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Open Access Highly Accessed Research article

High prevalence of diagnosis of diabetes, depression, anxiety, hypertension, asthma and COPD in the total population of Stockholm, Sweden – a challenge for public health

Axel C Carlsson12*, Per Wändell1, Urban Ösby34, Ramin Zarrinkoub15, Björn Wettermark56 and Gunnar Ljunggren57

Author Affiliations

1 Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 12, 141 83 Huddinge, Sweden

2 Department of Public Health and Caring Sciences/ Section of Geriatrics, Uppsala University, Uppsala, Sweden

3 Neurogenetics Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Solna, Sweden

4 Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden

5 Public Healthcare Services Committee Administration, Stockholm County Council, Box 6909, SE- 102 39 Stockholm, Sweden

6 Centre for Pharmacoepidemiology and Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska University Hospital, Huddinge, Sweden

7 Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Berzelius väg 3, SE-17177 Stockholm, Sweden

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BMC Public Health 2013, 13:670  doi:10.1186/1471-2458-13-670

Published: 18 July 2013

Abstract

Background

There is limited knowledge on the prevalence of disease in total populations. Such studies have historically been difficult to conduct but the development of health data registers has facilitated large-scale studies on recorded diagnoses in entire regions. The aim of this study was to analyze the prevalence of diagnosis of six common diseases in the Swedish capital region.

Methods

The study population included all living persons who resided in Stockholm County, Sweden, on December 31st 2011 (N = 2 093 717). Information on all consultations between 2007 and 2011 was obtained from primary health care, specialist outpatient care and inpatient care. Prevalence was defined as the proportion of individuals with a recorded diagnosis of diabetes, depression, anxiety disorders, hypertension, asthma and chronic obstructive pulmonary disease during the five year period, respectively. Analyses were done by age and gender.

Results

Hypertension had the highest five-year prevalence (12.2%), followed by depression (6.6%), diabetes mellitus (6.2%), asthma (5.9%), anxiety disorders/phobia (4.8%), and COPD (1.8%). Diabetes was more common in men (5.3% of women and 7.1% of men) while depression (8.7% in women and 4.4% in men) and anxiety (6.3% in women and 3.4% in men) were considerably more common in women. Smaller gender differences were also found for hypertension (13.0% in women and 11.4% in men), asthma (6.4% in women and 5.4% in men) and COPD (2.1% in women and 1.6% in men). Diabetes, hypertension and COPD increased markedly with age, whereas anxiety, depression and asthma were fairly constant in individuals above 18 years. During one year of observation, more than half of all patients had only been diagnosed in primary health care, with hypertension being the diagnosis with the largest proportion of patients only identified in primary health care (70.6%).

Conclusion

The prevalence of common diseases in the population can be estimated by combining data gathered during consecutive years from primary care, specialist outpatient care and inpatient care. However, accuracy of disease prevalence is highly dependent on the quality of the data. The high prevalence of the six diagnoses analysed in this study calls for preventive action to minimize suffering and costs to society.

Keywords:
Administrative databases; Primary care; Gender differences; Age differences; Epidemiology