Estimates of the prevalence of rheumatic diseases in the population of Tecumseh, Michigan, 1959–60

Abstract

THE TECUMSEH COMMUNITY HEALTH STUDY (TCHS) was not undertaken solely as a rheumatic disease survey but as a broad study of health and disease in a total community setting. [l, 21 It was conceived as a continuing dynamic study of the multitude of natural processes and interactions which are responsible for the maintenance of health or the development of disease. Interest has centered not so much on the identification of established disease as on the possibility of elucidating the early origins of disease and identifying those apparently healthy individuals with a predisposition to disease. The focus has been on the family unit and kindred since the working hypothesis has been that if genetic or environmental factors are operative in the production of a given disease then actual or potential viotims should cluster about the identifiable index cases. After careful study the community of Tecumseh, Michigan was selected as the site of (the study in 1957. Tecumseh is located in southeastern Michigan approximately 30 miles from AM Arbor. Its size of 9500 was considered adequate and yet small enough to make an ambitious study practicable. It is located in a rural agricultural area but also has a large manufacturing plant so that a variety of socioeconomic groups are present. Available information indicated the relative stability of the population and a friendly cooperative community spirit was apparent. In 1957 a complete census of the town was undertaken and all inhabitants charted by households and kindreds. Self-reported information was obtained regarding forty chronic health conditions including "arthritis", "rheumatism" and chronic back pain. During 1957 and 1958 several pilot studies, including an investigation of cerebral palsy, a prophylactic trial of influenza vaccine and a study of the relationship between blood group,s and fertility, were successfully concluded. METHOlDS OF STUDY The present phase of the study wlas designed to obtain medical historical information, a physical examination and certain physical and laboratory measurements

Prevalence of rheumatoid arthritis in persons 60 years of age and older in the United States: Effect of different methods of case classification

“…In women, RA prevalence ranged from 2.35% to 2.71%, and in men, it ranged from 1.60% to 1.85%. In the Tecumseh Community Health Study (conducted from 1959 to 1960), the prevalence of definite RA in persons ages 60 years and older was ϳ1% for men and ϳ2% for women, as defined by the ACR 1958 criteria (33). In a recent review of RA prevalence in the US, Lawrence and colleagues (13) reported that in the National Health Examination Survey (for the years 1960-1962), definite RA was identified in 1.8% of men and 4.9% of women between the ages of 65 and 79 years, using the ACR 1958 criteria for definite and classic RA.…”

Evaluating the predictive value of osteoarthritis diagnoses in an administrative database

“…This community-based program involved reviewing the medical history of residents from the area and a detailed physical examination. In subjects age Ն60 years, the prevalence estimates for "probable OA" were 17% for men and 29.6% for women based on history data alone (10).…”

Epidemiologi av urinsyregikt

“…Diagnosen urinsyregikt bygget på om det hadde forekommet typiske artrittanfall og om anfallet var diagnostisert og behandlet av lege. Prevalensen var sammenlignbar med det som ble funnet i Tecumseh (Michigan) (1,3%) og New York (2,4%) (7,8). Sammenlignet med de ikke-skandinaviske urinsyregiktstudiene hadde individene i denne, høyere vekt, diastolisk blodtrykk og alkoholforbruk.…”

“…Resultater fra regionale amerikanske populasjonsbaserte studier basert på ulike kriterier, er presentert i tabell 3 (7,(13)(14)(15). Den høyere prevalensen i Framinghamstudien skyldes en eldre populasjon sammenlignet med de to andre.…”