The Prevalence and Trend of Arthritis in Korea: Results from Korea National Health and Nutrition Examination Surveys

Nam-Wook Hur; Chan-Bum Choi; Wan-Sik Uhm; Sang-Cheol Bae

doi:10.4078/jkra.2008.15.1.11

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Hur, Choi, Uhm, and Bae: The Prevalence and Trend of Arthritis in Korea: Results from Korea National Health and Nutrition Examination Surveys

Original Article

J Korean Rheum Assoc 2008;15(1):11-26.

Published online: 20 March 2008

DOI: https://doi.org/10.4078/jkra.2008.15.1.11

The Prevalence and Trend of Arthritis in Korea: Results from Korea National Health and Nutrition Examination Surveys

Nam-Wook Hur, Ph.D.^∗, Chan-Bum Choi, M.D., Ph.D.^∗∗, Wan-Sik Uhm, M.D., Ph.D., Sang-Cheol Bae, M.D., Ph.D., MPH

Division of Rheumatology, Department of Internal Medicine, The Hospital for Rheumatic Diseases, Hanyang University College of Medicine, BK21 Project for Medical Science, Seoul, Korea

^∗Hanyang University, Seoul, Korea

^∗∗Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea

Received 23 October 2007 Accepted 11 December 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

To estimate the prevalence of musculoskeletal diseases, especially osteoarthritis, rheumatoid arthritis, osteoporosis and lumbar disc herniation, in Korean adults. For arthritis and total musculoskeletal diseases, trend of the age-standardized prevalence rates were evaluated.

Methods

This study was based on the data obtained from the Korea National Health and Nutrition Examination Surveys (KNHANES) I, II and III, conducted in 1998, 2001 and 2005, respectively. KNHANES is a nationwide cross-sectional study using a stratified, multistage probability sampling design for the selection of household units. Annual self-reported prevalence and its confidence interval were estimated in adults aged over 19, using Health Interview Survey in KNHANES. All analyses were done using SAS 9.1 with "survey procedure" except for age-standardized prevalence rates for comparison prevalence rates of each survey. Age-standardized prevalence rates were calculated using a direct-method.

Results

The prevalence of musculoskeletal diseases was 144.6, 140.0 and 197.2 and the annual self-reported prevalence of arthritis was 117.9, 109.2 and 146.4 per 1,000 population in 1998, 2001 and 2005, respectively. In KNHANES III, osteoarthritis was the most prevalent disease of the musculoskeletal diseases for both sex. Fifty-eight percent of the over 65 year-old population had at least one musculoskeletal disease and it was higher in women with 73%.

Conclusion

The prevalence of musculoskeletal diseases was high in Koreans with arthritis being the most prevalent. The prevalence of musculoskeletal disease correlated with low sociodemographic status.

Keywords: Musculoskeletal diseases, Arthritis, Health surveys, Nutrition surveys

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Fig. 1.

Age-standardized prevalence rates of arthritis in Korea National Health and Nutrition Examination Surveys (KNHANES) I, II and III.

Fig. 2.

Age-standardized prevalence rates of musculoskeletal diseases in KNHANES I, II and III.

Fig. 3.

Treatment outcomes of the musculoskeletal diseases in KNHANES III (2005).

Table 1.

Comparison of the survey methods used for musculoskeletal diseases in Korea National Health and Nutrition Examination Surveys (KNHANES) during 1998∼2005

	KNHANES I (1998)	KNHANES II (2001)	KNHANES III (2005)
Respondent	One representative member per households	One representative member per households	Individual interview for each household members
Method	The interviewee lists the chronic diseases and the interviewer codes the diseases for each member of the household Or the interviewer asks for the presence of the diseases on the chronic disease list for each member of the household	The interviewee and the inter-viewer sees the lists of chronic diseases together and the inter-viewer checks the diseases for each member of the household	Only the major chronic diseases were surveyed Interviewees were provided with a help-book on symptoms or introduction of each chronic diseases Each individual lists the chronic diseases and the interviewer codes the diseases
Classification of arthritis	No classification	Osteoarthritis, rheumatoid arth-ritis, and non-specific	Osteoarthritis and rheumatoid ar-thritis
Morbidity duration	More than 3 months during the last year	Having the disease during the last year	More than 3 months during the last year or currently suffering
Diagnosis (code) of the musculo-skeletal diseases	Arthritis (0101∼0103) Back pain or ischialgia (0104) Disc (0105) Neuralgia (0408) Osteoporosis (0122) Other diseases of the muculos-keletal system and connective tissue (5 diseases; 0106∼0109, 0121, 7713)	Arthritis (osteoarthritis/rheumatoid arthritis) (10101+30101) Back pain or ischialgia (10102+30102) Herniated disc (10103+30103) Neuralgia (10104+30104) Osteoporosis (10105+30105) Other diseases of the musculos-keletal system (24 diseases; 10106∼10129, +30106∼)	Osteoarthritis (201) Rheumatoid arthritis (200) Herniated disc (205) Osteoporosis (208)

Table 2.

Crude annual self-reported prevalence rates of musculoskeletal diseases in Korea National Health and Nutrition Examination Survey (KNHANES) during 1998∼2005. Values are person per 1,000 (95% CI)

	KNHANES I (1998)	KNHANES II (2001)	KNHANES III (2005)
Arthritis
Total	108.4 (101.2∼115.7)	107.2 (101.5∼112.8)	146.4 (140.1∼152.7)
Men	55.0 (49.3∼ 60.6)	52.3 (47.8∼ 56.9)	81.3 (75.6∼ 87.0)
Women	156.5 (146.5∼166.5)	156.1 (147.8∼164.5)	210.5 (201.3∼219.8)
All musculoskeletal diseases
Total	195.3 (185.4∼205.1)	217.8 (209.8∼225.8)
Men	125.1 (116.5∼133.8)	147.1 (139.3∼155.0)
Women	258.3 (245.6∼271.0)	280.9 (270.5∼291.3)
Four musculoskeletal diseases (arthritis, osteoporosis, lumbar disc herniation)
Total	134.3 (126.3∼142.3)	137.6 (131.4∼143.9)	197.2 (190.0∼204.3)
Men	77.9 (71.2∼ 84.4)	77.0 (71.4∼ 82.6)	124.9 (117.9∼131.8)
Women	185.1 (174.2∼195.9)	191.8 (182.8∼200.7)	268.4 (258.4∼278.5)
Prevalence rates of arthritis according to the age group
Total
19∼44	29.1 (25.9∼ 32.3)	23.8 (20.9∼ 26.7)	31.0 (27.6∼ 34.4)
45∼64	192.9 (180.8∼205.1)	171.0 (160.5∼181.5)	224.6 (213.2∼236.0)
65＋	356.7 (335.2∼378.2)	365.0 (344.3∼385.7)	505.0 (485.2∼524.9)
Men
19∼44	19.0 (15.7∼ 22.3)	18.0 (14.9∼ 21.2)	24.5 (20.5∼ 28.4)
45∼64	90.0 (79.1∼100.9)	72.6 (63.9∼ 81.3)	125.2 (113.7∼136.7)
65+	209.4 (185.0∼233.8)	199.6 (175.3∼224.0)	295.2 (268.9∼321.6)
Women
19∼44	38.5 (33.7∼ 43.3)	29.0 (24.7∼ 33.4)	37.9 (33.1∼ 42.8)
45∼64	291.4 (274.4∼308.5)	265.2 (249.1∼281.3)	323.4 (306.4∼340.5)
65＋	445.3 (417.3∼473.3)	471.0 (445.1∼496.8)	645.8 (622.2∼669.4)

All the prevalence rates were estimated after application of stratified cluster systematic sampling and weighting of the sample

Table 3.

Prevalence rates according to its definitions and age groups in Korea National Health and Nutrition Examination Surveys III. Values are person per T31,000 (95% CI)

		Four musculoskeletal diseases	Arthritis	Osteoarthritis	Rheumatoid arthritis	Osteoporosis	Herniated disc
Total
Annual self-reported prevalence rates^∗		197.2 (190.0∼204.3)	146.4 (140.1∼152.7)	129.7 (123.9∼135.6)	21.1 (18.9∼23.3)	40.9 (38.0∼ 43.8)	62.1 (58.2∼ 66.1)
Lifetime self-reported prevalence rates^∗∗		211.3 (204.1∼218.5)	151.5 (145.2∼157.8)	133.5 (127.6∼139.4)	22.7 (20.5∼24.9)	42.0 (39.1∼ 44.9)	73.1 (68.9∼ 77.3)
Annual physician-diagnosed prevalence rates^∗∗∗		163.4 (157.2∼169.5)	112.6 (107.3∼117.8)	99.0 (94.1∼103.9)	16.9 (15.1∼18.8)	38.6 (35.8∼ 41.4)	54.9 (51.5∼ 58.4)
Lifetime physician-diagnosed prevalence rates^†		177.3 (171.0∼183.6)	117.3 (112.0∼122.6)	102.4 (97.4∼107.3)	18.5 (16.6∼20.4)	39.7 (36.9∼ 42.5)	65.7 (62.0∼ 69.5)
Men
Annual self-reported prevalence rates^∗		124.9 (117.9∼131.8)	81.3 (75.6∼ 87.0)	70.8 (65.6∼ 76.0)	11.6 (9.3∼13.9)	5.2 (3.8∼ 6.5)	52.8 (48.2∼ 57.4)
Lifetime self-reported prevalence rates^∗∗		140.7 (133.5∼147.9)	85.4 (79.6∼ 91.1)	74.0 (68.8∼ 79.2)	12.6 (10.3∼14.9)	5.3 (3.9∼ 6.6)	65.8 (60.7∼ 70.8)
Annual physician-diagnosed prevalence rates^∗∗∗		96.4 (90.7∼102.2)	56.2 (51.7∼ 60.6)	47.9 (44.0∼ 51.9)	09.1 (7.2∼10.9)	4.8 (3.6∼ 6.1)	45.0 (40.8∼ 49.1)
Lifetime physician-diagnosed prevalence rates^†		111.5 (105.3∼117.6)	59.6 (55.0∼ 64.1)	50.4 (46.4∼ 54.5)	10.1 (8.1∼12.0)	4.9 (3.6∼ 6.2)	57.5 (52.8∼ 62.2)
Women
Annual self-reported prevalence rates^∗		268.4 (258.4∼278.5)	210.5 (201.3∼219.8)	187.9 (179.2∼196.6)	30.4 (27.1∼33.8)	76.1 (70.6∼ 81.6)	71.3 (65.8∼ 76.8)
Lifetime self-reported prevalence rates^∗∗		280.8 (270.9∼290.8)	216.7 (207.5∼226.0)	192.2 (183.5∼201.0)	32.6 (29.1∼36.0)	78.2 (72.7∼ 83.7)	80.3 (74.5∼ 86.2)
Annual physician-diagnose pre valence rates^∗∗∗		229.3 (220.3∼238.4)	168.2 (160.1∼176.3)	149.4 (141.7∼157.0)	24.7 (21.8∼27.6)	71.9 (66.6∼ 77.2)	64.8 (60.0∼ 69.6)
Lifetime physician-diagnosed prevalence rates^†		242.1 (233.2∼251.2)	174.2 (166.1∼182.3)	153.6 (145.9∼161.2)	26.8 (23.8∼29.8)	74.0 (68.6∼ 79.3)	73.8 (68.6∼ 79.0)
Life cycle (age)
Total	19∼44	66.9 (61.8∼ 72.1)	31.0 (27.6∼ 34.4)	21.2 (18.5∼ 23.9)	10.0 (8.1∼11.9)	3.4 (2.4∼ 4.4)	36.6 (32.9∼ 40.4)
	45∼64	294.6 (282.0∼307.2)	224.6 (213.2∼236.0)	201.2 (190.3∼212.1)	30.0 (25.5∼34.5)	58.7 (53.1∼ 64.4)	86.2 (78.8∼ 93.5)
	65⁺	578.9 (559.9∼598.0)	505.0 (485.2∼524.9)	472.6 (452.3∼492.9)	52.0 (43.3∼60.7)	176.8 (162.0∼191.6)	124.2 (111.9∼136.5)
Men	19∼44	61.8 (55.1∼ 68.5)	24.5 (20.5∼ 28.4)	16.0 (12.9∼ 19.0)	8.6 (6.2∼11.0)	0.3^‡ (0.0∼ 1.2)	39.8 (34.4∼ 45.2)
	45∼64⁺	177.0 (163.9∼190.0)	125.2 (113.7∼136.7)	110.6 (99.8∼121.4)	16.1 (11.5∼20.7)	5.5 (3.1∼ 7.8)	64.0 (55.9∼ 72.2)
	65⁺	351.7 (325.0∼378.4)	295.2 (268.9∼321.6)	284.5 (258.2∼310.9)	16.2 (9.1∼23.3)	32.5 (22.2∼ 42.7)	98.2 (82.3∼114.0)
Women	19∼44	72.4 (65.6∼ 79.3)	37.9 (33.1∼ 42.8)	26.7 (22.7∼ 30.8)	11.5 (8.7∼14.3)	6.3 (4.3∼ 8.3)	33.3 (28.6∼ 38.0)
	45∼64	411.6 (393.6∼429.6)	323.4 (306.4∼340.5)	291.3 (274.9∼307.8)	43.8 (36.8∼50.9)	111.7 (101.0∼122.4)	108.1 (97.3∼119.0)
	65⁺	731.3 (710.2∼752.5)	645.8 (622.2∼669.4)	598.8 (574.4∼623.2)	76.0 (62.9∼89.1)	273.7 (250.8∼296.5)	141.7 (125.3∼158.0)

^∗ Having disease for more than 3 months during the last year or currently suffering,

^∗∗ Having had the disease during the lifetime,

^∗∗∗ Having disease more than 3 months during one year or having it now and physician diagnosed the disease,

^† Having disease during the lifetime and physician diagnosed the disease,

^‡ Coef-ficient of variation is over than 30% so it needed careful interpretation All the prevalence rates were estimated after application of stratified cluster systematic sampling and weighting of the sample

All the prevalence rates were estimated after application of stratified cluster systematic sampling and weighting of the sample

Table 4.

Annual self-reported prevalence rates according to the place of residence in Korea National Health and Nutrition Examination Surveys III. Values are person per 1,000 (95% CI)

	Musculoskeletal diseases	Arthritis	Osteoarthritis	Rheumatoid arthritis	Osteoporosis	Herniated disc
Total
Metropolitan	179.9	132.0	116.1	18.9	38.0	59.8
	(170.0∼190.1)	(123.4∼140.7)	(108.2∼124.1)	(15.7∼22.0)	(34.1∼41.9)	(54.2∼65.3)
Urban	167.8	117.4	100.8	19.9	32.6	55.9
	(156.9∼178.6)	(107.8∼127.1)	(91.8∼109.8)	(16.3∼23.5)	(28.4∼36.7)	(49.7∼62.1)
Rural	297.4	238.1	219.6	29.1	64.1	80.0
	(275.5∼319.3)	(218.4∼257.7)	(200.3∼238.8)	(23.1∼35.0)	(54.3∼73.9)	(68.6∼91.3)
Men
Metropolitan	116.1	76.4	65.5	12.0	4.7	50.0
	(106.8∼125.4)	(68.8∼84.1)	(58.6∼72.4)	(8.5∼15.5)	(2.9∼6.5)	(43.5∼56.5)
Urban	105.6	60.3	50.0	10.8	4.1	50.3
	(94.1∼117.0)	(51.3∼69.2)	(41.9∼58.0)	(7.0∼14.6)	(2.1∼6.2)	(42.9∼57.7)
Rural	184.8	134.4	124.5	12.3	8.4	65.1
	(163.5∼206.1)	(116.3∼152.6)	(107.3∼141.7)	(7.8∼16.8)	(4.2∼1.3)	(52.5∼77.6)
Women
Metropolitan	242.5	186.7	166.0	25.6	70.8	69.4
	(228.4∼256.7)	(173.7∼199.7)	(154.1∼177.8)	(21.3∼30.0)	(63.5∼8.0)	(61.7∼77.0)
Urban	230.0	174.7	151.7	29.0	61.0	61.5
	(214.4∼245.7)	(160.5∼188.8)	(138.6∼164.8)	(23.3∼34.7)	(52.9∼69.2)	(52.7∼70.3)
Rural	406.1	338.1	311.3	45.3	117.8	94.3
	(377.7∼434.5)	(310.8∼365.3)	(284.1∼338.4)	(35.6∼55.0)	(99.9∼135.7)	(78.6∼110.1)

All the prevalence rates were estimated after application of stratified cluster systematic sampling and weighting of the sample

Table 5.

Annual self-reported prevalence rates according to the sociodemographic characteristics in Korea National Health and Nutrition Examination Surveys III. Values are person per 1,000 (95% CI)

	Musculoskeletal diseases	Arthritis	Osteoarthritis	Rheumatoid arthritis	Osteoporosis	Herniated disc
Marrital status
Single	46.2 (39.5∼ 53.0)	18.1 (14.1∼ 22.0)	11.5 (8.6∼ 14.5)	6.7 (4.0∼ 9.3)	2.4 (1.1∼ 3.7)	28.8 (23.6∼ 33.9)
Married	200.8 (192.5∼209.1)	146.5 (139.1∼153.8)	129.1 (122.2∼136.0)	21.2 (18.6∼23.8)	36.8 (33.6∼ 40.1)	65.1 (60.4∼ 69.9)
Other	488.7 (469.4∼508.0)	411.0 (391.9∼430.1)	616.2 (597.3∼635.1)	50.3 (42.0∼58.5)	143.4 (131.0∼155.7)	114.2 (101.2∼127.3)
Education
No formal education	636.8 (614.5∼659.0)	558.7 (534.8∼582.6)	519.9 (496.3∼543.6)	63.2 (51.6∼74.8)	199.6 (179.6∼219.7)	134.8 (119.4∼150.2)
Elementary school	460.2 (441.6∼478.7)	374.2 (355.8∼392.7)	343.6 (325.2∼362.1)	43.6 (36.5∼50.7)	112.6 (101.8∼123.5)	119.2 (106.0∼132.3)
Middle school	284.4 (265.2∼303.6)	208.4 (191.2∼225.7)	187.3 (171.1∼203.6)	25.6 (19.0∼32.1)	50.6 (41.4∼ 59.7)	96.2 (84.0∼108.3)
High school	110.5 (103.5∼117.4)	66.0 (60.6∼ 71.3)	52.8 (48.0∼ 57.6)	14.2 (11.4∼17.0)	11.9 (9.9∼ 14.0)	45.5 (41.1∼ 49.9)
College or higher	63.4 (56.6∼ 70.2)	32.7 (28.1∼ 37.3)	26.0 (21.9∼ 30.1)	7.0 (4.7∼ 9.3)	7.0 (5.0∼ 9.0)	31.4 (26.5∼ 36.3)
Occupation
High & middle high class	59.2 (45.5∼ 72.9)	29.7 (19.9∼ 39.5)	21.8 (13.7∼ 29.9)	7.9 (2.5∼13.4)^∗	6.1 (1.9∼ 10.3)^∗	28.7 (18.8∼ 38.5)
New middle class	65.3 (50.1∼ 80.5)	35.1 (24.6∼ 45.6)	20.5 (12.3∼ 28.8)	14.5 (7.4∼21.7)	5.1 (0.8∼ 9.5)^∗	30.4 (18.7∼ 42.0)
Old middle class	162.7 (145.3∼180.1)	107.3 (92.5∼122.0)	94.2 (80.7∼108.0)	16.3 (10.6∼21.9)	21.0 (15.2∼ 26.8)	62.5 (51.2∼ 73.9)
Labors	115.2 (102.2∼128.2)	73.5 (62.8∼ 84.2)	62.7 (53.0∼ 72.4)	11.3 (7.1∼15.6)	7.6 (4.3∼ 10.9)	47.7 (38.9∼ 56.6)
Low class	334.9 (313.9∼355.9)	266.4 (247.4∼285.4)	242.7 (224.1∼261.2)	35.6 (28.6∼42.6)	62.9 (53.4∼ 72.4)	95.4 (83.2∼107.5)
Others	207.9 (199.1∼216.7)	156.8 (148.9∼164.6)	139.2 (131.9∼146.6)	21.9 (19.1∼24.7)	50.8 (46.8∼ 54.9)	62.4 (57.8∼ 67.0)
Health insurance
Self-employed insured	199.8 (190.1∼209.5)	144.7 (136.5∼152.9)	129.3 (121.5∼137.1)	20.1 (17.1∼23.2)	36.3 (32.4∼ 40.2)	65.8 (60.0∼ 71.6)
Employee insured	177.6 (169.8∼185.3)	132.5 (125.7∼139.3)	116.3 (109.9∼122.8)	19.8 (17.0∼22.5)	38.8 (35.3∼ 42.3)	55.1 (50.6∼ 59.6)
Medical aid	463.0 (425.3∼500.6)	374.4 (336.7∼412.1)	337.1 (301.6∼372.5)	51.4 (36.6∼66.2)	123.9 (104.6∼143.3)	127.8 (103.3∼152.2)
Monthly income (Won)
＜1 million	374.3 (357.7∼391.0)	306.2 (290.2∼322.1)	277.7 (262.4∼293.0)	40.7 (34.8∼46.5)	91.2 (82.7∼ 99.7)	104.1 (94.7∼113.4)
≤1∼2 million	174.5 (164.6∼184.3)	122.9 (114.6∼131.1)	107.4 (99.6∼115.2)	18.9 (15.2∼22.6)	31.3 (27.3∼ 35.3)	59.1 (52.7∼ 65.5)
≤2∼3 million	133.3 (123.3∼143.3)	91.8 (83.5∼100.0)	81.3 (73.4∼ 89.2)	11.5 (8.6∼14.4)	21.8 (17.9∼ 25.7)	43.7 (37.4∼ 50.0)
≤3∼4 million	118.1 (105.9∼130.2)	82.4 (72.6∼ 92.3)	68.9 (59.8∼ 78.0)	14.7 (9.4∼19.9)	19.3 (14.4∼ 24.2)	42.8 (34.9∼ 50.7)
≤4 million	120.0 (105.8∼134.2)	74.0 (63.2∼ 84.7)	62.0 (52.0∼ 71.9)	13.4 (8.7∼18.1)	27.6 (21.3∼ 33.9)	42.9 (34.3∼ 51.4)

^∗ Coefficient of variation is over than 30%

All the prevalence rates were estimated after application of stratified cluster systematic sampling and weighting of the sample

Table 6.

Annual self-reported prevalence rates according to the sociodemographic characteristics in Korea National Health and Nutrition Examination Surveys III (Men). Values are person per 1,000 (95% CI)

	Four musculoskeletal diseases	Arthritis	Osteoarthritis	Rheumatoid arthritis	Osteoporosis	Herniated disc
Marrital status
Single	52.8 (43.5∼ 62.1)	17.4 (12.4∼ 22.5)	11.1 (7.1∼ 15.1)	6.3 (3.1∼ 9.6)	1.1 (0.0∼ 2.3)^∗	36.8 (29.4∼ 44.2)
Married	148.1 (139.4∼156.8)	101.7 (94.3∼109.1)	89.8 (83.0∼ 96.7)	13.1 (10.3∼15.8)	6.3 (4.6∼ 8.0)	57.8 (52.2∼ 63.3)
Other	230.0 (196.6∼263.4)	176.7 (146.6∼206.9)	159.6 (130.0∼189.1)	22.5 (10.4∼34.6)	13.6 (4.8∼22.3)^∗	79.0 (57.0∼100.9)
Education
No formal education	378.5 (334.9∼422.1)	306.1 (263.8∼348.3)	293.4 (250.0∼336.8)	16.7 (4.5∼29.0)	37.3 (19.5∼55.1)	114.5 (85.8∼143.3)
Elementary school	314.8 (286.6∼343.1)	242.1 (215.7∼268.6)	221.9 (195.7∼248.2)	23.4 (14.2∼32.7)	17.5 (9.9∼25.1)	102.0 (82.8∼121.2)
Middle school	223.7 (197.5∼250.0)	155.4 (132.8∼178.0)	140.5 (119.3∼161.8)	17.1 (9.6∼24.6)	7.7 (2.4∼13.0)	89.2 (73.2∼105.2)
High school	94.8 (86.1∼103.6)	52.0 (45.8∼ 58.2)	40.8 (35.3∼ 46.3)	11.9 (8.5∼15.4)	2.5 (1.2∼ 3.8)	47.4 (41.1∼ 53.7)
College or higher	54.6 (46.6∼ 62.5)	27.9 (22.4∼ 33.3)	22.8 (18.0∼ 27.7)	5.0 (2.5∼7.5)	1.3 (0.1∼ 2.4)^∗	29.6 (23.3∼ 35.9)
Occupation
High & middle high class	53.5 (37.5∼ 69.6)	34.8 (21.5∼ 48.1)	24.4 (13.2∼ 35.5)	10.4 (2.3∼18.5)	1.6 (0.0∼ 3.9)^∗	23.2 (12.2∼ 34.2)
New middle class	73.1 (53.7∼ 92.5)	38.1 (24.4∼ 51.8)	26.7 (15.3∼ 38.2)	11.4 (3.3∼19.4)	2.1 (0.0∼ 5.4)^∗	37.8 (21.9∼ 53.6)
Old middle class	111.7 (94.8∼128.7)	59.9 (47.0∼ 72.8)	53.7 (41.7∼ 65.6)	7.2 (2.7∼11.7)^∗	5.6 (0.0∼ 2.1)^∗	56.5 (43.7∼ 69.4)
Labors	98.8 (83.6∼113.9)	52.7 (40.7∼ 64.7)	44.7 (34.0∼ 55.5)	8.0 (3.0∼13.0)^∗	1.9 (0.0∼ 4.1)^∗	54.3 (42.4∼ 66.1)
Low class	234.6 (213.8∼255.4)	173.3 (155.1∼191.6)	153.3 (135.9∼170.7)	23.2 (15.2∼31.2)	6.0 (2.3∼ 9.8)^∗	81.6 (67.8∼ 95.4)
Others	119.0 (109.3∼128.6)	78.9 (71.0∼ 86.7)	69.5 (62.0∼ 76.9)	10.5 (7.5∼13.4)	6.6 (4.5∼ 8.7)	48.9 (42.6∼ 55.1)
Health insurance
Self-employed insured	130.0 (119.5∼140.5)	79.1 (71.3∼ 86.8)	70.1 (62.8∼ 77.4)	10.0 (7.2∼12.8)	5.3 (3.3∼ 7.4)	59.8 (52.3∼ 67.3)
Employee insured	110.5 (102.3∼118.7)	74.6 (67.7∼ 81.5)	63.3 (57.0∼ 69.6)	11.9 (8.7∼15.1)	4.3 (2.7∼ 5.8)	43.8 (38.6∼ 49.1)
Medical aid	320.0 (267.0∼373.1)	234.7 (187.1∼282.4)	217.3 (171.0∼263.5)	29.1 (11.6∼46.6)^∗	20.2 (5.3∼ 3.5)^∗	123.1 (81.0∼165.1)
Monthly income (Won)
＜1 million	221.3 (201.8∼240.8)	162.1 (145.3∼178.9)	148.8 (132.7∼164.9)	17.7 (12.3∼23.1)	12.2 (7.7∼16.7)	84.3 (71.6∼ 97.0)
≤1∼2 million	120.6 (109.8∼131.4)	74.1 (65.5∼ 82.7)	62.8 (55.1∼ 70.5)	11.6 (7.4∼15.8)	4.8 (2.7∼ 7.0)	54.5 (46.6∼ 62.3)
≤2∼3 million	99.0 (86.8∼111.3)	60.5 (51.1∼ 69.8)	53.0 (44.5∼ 61.5)	7.5 (3.7∼11.3)	0.3 (0.0∼ 1.0)^∗	42.8 (34.5∼ 51.2)
≤3∼4 million ≤	78.6 (64.2∼ 93.1) ∼	46.4 (35.2∼ 57.5) ∼	38.2 (28.3∼ 48.2) ∼	8.5 (3.1∼13.8)^∗∼	1.0 (0.0∼ 2.1)^∗∼	38.5 (28.1∼ 48.9)∼
≤4 million	70.0 (56.1∼ 84.0)	40.9 (30.2∼ 51.5)	28.7 (19.8∼ 37.5)	12.9 (6.6∼19.1)	1.7 (0.0∼ 3.7)^∗	30.6 (20.9∼ 40.4)

^∗ Coefficient of variation is over than 30%

All the prevalence rates were estimated after application of stratified cluster systematic sampling and weighting of the sample

Table 7.

Annual self-reported prevalence rates according to the sociodemographic characteristics in Korea National Health and Nutrition Examination Surveys III (Women). Values are person per 1,000 (95% CI)

	Musculoskeleal diseases	Arthritis	Osteoarthritis	Rheumatoid arthritis	Osteoporosis	Herniated disc
Marrital status
Single	36.5 (28.4∼ 44.6)	19.0 (13.5∼ 24.6)	12.2 (7.8∼ 16.6)	7.2 (3.7∼10.6)	4.4 (1.8∼ 7.0)^∗	16.8 (10.9∼ 22.8)
Married	255.4 (244.3∼266.6)	192.8 (182.7∼203.0)	169.8 (160.2∼179.3)	29.6 (25.7∼33.6)	68.4 (62.3∼ 74.6)	72.8 (66.2∼ 79.3)
Other	560.8 (539.1∼582.5)	476.4 (454.1∼498.6)	438.5 (417.1∼460.0)	58.0 (48.3∼67.8)	179.6 (164.2∼195.0)^∗	124.0 (108.9∼139.2)
Education
No formal education	707.4 (683.8∼731.0)	627.7 (601.3∼654.2)	581.9 (555.5∼608.2)	75.9 (61.5∼90.3)	244.0 (219.8∼268.3)	140.3 (122.8∼157.8)
Elementary school	557.4 (533.4∼581.3)	462.6 (438.6∼486.6)	425.0 (401.0∼449.0)	57.1 (47.2∼67.1)	176.2 (159.1∼193.4)	130.7 (112.3∼149.1)
Middle school	338.5 (312.8∼364.2)	255.8 (232.1∼279.4)	229.1 (206.6∼251.5)	33.1 (23.2∼43.0)	88.7 (72.3∼105.2)	102.4 (84.6∼120.1)
High school	128.1 (118.3∼138.0)	81.7 (73.7∼ 89.8)	66.4 (59.1∼ 73.6)	16.8 (12.7∼20.9)	22.6 (18.4∼ 26.8)	43.4 (37.4∼ 49.4)
College or higher	75.2 (64.2∼ 86.2)	39.1 (31.3∼ 47.0)	30.1 (23.5∼ 36.7)	9.7 (5.6∼13.8)	14.5 (10.1∼ 18.9)	33.8 (26.9∼ 40.7)
Occupation
High & middle high class	69.1 (43.9∼ 94.3)	20.9 (7.7∼ 34.0)^∗	17.3 (5.7∼ 28.8)^∗	3.6 (0.0∼ 8.4)^∗	14.0 (3.3∼ 24.8)^∗	38.2 (21.2∼ 55.2)
New middle class	50.1 (26.7∼ 73.5)	29.2 (12.0∼ 46.4)	8.3 (0.0∼ 18.3)^∗	20.8 (6.4∼35.3)^∗	11.1 (0.1∼ 22.2)^∗	15.7 (30.0∼ 28.5)^∗
Old middle class	263.7 (228.6∼298.9)	201.0 (168.8∼233.3)	174.5 (143.2∼205.8)	34.3 (20.8∼47.7)	51.5 (35.9∼ 67.2)	74.4 (53.5∼ 95.3)
Labors	141.0 (119.3∼162.6)	106.1 (88.5∼123.7)	90.9 (75.1∼106.6)	16.6 (8.6∼24.6)	16.6 (8.8∼ 24.4)	37.5 (25.1∼ 50.0)
Low class	444.4 (414.9∼473.9)	367.9 (339.1∼396.6)	340.2 (311.1∼369.3)	49.1 (38.3∼60.0)	124.9 (106.0∼143.8)	110.4 (92.5∼128.3)
Others	272.0 (260.5∼283.5)	212.9 (202.3∼223.5)	189.5 (179.6∼199.5)	30.2 (26.2∼34.1)	82.7 (76.1∼ 89.3)	72.2 (66.0∼ 78.4)
Health insurance
Self-employed insured	270.7 (256.6∼284.8)∼	211.3 (198.5∼224.1)∼	189.3 (177.1∼201.5) ∼	30.4 (25.3∼35.5)∼	67.8 (60.4∼ 75.1)∼	71.8 (63.8∼ 79.8)∼
Employee insured	243.9 (232.8∼255.1)	189.7 (180.0∼199.9)	168.9 (159.2∼178.5)	27.6 (23.6∼31.6)	73.0 (66.3∼ 79.6)	66.2 (59.8∼ 72.7)
Medical aid	558.1 (513.0∼603.1)	467.3 (419.0∼515.6)	416.7 (371.6∼461.9)	66.2 (45.5∼86.8)	192.9 (164.2∼221.6)	130.9 (102.1∼159.6)
Monthly income (Won)＜	∼	∼	∼	∼	∼	∼
＜1 million ≤ ∼	497.9 (477.3∼518.5)∼	422.5 (401.4∼443.7)∼	381.8 (361.4∼402.3) ∼	59.2 (50.2∼68.2)∼	155.0 (141.0∼169.1)∼	120.0 (107.2∼132.9)∼
≤1∼2 million	231.1 (216.0∼246.3)	174.2 (161.1∼187.2)	154.3 (141.9∼166.8)	26.7 (21.3∼32.0)	59.1 (51.4∼ 66.8)	64.0 (55.2∼ 72.8)
≤2∼3 million ≤ ∼	169.2 (154.3∼184.1)∼	124.6 (111.9∼137.3)∼	111.0 (99.1∼122.9) ∼	15.7 (11.1∼20.3)∼	41.4 (33.8∼ 49.0)∼	44.7 (35.9∼ 53.4)∼
≤3∼4 million ≤4 million	159.7 (141.6∼177.8) 168.7 (146.9∼190.4)	120.5 (105.5∼135.6) 106.2 (89.7∼122.7)	101.2 (86.8∼115.6) 94.4 (78.8∼110.0)	21.2 (13.3∼29.1) 13.9 (8.0∼19.8)	38.7 (28.5∼ 48.9) 52.8 (40.6∼ 64.9)	47.3 (35.8∼ 58.8) 54.7 (42.4∼ 67.1)
≤4 million	168.7 (146.9∼190.4)	106.2 (89.7∼122.7)	94.4 (78.8∼110.0)	13.9 (8.0∼19.8)	52.8 (40.6∼ 64.9)	54.7 (42.4∼ 67.1)

^∗ Coefficient of variation is over than 30%

All the prevalence rates were estimated after application of stratified cluster systematic sampling and weighting of the sample

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