5 2.0

2.2 1.7

Percent of population

11.2

3.5

2.0

2.4

4.7

4.0

2.0

5.9

1.3

0.7

1.4

2.1

1.0

0.8

7.9

2.4

0.6

3.0

3.0

1.6

0.5

74.7

4.6

2.5

4.3

7.0

2.4

2.2

17.7 I 13.8

1- 7.8 7.0

3.5 2.5

3.5 2.6

7.0 5.8

4.0 2.9

3.9 2.1

lThe percents in the columns of the table do not add up to the total due to the fact that persons were alIowed to designate more

than 1 response to the question.

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, sweIling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. AH of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

15
Table 17, Estimated percent of U.S. population ages 25-74 years ever having significant swelling of joints and pain present when joints

touched, on most days for at least 1 month, by sex, race, and age: HAN ES, 1971-75

Location of joint swelling

and pain

Totall .................................. .. .....

Fingers ........ ................ .... ............................

Wrists. ......................... ....................... ......,.

El bows.. ......................................................

Shoulders ....................................................

Hips ............................................................

Knees .............. ............................................

Ankles... ................ ...................... ................

Swelling present now in any location ..........

6.0 II 4.8

T2.1 1.1

0.9 0.5

1

0.8 0.6

0.6 0.3

0.3 0.1

2.2 1.8

0.8 0.5

2.0 1.3

“7.1

:3.0

1.2

0.9

0.9

0.4

:2.6

1.0

2.6

Race Age in years

White Black 25-34 35-44 45-54 55-64 65-74

Percent of population

6.0

2.2

0.8

0.7

0.5

0.2

2.0

0.8

2.0

6.6

1.7

1.4

0.8

1.0

0.4

3.4

0.5

2.0

3.2

0.7

0.4

0.3

0.1

0.3

0.8

0.4

0.4

4.7

1.5

0.3

0.8

0.3

0.2

1.1

0.1

1.1

7.5

2.3

1.3

1.0

1.1

0.4

3.1

1.0

3.1

9.3

4.2

1.6

1.3

1.4

0.4

3.7

1.8

3.2

7.0

2.9

0.9

0.4

0.4

0.1

3.0

0.8

3.4

lThe percents in the co]umn~ of the table do not add UD to the total due to the fact that personS were allowed to desienate more

than 1 response to the question.

. .––

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

16
Table 18. Estimated percent of U.S. population ages 25-74 years ever having significant stiffness in joints and muscles when first getting

out of bed in morning, for at least 1 month, by sex, race, and age: HAN ES, 1971-75

Location and duration of

joint-muscle stiffness

Totall .... .....................................

Location of stiffness

Fingers .. ......................................................

Wrists ................................................... .......

Eibows ....................................... .................

Shoulders .................................. .. ................

Hips ........... .................................................

Knees ..........................................................

Ankles .........................................................

Feet ............................................................

Back ................................. ...........................

Duration of stiffness

Lasts less than 15 minutes, .................. ...... ..

Lasts 15 minutes to half hour .....................

Lasts half hour but less than all day ............

All day ........................................................

Stiffness present now ...... ....................... .....

Total

Sex I Race I Age in years

Male I Female I White I Black I 25-34 I 35-44 I 45-54 I 55-64 I 65-74

14.4

4.3

1.9

1.9

3.4

3.9

7.1

3.0

1.9

6.7

4.6

3.5

4.2

1.1

10.9

11.5

2.8

1.6

2.0

3.0

3.0

6.0

2.4

1.5

4.9

4.2

3.1

3.0

0.6

8.6

17.0

5.6

2.1

1.B

3.7

4.7

8.2

3.5

2.3

8.3

5.1

3.9

5.4

1.5

12.9

14.4

Percent of population

4.4

1.9

1.9

3.4

4.0

6.9

2.9

2.0

6.9

4.7

3.6

4.0

1.1

10.8

16.1

3.7

2.0

2.7

3.7

3.8

9.6

3.9

1.8

5.4

4.5

3.3

6.7

1.3

12.9

4.7

0.8

0.3

0.2

0.3

0.5

1.9

0.7

0.2

1.9

1.3

1.0

1.3

0.3

2.7

12.7

3.0

1.7

2.4

2.5

4.2

5.5

3.1

1.6

6.6

5.0

2.8

3.2

1.0

9.8

17.3

4.5

2.0

2.4

4.5

4.2

8.2

3.2

2.1

7.8

5.6

4.0

5.2

1.4

13.1

21.5

8.2

2.8

2.6

5.2

5.8

10.6

4.7

3.6

10.4

6.5

6.0

6.6

1.2

16.8

22.5

7.8

3.9

2.8

6.8

7.6

14.1

4.7

3.4

9.7

6.7

5.4

7.2

2.0

17.5

lThe ~ercent~ in the columns of the table do not add UD to the total due to the fact that Wrsons were allowed to desismate more

than 1 re;ponse to the question.

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Table 19. Estimated percent of U.S. population ages 25-74 years ever having pain, swelling, or stiffness in a joint because of an accident

or injury, by sex, race, and age: HAN ES, 1971-75

Accident or injury as a cause of Sex Race Age in years

Total

pain, swelling, or stiffness

Male Female White Black 25-34 35-44 45-54 55-64 65-74

Percent of population

1

Total .............................................. ............. 12.4 13.3 11.6 12.8 9.6 9.6 12.0 13.3 14.1 14.9

Cause of present pain .................................. 8.3 9.4 7.4 8.5 7.3 7.6 8.3 8.8 8.6 8.8

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sampIe who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

17
Table 20, Estimated percent of U.S. population ages25-74 years ever having been treated by selected practitioners for joint trouble, by

sex, race, and age: HAN ES, 1971-75

=

Sex Race Age in years

Total

Male Female White Black 35.44 45-54 55-64 65-74

Practitioner

Percent of population

General practitioner ....................................

internist ......................................................

Rheumatologist ...........................................

Orthopedist .................................................

Chiropractor ...............................................

Osteopath ...................................................

Foot doctor ................................................

Physical therapist ........................................

Occupational therapist ................................

Other ..........................................................

15.8

2.4

0.6

8.0

4.7

2.2

0.7

2.2

0.1

2.5

13.7

1.7

0.4

8.4

4.8

2.1

0.5

2.3

0.1

2.9

17.6

2.9

0,7

7.7

4.7

2.3

0.8

2.1

0.0

2.1

—.

16.1

2.5

0.6

8.5

5.2

2.5

0.7

2.3

0.1

2.6

13.6

1.5

0.2

4.6

1.2

0.2

0.3

1.3

0.0

1.7

9.4

0.7

0.1

5.0

2.2

1.0

0.4

1.1

1.7

12.5

1,5

0.4

9.9

4.5

1.5

0.2

2.7

0.1

2.4

17.4

3.5

0.9

9.5

5.4

2.4

0.8

2.4

2.8

22.4

3.4

0.8

9.2

6.5

4.0

1.3

3.1

0.0

3.0

:22.4

3.6

0,8

6.7

,6.7

3.0

0.8

2.0

0.4

2.8

.—

NOTE: This table is based u~on the Arthritis History Suo!iemerrt which was given only to those in the detailed sample who had

indicated that the y had pain, ach”ing, swelling, or stiffness in ~fiy of their joints fo; at least -1 month or had indicated tha~ they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Table 21. Estimated percent of U.S. population ages 25-74 years currently being treated by selected practitioners for joint troublf!, by

sex, race, and age: HAN ES, 1971-75

=

Sex Race Age in years

Practitioner Total

Male Famale White Black 25-34 35-44 45-54 55-64 65.74

I

Percent of population

Total . .....................................

ml== r

8.4 6.7

=

4.4 3.4

1.() 0.7

0.11 0.1

1.() 0.9

O.;r 0.6 T

7.0 3.1

4.3 1.7

0.8 0.2

0.0 0.1

0.7 0.4

0.3

5.2 8.1 9.4 I 10.2

General practitioner ....................................

Internist ......................................................

Rheumatologist ...........................................

Orthopedist .................................................

Chiropractor ...............................................

Osteopath ...................................................

3.5

0.7

0.1

0.9

0.6

0.3

2.4

0.4

0.1

0.7

0.5

0.1

2.2

0.3

1.2

0.8

3.4

1.4

0.2

1.0

0.8

5.3

0.6

0.1

1.3

0.6

0.7

6.9

1.6

0.1

0.4

0.3

1).4 0.3 0.1 0.1 ().1 0.4 0.1

I

lThe ~ercent5 in the column5 of the table do not iidd Up to the total due to the fact that Persons were allowed to designate ‘ore

than 1 response to the question.

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample whd had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis Hktory Supplement are assumed to have had no histoky of

significant joint problems.

18
Table 22. Estimated percent of U.S. population ages 25-74 years, by use and effectiveness of selected types of treatments for joint

trouble: HAN ES, 1971-75

Type of treatment for joint trouble

Splints ......................... ............ .. ...... ...... .... .. ....................................................................... ................ ...................

Braces ..... ........ ...... ............ ...... ........ .... .. .......................................... ...... ................................................................

Diathermy or paraffin .. ................................ .........................................................................................................

Hot pack or heating pad ...................................... ....................................................... ...........................................

Cold pack or ice ............................... .................. ........ ...... .....................................................................................

Rest ...................... ...... .............. ...... ............ .................... ......................................................................................

Traction ....................................................... ...... .............. ............................................ ..........................................

Exercise or physical therapy ................... ............................................... ........ ..... ....... ...........................................

Aspirin ........................................ ......................... .......................................... ............ ...........................................

Cane ....... ................ ............................................. ............................................................................................... ,.

Crutch ............................................................................... ....................................................................................

Stiff mattress ......... .................... ................................ ............................................ ...............................................

Bedboard ........ ............ ........ .. ...... ...... .............. ........................ .................................... ..........................................

Injections into any joints ...... ............ ........................................... .............. ..................................... ......................

Cortisone-like medicine by mouth .................. ....................... ................................................... ............................

Butazolidin ............................ .................. ........ .................................... .................................................................

Darvon or Tylenol ....................... ...................................................................... ....................................................

Indocin ................. ............................ ......................................................... .................. .........................................

IFDo treatTreat- ments

ment help?

used

Yes No

Percent of

population

2.1 1.9

3.2 2.4

2.1 1.7

11.8 10.0

1.4 1.1

9.6 B.6

3.4 2.6

6.8 5.8

13.9 11.6

1.5 1.4

1.B 1.7

6.4 5.5

4.3 3.6

7.0 5.9

2.6 1.9

1.0 0.8

5.1 3.7

2.0 1.4

0.2

0.7

0.4

1.8

0.3

1.1

0.8

1.0

2.3

0.1

0.1

0.8

0.7

1.1

0.8

0.2

1.4

0.6

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they hada

history of arthritis or gout. Allofthose notasked torespond tothe Arthritis History Supplement areassumed tohavehad no history of

significant joint problems.

Table 23. Estimated percent of U.S. population ages 26-74 years unable toperform various activities without the help of someone else

orthehelp ofsomespacial device, bysex, rsce, and age: HAN ES,1971-75

Activity requiring assistance

Go up or down stairs...................................

Get into or out of a car ...............................

Use washing facilities ..................................

Dressself.....................................................

Feed self .....................................................

Get into or out of bed.................................

Total

1.7

1.6

1.4

1.5

1.3

1.4

Sex Race Age in years

Male Female White I Black 25-34 35-44 45-54 55-64 65-74

J- 1.6 1.8

1.4 1.7

1.4 1.4

1.5 1.5

1.3 1.3

1.4 1.4

Percent of population

0.9

0.7

0.3

0.3

0.3

0.4

1.7

1.5

1.4

1.4

1.4

1.4

1.8 1.1

1-

1.3 3.7

1.6 1.1 1.4 3.5

1.5 1.0 1.2 2.5

1.6 1.0 1.5 2.4

1.4 1.0 1.1 2.3

1.4 1.0 1.1 2.4

1.7

1.3

1.4

1.5

1.3

1.3

NOTE: This table is based upon the Arthritis History Supplement which was given only tothose inthedetai[ed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for =atleast I month or had indicated that they hada

history of arthritis orgout. Allofthose notasked torespond tothe Arthritis History Supplement areassumed tohavehad no history of

significant joint problems.

19
Table 24. Estimated percent of U.S. population ages 25-74 years currently having their physical activity restricted because of a joint

condition, bysex, race, arvd age: HAN ES,1971-75

Degree of current restriction Sex Race Age in years

Total

of physical activity

Male Female White Black 25-34 35-44 45-54 55-64 65-74

I

Percent of population

Very little .............. ..................... ...... ......... 27.9 26.3 29.3 28.8 21.5 18.0 28.0 30.8 33.5 35.6

Quite a bit ................................................... 3.9 3.4 4.3 3.9 4.3 1.0 2.1 4.8 5.8 9.0

A whole lot ................................................. 1.6 1.4 1.7 1.4 3.2 0.5 1.5 2.1 2.5 2.0

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample whi) had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they ,had a

history of arthritis or gout. All of those not asked to respond to the ,4rthritis History Supplement are assumed to have had no history of

significant joint problems.

Table 25. Estimated percent of U.S. population ages 25-74 years euer having stayed in bed at home for long periods or overnight in a

hospital because of joint trouble, by sex, race, and age: HAN ES, 1971-75

Sex Race Age in years

Bed or hospital stay

‘eta’ A-e ‘bite I “ack 25-34 I 35-44 I 45-54 I 55-64 I +z

I

Percent of population

In bed at home for long period ................... 5.5 4.6 6.4 5.4 3.0 5.5 7.0 6.5 7.0

In hospital overnight ................................... 6.6 7.0 8.3 8.9 7.5

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

Table 26. Estimated percent of U.S. population ages 25-74 years ever having mild, moderate, or severe joint trouble, by sex, ra(;e, and

age: HAN ES, 1971-75

Sex Race Age in years

Reported condition of joint trouble Total

Male Female White 81ack 25-34 35-44 45-54 55-64 65-74

I

Percent of population

Mild ............................................................ 24.2 23.4 25.0 25.0 18.8 15.9 23.7 26.8 28.4 32.5

Moderate ....... ........ ................ ...... ................ 7.0 6.0 7.8 7.1 6.1 3.0 6.0 8.8 8.9 10.9

Severe ............. ............ ................ ........ ........ 2.2 I .9 2.5 2.0 4.1 0.6 1.7 2.2 4.4 3.3

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

20
Table 27. Estimated percent of U.S. population ages 25-74 years whose joint condition has necessitated a change in job status, by sex,

race, and age: HAN ES, 1971-75

Reported change in job status

Sex Race Age in years

Total

as result of joint condition

Male Female White Black 25-34 35-44 45-54 55-64 65-74

Percent of population

Totall ......................................... 5.4 5.1 5.8 5.5 5.6 2.7 4.4 6.8 7.3 8.1

Ratired becausa of disability ... .... .............. .. 1.1 1.4 O.B 1.0 1.2 0.0 0.4 1.0 2.4 2.6

Unemployed .................... ........................... 0.4 0.4 0.4 0.4 0.9 0.2 0.5 0.6 0.4 0.7

Changed to easier job ...................... ............ 1.1 1.4 0.8 1.1 1.2 0.9 1.2 1.2 1.2 0.6

Working ................ ...................................... 0.9 1.1 0.7 0.9 0.5 0.5 1.0 1.7 0.8 0.1

Housewife with partial duties ............. ......... 0.9 . . . 1.7 0.9 0.6 0.3 0.6 1.0 1.1 2.2

Housewife with no duties ............................ 0.2 . . . 0.3 0.2 0.1 0.1 0.1 0.1 0.3 0.5

lThe percents in the columns of the table do not add Up to the total due to the fact that persons were allowed to designate more

than 1 response to the question.

NOTE: This table is based upon the Arthritis History Supplement which was given only to those in the detailed sample who had

indicated that they had pain, aching, swelling, or stiffness in any of their joints for at least 1 month or had indicated that they had a

history of arthritis or gout. All of those not asked to respond to the Arthritis History Supplement are assumed to have had no history of

significant joint problems.

21
APPENDIXES

CONTENTS

1. Statistical Notes ....................................................................................................... ...................... 23

Survey Design .................................................................................................................. ......... 23

ReEabili~of Estimates ............................................................................................................. 24

II. Demographic Terms ........................................... ............................................................................ 26

III. Data Tape Summary .................. ........... ............. ...................... ............ .................................... ....... 27

Summa~of Arfintis Microdata Ta~~e(H~ES Catiog No.4121 ) .......................................... 27

&thritis Data Summ~.H~ES I ............ .............................................................................. 31

APPENDIX TABLE

I. Number of exmined persons intie H4~NESdetiled 100-location desi~and tieestimatednumber of persons in the U.S. populatic,n as of February 1974, by sex, race, and age: HANES, ~

1971-75 ............... ............................................... ....... .................................................................. 24

22
APPENDIX i

STATISTICAL NOTES

Survey Design

The sampIe desi~ for HANES I is basically a

three-stage, stratified, probability sample of

loose clusters of persons in land-based segments.

The sample was designed to be representative of

the civilian noninstitutiona.lized population, ages

1-74 years, living within the coterminous United

States, with the exception that all persons residing upon reservation lands set aside for the use

of American Indians would be excluded.

In the first stage of the design, 100 primary

sampling units (PSU’S) were selected with probability proportional to size from the approximately 1,900 PSU’S into which the United

States has been divided. (Ten of the PSU’S were

selected into the sample twice, so that in fact,

there were only 90 distinct PSU’S selected.) A

PSU consists of a county, a small group of contiguous counties, or a standard metropolitan

statistical area. Before selecting the 100 PSU’S

for inclusion in HANES I, the approximately

1,900 PSU’S were first grouped into 40 strata of

which 15 contained ordy 1 PSU, consisting of a

single large metropolitan area with a population

of more than 2 miIlion. M 15 of the largest

PSU’S and 3 PSU’S from each of the other 25

strata were selected.

At the second stage of the design a sample

of segments, consisting of approximately six

households each, was systematically selected

within each selected PSU. A1though the 1970

census data were used as the frame for sampling

within PSU’S when they became available, the

calendar of operations required that the 1960

census data be used for the first 44 selected

Psu’s.

used:

1.

2.

3.

At

Generally, three types of segments were

Segments from the Census Listing Books

that were created in taking the population census.

Area segments that are defined geographically.

Permit segments, using updated lists of

building permits issued in sample PSU’S

since January 1970.

the third stage of sampling, a list of all

eligible persons was‘made wi&in ‘each selected

segment. From this list, persons were then systematically selected for inclusion in HANES L

A more complete description of the survey

design is included in Vital and Health Statistics,

Series 1, No. 10a] and supplemented in Series

1, No. 14.2

Because the design of HANES I is a multistage probability sample, it is necessary to use

complex procedures in the derivation of estimates. Three basic operations are involved, the

results of which are presented in table I.

Inflation by th; reciprocal of the probability

of selection. —The probability of selection is the

product of the probabilities of selection from

each step of selection in the design (PSU, segment, and sample person).

ATonresponse adjustment. –The estimates are

inflated by a multiplication factor calculated

within each PSU for each of five select.ed income

groups. The numerator of these factors consists

23
.

Table 1. Number of examined persons in the HANES detailed 100-location dasign and the estimated number of parsons in the U.S. population as of February 1974, by sex, race, and age: HANES 1971-75

1

Sex Race Sex Race

Age Tota I Total

Male Female White Black Male Female White Black

Number of examined persons Estimated number of persons in U.S. population

Total ..... 6,913 3,171 3,742 5$68 873 1C16,639,033 50,586,997 56,052,036 94,885,892 10,656,186

25-34 years ........... 1,563 672 681 1,362 175 ;!8,296,796 13,663,092 14,633,704 24,835>50 3,039,000

35-44 years ........... 1,216 528 688 1,048 149 :!2,302,278 10,761,322 11540,958 19,582,183 2,415,030

45-54 years ........... 1,613 746 867 1,396 206 2!3,548,824 11,288,375 12,260,449 21,053,345 2,357,701

50-54 years ........... BI 1 375 436 707 98 111,812$331 5,733,376 6,079,555 10,717,641 1,042,219

55-64 years ........... 1,288 626 662 1,118 161 119,345,852 9,191,996 10,153,856 17,500,480 1,674,111

65-74 yaars ........... 1,233 599 634 1,044 182 113,145,283 5,882,212 7,463,071 11914,534 1,170,344

NOTE: The numbers in this table constitute estimates and closely approximate the U.S. population as estimated by the U.S. Bureau of the

Census as of February 1, 1974.

of the sum of the weights for sample persons

resulting from the reciprocal of the probability

of selection and the denominator consists of the

sum of the weights for examined persons also

resulting from the reciprocal of the probability

of selection.

Poststratification by age-sex -race. –The estimates are ratio adjusted within each of 60 agesex-race cells to an independent estimate, provided by the U.S. Bureau of the Census, of the

population of each cell as of the midpoint of

the survey. The effect of the ratio-estimating

process is to make the sample more closely

representative of the civilian noninstitutionalized population by age, sex, and race, which

thereby reduces sampling variance.

Reliability of Estimates

Because the statistics presented in this report

are based on a sample, they will differ somewhat

from the figures that would have been obtained

if the survey had been conducted on the complete population. In other words, the statistics

are subject to sampling variability.

The standard error is primarily a measure of

sampling variability, but may also include part

of the variation that arises in the measurement

process. The standard errors presented in tables

1-3, 7, and 13 have been calculated by a technique referred to as “balanced repeated replication. ” The need for this specialized technique

for estimating standard errors arises because of

the complexity of the sample design of HANES I

which makes it inappropriate to calculate them

by a technique that does not account for the

complex sample design. It must be noted that

estimates of standard errors are themselves subject to errors that may be large if the number of

cases upon which the estimates are based is

small.

Standard errors of estimates shown in tables

1-3, 7, and 13 have been computed using the

balanced half-sample replication procedur~. For

percents shown in other tables in this rt!port,

standard errors may be approximated from the

following formula:

Standard error = 2.25@ q/rz)%

where

p = percent of population with the attribute

of interest.

q= loo-p.

n = number of sample persons upon which p

is based.

For example, from table 11, 5.1 percefit of the

males said that they have had a sprained back

due to physical activity. To compute a standard

error estimate for this statistic, the reader should

make the following computation:

Standard error = 2.25 (5.1 X 94.9/3171)%

=’0.88

24
where

p = 5.1

q= 100- 5.1 =94.9

from table I,

n= 3,171.

The reader might then want to make

same calculation for females, resulting in

standard error, 0.68.

the

the

If a reader wants to know whether proportionately more males have had sprained backs

due to physical activity than females have had,

then the foIlowing procedure can be used. The

procedure used to test the significance of the

difference between the percents for males and

females consists of dividing the difference between the two percents by the standard error

of the difference; that is, a Z-statistic can be

computed, where Z = d/Sd. An approximation

of the standard error of the difference

d=Pm - Pf is given by the forrmda

where

Pm = percent for males,

Pf =percent for femzdes,

and Sp and Spf are the standard errors, respectively, ;f Pm and Pf. This estimate might be an

overestimate or underestimate of the actual

standard error of the difference where two

groups or measures are, respectively, positively

or negatively correlated.

For our exampIe,

5.1 -3.6

z.

(0.882 + 0.682)%

= 1.35

Because Z is Iess than 1.96, the difference is not

significant at the 95-percent level.

Alternatively, the reader may want to compute a confidence interval (95 percent, for

example) around the percent for males. That

should be done in the following manner:

P*1”96SP

For p = 5.1 and S@ = 0.88 the resuItant 95.

percent confidence interval for the percent of

men who have had a sprained back due to physical activity is 3.38 to 6.82. In other words, the

probability that the true estimate lies within

that interval is 95 percent.

000

25
APPENDIX II

DEMOGRAPHIC TERMS

Age. –Two ages were recorded for each examinee: the age at last birthday at the time of

examination and age at the time of the census

interview. The age criterion for inclusion in the

sample used in this survey was defined as age at

time of census interview. The adjustment and

weighting procedures used to produce national

estimates were based on the age at interview.

Data in the detailed tables and text of the report

are shown by age at the time of the examination, except that those few who became 75

years by the time of the examination are included in the 65-74-year group.

Race. –Race was recorded as “white,”

“NegroJ’ or “other.” “ Other” includes Jap,anese,

Chinese, American Indian, Korean, Eskimo, and

all races other than white and Negro. Mexicans

were included with “white” unless definitely

known to be American Indian or of other nonwhite race. Negroes and persons of mixed Ne.qo

and other parentage were recorded as “Negro.”

When a person of mixed racial background was

uncertain about his race, the race of his father

was recorded.

——000

26
APPENDIX Ill

DATA TAPE SUM MARY

SUMMARY OF ARTHRITIS MICRODATA TAPE (HANES Catalog No. 4121)

Tape

positions

CATALOG NUMBER 4121 ........................................................................................................................................................... 201

ARTHRITIS HISTORY SUPPLEMENT

Pain in back or neck on most days for at least 1 month? ................................................................................................................ 225

Has pain been present on any one occasion for at least 6 weeks? ................................................................................................... 226

Is pain usually located in nack? In upper back? In midback? In lower back? ................................................................................. 227

Is pain most intense in neck? [n upper back? In midback? In lower back? ..................................................................................... 231

Pain present when resting at night? ................................................................................................................................................ 235

Does pain awaken you from sleap at night? .................................................................................................................................... 236

Has pain in back ever seemed to spread? ........................................................................................................................................ 237

Does pain spread to the back of the right lag?To the back of the left leg? Both legs?.................................................................... 238

Does pain spread to the top of the head? To the sides of the body? ............................................................................................... 241

Has pain in neck ever seemed to spread? ........................................................................................................................................ 243

Does pain spread to the top and back of the head? To either shoulder araa? To the arms or hands? To other locations? ............... 244

Is back or neck pain made worse by coughing, snaezing or deep breathing? With bending or twisting motion? After prolonged

activity? By prolonged sitting? After prolonged standing? ........................................................................................................... 248

How old when first experienced recurring beck and neck pain? ..................................................................................................... 253

When was last time you had this pain? ........................................................................................................................................... 254

What is longest episode of back or neck pain you have ever had? ...............# .................................................................................. 255

Does back or neck pain cccur more frequently now than before? .................................................................................................. 256

Ever had sprainad back due to some type of physical activity? ...................................................................................................... 257

Ever had a “whiplash” injury of the neck? ..................................................................................................................................... 25B

Ever had a ruptured disc in aither your back or neck? .................................................................................................................... 259

At what age? .................................................................................................................................................................................. 260

Were you in traction? ..................................................................................................................................................................... 262

Was surgery necessary? ................................................................................................................................................................... 263

Ever stayed in hospital overnight for back or neck pain? ................................................................................................................ 264

Had pain in or around either hip joint most days for at least 1 month? .......................................................................................... 265

Has pain in hip area been present on any one occasion for at least 6 weeks? .................................................................................. 266

Where did you first notice it? ......................................................................................................................................................... 267

In hip area is pain usually most intense in tha right buttock? In the left buttock? In both buttocks? In the right groin? In the

left groin? In both groins? In the side of right thigh? In the side of left thigh? In the sides of both upper thighs? In other

areas? ........................................................................................................................................................................................... 268

From hip has pain tended to spread to the inside of your leg?To the front of your leg? To the outside of your leg?To the beck

of your leg? ................................................................................................................................................................................. 279

Had pain in or around hip when coughing or sneezing? .................................................................................................................... 282

When hip pain present does it hurt at rest as well as moving? ......................................................................................................... 283

27
Tape

Dosilions

How old when first experienced recurring pain in hip? .................. ...................... ....... .................................................................... 284

Last time you had pain? ...... ...... ............... ...................................................................................................................................... ~85

Longest episode of hip pain you have ever bed? ................................................................................ ............................................. 286

Ever had a fractured hip? .......................................................................................... ..................................................................... 287

Which hip was broken? .................................................... .............................. ..................... ................................................... ......... 288

How old when it happened? ....... ............................... ..................... .................... ................ ............ .. .............................................. 289

Was hip in traction? ... ..................................................................................................................................................................... 291

Was there surgery? ........................... ... ............ ............... ................................................... .............................................................. 292

Evar had a dislocated hip? ............................... ............... ............... ............ ..................................................................................... 293

Which hip dislocated? ............................... ............ .......................................................................................................................... 294

How old when it happened? ....................................................................... .............................. ...................................................... 295

Was hip in traction? ... ...... ... ........................................... ...................... ............................................ ............................................... 297

Was there surgery? .................... ............ ............... ........................................................................................................................... 298

Had pain in or around knee most days for at least 1 month? ........................................................... ............................................... 299

Pain in knee area baan present on any one occasion for at least 6 weeks? ................ ...................................................................... ?OO

In which knee did you first have it? ................................................................ ............................................................................... 301

How old when first experienced recurring pain in knee? .............................................. ...................................................... ............ 302

When knee pain present, is it most intense in right knee? In left knee? [n both knees? Bahind the right knee? Behind the left

knee? Behind both knees? .......... .................................................... ............................................................................. ............... 303

When knee pain present, does it hurt at rest as well as moving? ......... ............................................ ...... ........................................... 909

When knee pain present, is there also swelling of the knea joint? ............. ............................................................ ...................... .... 310

When pein present, ever had “locking” of the knee? .......... ............ ... ........................... ........................ ........................ .................. 31 I

Either knee ever “given way” under you? ....................... ............... ............................................... ....... ...... .................................... 312

Which knee gave way? ............................................................. ............................................. ............... ....................... .................... 513

Last time you had this knee pain? ....................................................................................... ................ ........ ................................... 314

Longest episode of knee pain ever had? .............................................................................. ................ ............................................ 315

Ever had a fractured knee? .................. .......................................... ........................................ ......................................................... 316

Which knee fractured? ............................... .............................. ....................................................................................................... 317

Evar had severe twisting of either knee with resultant sprain or swelling lasting more than 2 weeks? ........................ ..................... 318

Which knee? ....... ....................................... ..... .......... .................................................. .................................................................... 319

Ever had any other knae injury? ................................................................................................................ ..................................... 320

Which knee? .......................................................................... ....... ................................................................................................. ~sl

Ever had hip, knee or back disease treated by an operation? ............................... .............................. ............................................. 322

Which joint? .............................. .........!.. .............................. ............... .......................... . . . . . . . . . . . . . . . . . . ......... ............................ ........... 323

If hip, which hip? ............ ........ .................................................................................................. ..................................................... 324

If knee, which knee? ................ ........................................................................ ........ ...................... .............................................O.. 325

Had pain or aching in any joint other than hip, back or knae on most days for at least 6 weeks? ................... ................................ 326

Were fingers painful? If yes, which fingers? ................... ...... ...... ................................................................................................O.... 327

Was wrist painful? If yes, which wrist? .. ....... ..................................... .................................................. .......................................... 329

Was elbow painful? If yes, which elbow? .................................. ..................................................... ................................................. 331

Was shoulder painful? If yes, which shoulder? ............ ........................................................................................ ............................ 333

Was ankle painful? If yes, which ankle? ............... ................................................ ........................................................................... 335

Was foot painful? If yes, which foot? ........................................... ............ .............................. ........................................................ 337

Any swelling of joints with pain present when joint touched on most days for at least 1 month? ................................................. . 339

Has this swelling been present on any one occasion for at least 6 waeks? .. ..................................................................................... 340

IS swelling and tenderness on touching in fingers? If yes, which fingars? ....................................... .............. ................................... 341

Is swelling and tenderness on touching in wrists? If yes, which wrist? ................................. ....................... .............................. O..... 343

IS swelling and tenderness on touching in elbows? If yes, which elbow? .............. ....................... .................................................... 345

Is swelling and tenderness on touching in shoulders? If yes, which shoulder? ...... ........................................................................... 347

Is swelling and tenderness on touching in hips? If yes, which hip? .................................................... ............................................. ’349

Is swelling and tenderness on touching in knees? If yes, which knee? ...................................... ....................................................... 351

Is swelling and tenderness on touching in ankles? If yes, which ankle? ............... ...................... ...................................................... 353

Is swelling and tenderness on touching in feet? If yes, which foot? .......... ...................................... ......................................... ....... 355

How old when first experienced swelling of joints? ............. .......................................................... ................ ...... ........................... 357

28
Tape

positions

Last time You had this swelling? ............................ .................. ...... ........................ ........ ................................................................. 358

Had stiffness in joints and muscles when first getting out of bed in morningcmmost~orning5for at least 1 month? .... ....... ........ 359

Has stiffness been present on any one occasion for at least 6 weeks?

Is morning stiffness usually in fingers? If yes, which fingers?

...................... ..................................... .................................. 360

................................................................... ...................................... 361

Is morning stiffness usually in wrists? If yes, which wrist? ... .............................. ...... ........................... ........................................... 363

Is morning stiffness usually in elbows? If yes, which elbow? ......................................................... ................................................. 365

Is morning stiffness usually in shoulders? If yes, which shoulder? ........................................................................................ .......... 367

Is morning stiffness usually in hips? If yes, which hip? ............. ................................... ...................................... .............. ............... 369

Is morning stiffness usually in knees? If yes, which knee? .. ...... ...... .............................. ........................ ........................................ .. 371

Is morning stiffness usually in ankles? If yes, which ankle?

IS morning stiffness usually in feet? If yes, which foot?

................... ......................................................................................... 373

Is morning stiffness usually in your back?

................. ........ ............ ................................................ ............................ 375

............... ...... .............................. .................. ............... .................................................. 377

How long does stiffness last? .... ................................................................................ ............. ................. ........................................ 379

How old when first experienced morning stiffness of joints? .

When was last time you had this stiffness?

. .......... ........ ...................... ................................................................ 380

.................................................... ................................................................................. 381

Ever had pain, swelling or stiffness in a joint as a result of accident or injury? . .... .. .......... ........ ................... ........................ ........... 382

Was this the cause of pain, swelling or stiffness mentioned previously? .......... ................................ ............. ......................... .......... 383

Is this the cause of any pain, swelling or stiffness which might still be prasent? ...................................... ...... ................................. 384

Have you ever been treated by any of the following for your joint troubles? (General practitioner, internist, rheumatologist,

orthopedist, chiropractor, osteopath, foot doctor, physical therepist, occupational therapist, other, never been treated) .... ...... . 385

Are you currently being treated by doctor for troubles just described? . ......................................................... .................... ............ 396

What type of doctor? .. ......................................................... ........................ ...... .. .... ...... ................................................................ 397

Did he say the problem was one of the following? (Acute arthritis; arthritis of spine, hip,upperandtowerextremities; arthritis

due to an infection; rheumatoid arthritis, etc.) ...... ............ .............. ............................................................................ ................ 398

Did he say the problem was one of the following? (Osteoarthritis and allied conditions; other specified forms of arthritis; arthritis, unspecified, etc.)

................................................................................................................................................................... 399

Did he say the problem was one of the following? (Rheumatism, polymyositis, and dermatomyositis; rheumatism, etc.) .............. 400

Did he say the problem was one of the following? (Osteomyelitis and pariostitis, etc.) 401

Did he say the problem was one of the following? (Other diseases of the musculoskeletal sYstem, etc.) ........................................ 402

... ................... ............................................

Did he say the problem was something other than listed above? .......................... ...... .................................................................... 403

When was the last time YQU saw him? ....... ........................... .............................. ...... ...... ...................... ...... .............. ....................... 404

Who originally referred you to this doctor? ......................................................... .................... ....................................................... 405

When do you usually see him? .................. ...... ............... ...... ......................................................... .................................................. 406

How long will it be until your next visit with him? .................................................................................................. ...................... 407

Ever used splints or casts for treatment of your joint troubles? Do splints or casts do you any good? If yes to either, do you use

splints or casts regularly? ............ ...... ...... ...... ......... ............................................. ........................ ................................................. 408

Ever used braces for treatment of your joint troubles? Do they do you any good? If yes to either, do you use them regularly ?..... 411

Ever used diathermy or paraffin for treatment of your joint troubles? Do they do you any good? If yes to either, do you use

them regularly? .... ............ .................... ....................................................................... ....... .......................................................... 414

Ever use hot packs or heating pads for treatment of joint troubles? Do they do you any good? If yes to either, do you use them

regularly? .............. ............................................. ...... ............................................. ...... ................................................................. 417

Ever use cold packs or ice for treatment of joint troubles? Do they do you any good? If yes to either, do you use

regularly? .......... .................. .............. ...... .................................................... ...... ........................................................................... 420

Ever use rest for treatment of joint troubles? Does it do any good? If yes to either, do you rest regularly? ................................... 423

Ever use traction for treatmant of joint troubles? Does it do any good? If yes to either, do you use it regularly? ..... ..................... 426

Ever use exercise or physical therapy for traatment of joint troubles? Does it do any good? If yes to either, do you use it

regularly? ......................................................................................... ............ ......... ....................................................................... 429

Ever use aspirin for treatment of joint troubles? Does it do any good? If yes to either, do you use it regularly? . ........................... 432

Ever use a cane for treatment of joint troubles? Does it do any good? If yes to either, do you use it regularly? ............................ 435

Evar use a crutch for treatment of joint troubles? Does it do any good? If yes to either, do you use it regularly? ......................... 438

Ever use a stiff mattress for treatment of joint troubles? Does it do any good? If yes to either, do you use it regularly? ............... 441

Ever use a bedboard for treatment of joint troubles? Does it do any good? If yes to either, do you use it regularly? ..................... 444

Ever had injections into joints? Did they do any good? ................................ .................................................................................. 447

Ever taken any cortisone-like medicine by mouth for your joints? If yes, did it do any good? ................. ...................................... 449

Ever taken any Butazolidin for your joints? If yes, did it do any good? .................................. ....................................................... 451

29
Tape

positions

Ever taken Darvon or Tylenol for your joints? If yes, did it do any good? ..................................................................................... 453

Ever taken Indocin for ? our joints? If yes, did it do any good? ....... .............................. ................................................................. 455

Can you do the following things without the help of someone else or the help of some special device? (Go up and down stairs;

get into or out of a car; use washing facilities; dress yourself; feed yourself; get into or out of bed?) ............. ............................. 457

At present time, does joint condition restrict your physical activity? . ................................................... ......................................... 463

Ever had to stay in bed at home for long periods because of joints? ................................................... .. .......................................... ’464

Ever stayed overnight in hospital because of joint problems? .......... ......................................................... ...................................... 465

With respect to your joint trouble, would you say condition is? (Mild/moderate/severe) ............................................................... 466

Job status 1 month before first developing joint condition? .......................................... ................................................................. 467

As result of joint condition, has there been a change in your job status? What is it now? ............................................................... 468

Days lost during past 12 months as result of joint condition? ............................................................................... .................. ....... 470

ARTHRITIS ASSESSMENTS

Osteoarthrosis ........... ..................... ..................... ........................................................... ................................................................

Quality of film (pelvis) ............. ............ .............................. ................ ............................................................................................

Sacroiliac joint – general abnormal .................................................................................................... ............................................

Sacroiliac joint – osteoarthrosis ........... ......... ...... .......................................................... .................................................................

Hips – general abnormal ....... ........ ...... ...................... .............................. .............................. .... .....................................................

Hips – osteoarthrosis ................................................................................... .. ................................................................................

Hip measurement (plus/minus) measurement ..................................................................... ............................................................

471

472

473

474

475

,476

477

478

479

30
ARTHRITIS DATA SUMMARY–HANES I

Arthritis assessments

Recording Form – KNEES

Reader number

Osteoarthrosis (overall grade)

Joint space narrowing (by location)

Osteophytosis (grade by quadrants)

Tibial spine osteophytes

Bony sclerosis near joint margin

Cysts near joints

Erosions

Osteoporosis

Chondrocalcinosis (right/left)

Loose calcified bodies

Recording Form - HIPS

Raader number

Osteoarthrosis (overall grade–right/left hip)

Joint space narrowing (by location)

Bony sclerosis (by location)

Osteophytosis (by location)

cysts

Erosions

Osteoporosis

Acetabular abnormalities

Chondrocalcinosis (right)

Chondrocalcinosis (symphysis)

Chondrocalcinosis (left)

Head daformity (primary/secondary)

Recording Form – SACROILIAC JOINTS

Reader number

Sacroiliitis (overall grade)

Erosions (right/left)

Sclerosis (right/laft)

Ankylosis (right/left)

First

reading

483

484

485

489

497

498

a499

500

501

502

504

548

549

551

557

561

575

576

577

578

579

580

581

582

655

656

657

659

661

Tape locations

Second

reading

505

506

507

511

519

520

521

522

523

524

525

584

585

587

593

597

611

612

613

614

615

616

617

618

663

664

665

667

669

000

Adjudicated

reading

527

528

532

540

541

542

543

544

545

547

—

620

622

628

632

646

647

648

649

650

651

652

653

671

672

674

676

W.s. Gowsmwmr? PSINTIWG OPFICS , 1979 o-2ak259/29

31
VITAL AND HEALTH STATISTICS Series

Series 1. Programs and Collection Procedures. –Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions and data collection methods used and include

definitions and other material necessary for understanding the data.

Series 2. Data Evaluation and Methods Research. –Studies of new statistical methodology including experimental tests of new survey methods, studies of vital statistics collection methods, new analytical

techniques, objective evaluations of reliability of collected data, and contributions to statistical theory.

Series 3. .4nalytical Studies. –Reports presenting analytical or interpretive studies based on vita] and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Series 4. Documents and Committee Reports. –Final reports of major committees concerned with vital and

health statistics and documents such as recommended model vital registration laws and revised birth

and death certificates.

Series 10. Data From the Health Interview Survey. –Statistics on illness, accidental injuries, disability, use of

hospital, medical, dental, and other services, and other health-related topics, all based on data collected

in a continuing national household interview survey.

St,rirs 11. Data From the Health Examination Survey and the Health and Nutrition Examination Surz,ey. –Data

from direct examination, testing, and measurement of national samples of the civilian noninstitutionalized population provide the basis for two types of reports: (1) estimates of the medically defined

prevalence of specific dkeases in the United States and the distributions of the population with respect

to physical, physiological, and psychological characteristics and (2) analysis of relationships among the

various measurements without reference to an explicit finite universe of persons.

Series 12. Data From the Institutionalized Population Surveys. –Discontinued effective 1975. Future reports from

these sumeys will be in Series 13.

Series 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilities

providing long-term care, ambulatory care, hospital care, and family planning services.

Series 14. Data on Health Resources: Manpower and Facilities. –Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health

occupations, hospitals, nursing homes, and outpatient facilities.

Series 20. Data on Mortality. –Various statistics on mortaIity other than as included in regular annual or monthly

reports. Special analyses by cause of death, age, and other demographic variables; geographic and time

series analyses; and statistics on characteristics of deaths not available from the vital records based on

sample surveys of those records.

Series 21. Data on Natality, Man-iage, and Divorce. –Various statistics on natality, marriage, and divorce other

than as included in regtdar annual or monthly reports. Special analyses by demographic variables;

geographic and time series analyses; studies of fertility; and statistics on characteristics of births not

available from the vital records based on sample surveys of those records.

Series 22. Data From the National Mortality and Natality Surveys. –Discontinued effective 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Series 23. Data From the National Survey of Family Growth. –Statistics on fertility, family formation and dissolution, family planning, and related maternal and infant health topics derived from a biennial survey

of a nationwide probability sample of ever-married women 15-44 years of age.

For a list of titles of reports published in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service

Hyattsville, hfd. 20782