RESUMEN
OBJECTIVE: Depression is common in individuals with chronic cutaneous lupus erythematosus (CCLE). However, how CCLE may impact patients' psychological well-being is poorly understood, particularly among disproportionally affected populations. We examined the relationships between depression and psychosocial factors in a cohort of predominantly Black patients with primary CCLE (CCLE without systemic manifestations). METHODS: Cross-sectional assessment of individuals with dermatologist-validated diagnosis of primary CCLE. NIH-PROMIS short-forms were used to measure depression, disease-related stigma, social isolation and emotional support. Linear regression analyses (É=0.05) were used to test an a priori conceptual model of the relationship between stigma and depression and the effect of social isolation and emotional support on that association. RESULTS: Among 121 participants (87.6% women; 85.1% Black), 37 (30.6%) reported moderate to severe depression. Distributions of examined variables divided equally among those which did (eg, work status, stigma (more), social isolation (more), emotional support (less)) and did not (eg, age, sex, race, marital status) significantly differ by depression. Stigma was significantly associated with depression (b=0.77; 95% CI0.65 to 0.90), whereas social isolation was associated with both stigma (b=0.85; 95% CI 0.72 to 0.97) and depression (b=0.70; 95% CI0.58 to 0.92). After controlling for confounders, stigma remained associated with depression (b=0.44; 95% CI0.23 to 0.66) but lost significance (b=0.12; 95% CI -0.14 to 0.39) when social isolation (b=0.40; 95% CI 0.19 to 0.62) was added to the model. Social isolation explained 72% of the total effect of stigma on depression. Emotional support was inversely associated with depression in the univariate analysis; however, no buffer effect was found when it was added to the multivariate model. CONCLUSION: Our findings emphasise the psychosocial challenges faced by individuals living with primary CCLE. The path analysis suggests that stigmatisation and social isolation might lead to depressive symptoms. Early clinical identification of social isolation and public education demystifying CCLE could help reduce depression in patients with CCLE.
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Lupus Eritematoso Discoide , Lupus Eritematoso Sistémico , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Lupus Eritematoso Discoide/diagnóstico , Lupus Eritematoso Sistémico/diagnóstico , Masculino , Aislamiento SocialRESUMEN
Pain has been established as a major public health problem in the United States (U.S.) with 50 million adults experiencing chronic pain and 20 million afflicted with high-impact chronic pain (ie, chronic pain that interferes with life or work activities). High financial and social costs are associated with chronic pain. Over the past 2 decades, pain management has been complicated by the marked increase in opioids prescribed to treat chronic noncancer pain and by the concurrent opioid crisis. Monitoring the prevalence of chronic pain and pain management is especially important because pain management is changing in uncertain ways. We review potential U.S. chronic pain surveillance systems, present potential difficulties of chronic pain surveillance, and explore how to address chronic pain surveillance in the current opioid era. We consider case definitions, severity, anatomic site, and varieties of chronic pain management strategies in reviewing and evaluating national surveys for chronic pain surveillance. Based on the criteria evaluated, the National Health Interview Survey offers the best single source for pain surveillance as the pain-related questions administered are brief, valid, and cover a broad scope of pain-related phenomena. PERSPECTIVE: This review article describes data sources that can be leveraged to conduct national chronic pain surveillance in the United States, explores case defining or pain-related questions administered, and evaluates them against 8 surveillance attributes.
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Dolor Crónico , Adulto , Analgésicos Opioides/uso terapéutico , Dolor Crónico/epidemiología , Costos y Análisis de Costo , Humanos , Manejo del Dolor , Prevalencia , Estados Unidos/epidemiologíaRESUMEN
Arthritis is a highly prevalent and disabling condition among U.S. adults (1); arthritis-attributable functional limitations and severe joint pain affect many aspects of health and quality of life (2). Self-management education (self-management) and physical activity can reduce pain and improve the health status and quality of life of adults with arthritis; however, in 2014, only 11.4% and 61.0% of arthritis patients reported engaging in each, respectively. To assess self-reported self-management class attendance and health care provider physical activity counseling among adults with doctor-diagnosed arthritis, CDC analyzed 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. In 2019, an age-standardized state median of one in six (16.2%) adults with arthritis reported ever attending a self-management class, and 69.3% reported ever receiving health care provider counselling to be physically active. Prevalences of both differed by state and sociodemographic characteristics; decreased with lower educational attainment, joint pain severity, and urbanicity; and were lower in men than in women. Health care providers can play an important role in promoting self-management class attendance and physical activity by counseling arthritis patients about their benefits and referring patients to evidence-based programs (3).
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Artritis/terapia , Consejo/estadística & datos numéricos , Ejercicio Físico , Personal de Salud/psicología , Educación del Paciente como Asunto/estadística & datos numéricos , Relaciones Médico-Paciente , Automanejo/educación , Adolescente , Adulto , Anciano , Artritis/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto JovenRESUMEN
The numerous health benefits of physical activity include reduced risk for chronic disease and improved mental health and quality of life (1). Physical activity can improve physical function and reduce pain and fall risk among adults with arthritis, a group of approximately 100 conditions affecting joints and surrounding tissues (most commonly osteoarthritis, fibromyalgia, gout, rheumatoid arthritis, and lupus) (1). Despite these benefits, the 54.6 million U.S. adults currently living with arthritis are generally less active than adults without arthritis, and only 36.2% of adults with arthritis are aerobically active (i.e., meet aerobic physical activity guidelines*) (2). Little is known about which physical activities adults with arthritis engage in. CDC analyzed 2019 Behavioral Risk Factor Surveillance System (BRFSS) data to examine the most common nonwork-related physical activities among adults with arthritis who reported any physical activity during the past month, nationally and by state. In 2019, 67.2% of adults with arthritis reported engaging in physical activity in the past month; among these persons, the most commonly reported activities were walking (70.8%), gardening (13.3%), and weightlifting (7.3%). In 45 U.S. states, at least two thirds of adults with arthritis who engaged in physical activity reported walking. Health care providers can help inactive adults with arthritis become active and, by encouraging physical activity and referring these persons to evidence-based physical activity programs, improve their health and quality of life.
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Artritis/epidemiología , Ejercicio Físico , Caminata/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto JovenRESUMEN
Arthritis has been the most frequently reported main cause of disability among U.S. adults for >15 years (1), was responsible for >$300 billion in arthritis-attributable direct and indirect annual costs in the U.S. during 2013 (2), is linked to disproportionately high levels of anxiety and depression (3), and is projected to increase 49% in prevalence from 2010-2012 to 2040 (4). To update national prevalence estimates for arthritis and arthritis-attributable activity limitation (AAAL) among U.S. adults, CDC analyzed combined National Health Interview Survey (NHIS) data from 2016-2018. An estimated 58.5 million adults aged ≥18 years (23.7%) reported arthritis; 25.7 million (10.4% overall; 43.9% among those with arthritis) reported AAAL. Prevalence of both arthritis and AAAL was highest among adults with physical limitations, few economic opportunities, and poor overall health. Arthritis was reported by more than one half of respondents aged ≥65 years (50.4%), adults who were unable to work or disabled* (52.3%), or adults with fair/poor self-rated health (51.2%), joint symptoms in the past 30 days (52.2%), activities of daily living (ADL) disability (54.8%), or instrumental activities of daily living (IADL)§ disability (55.9%). More widespread dissemination of existing, evidence-based, community-delivered interventions, along with clinical coordination and attention to social determinants of health (e.g., improved social, economic, and mental health opportunities), can help reduce widespread arthritis prevalence and its adverse effects.
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Artritis/epidemiología , Artritis/fisiopatología , Limitación de la Movilidad , Adolescente , Adulto , Anciano , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estados Unidos/epidemiología , Adulto JovenRESUMEN
Primary care providers (PCPs) can offer counseling to adults with arthritis on physical activity, which can reduce pain and improve physical function, mental health, and numerous other health outcomes. We analyzed cross-sectional 2018 DocStyles data for 1,366 PCPs who reported they always or sometimes recommend physical activity to adults with arthritis. Most PCPs sampled (88.2%) recommended walking, swimming, or cycling; 65.5% did not recommend any evidence-based, arthritis-appropriate physical activity programs recognized by the Centers for Disease Control and Prevention. Opportunities exist for public health awareness campaigns to educate PCPs about evidence-based physical activity programs proven to optimize health for adults with arthritis when more than counseling is needed.
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Artritis , Ejercicio Físico , Adulto , Artritis/terapia , Estudios Transversales , Personal de Salud , Humanos , Atención Primaria de SaludRESUMEN
OBJECTIVE: To examine the relationship between depressive symptoms, arthritis, and employment, and to determine whether this relationship differs across young, middle-age, and older working-age adults with arthritis. METHODS: Data from the US National Health Interview Survey from 2013-2017 were analyzed. Analyses were restricted to adults with doctor-diagnosed arthritis of working age (ages 18-64 years) with complete data on depressive symptoms (n = 11,380). Covariates were sociodemographic information, health, and health system utilization variables. Employment prevalence was compared by self-reported depressive symptoms. We estimated percentages, as well as univariable and multivariable logistic regression models, to examine the relationship between depression and employment among young adults (ages 18-34 years), middle-age adults (ages 35-54 years), and older adults (ages 55-64 years). RESULTS: Among all working-age US adults with arthritis, the prevalence of depressive symptoms was 13%. Those reporting depressive symptoms had a higher prevalence of fair/worse health (60%) and arthritis-attributable activity limitations (70%) compared to those not reporting depression (23% and 39%, respectively). Respondents with depressive symptoms reported significantly lower employment prevalence (30%) when compared to those not reporting depressive symptoms (66%) and lower multivariable-adjusted association with employment (prevalence ratio 0.88 [95% confidence interval (95% CI) 0.83-0.93]). Middle-age adults reporting depression were significantly less likely to be employed compared to their counterparts without depression (prevalence ratio 0.83 [95% CI 0.77-0.90]); similar but borderline statistically significant relationships were observed for both young adults (prevalence ratio 0.86 [95% CI 0.74-0.99]) and older adults (prevalence ratio 0.94 [95% CI 0.86-1.03]). CONCLUSION: For adults with arthritis, depressive symptoms are associated with not participating in employment. Strategies to reduce arthritis-related work disability may be more effective if they simultaneously address mental health.
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Artritis/psicología , Depresión/psicología , Empleo/psicología , Salud Mental , Adolescente , Adulto , Factores de Edad , Artritis/diagnóstico , Artritis/epidemiología , Estudios Transversales , Depresión/diagnóstico , Depresión/epidemiología , Femenino , Estado Funcional , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estados Unidos/epidemiología , Evaluación de Capacidad de Trabajo , Adulto JovenRESUMEN
OBJECTIVE: Self-management education programs are recommended for many chronic conditions. We studied which adults with arthritis received a health care provider's recommendation to take a self-management education class and who attended. METHODS: We analyzed data from a 2005--2006 national telephone survey of US adults with arthritis ≥45 years (n = 1793). We used multivariable-adjusted prevalence ratios (PR) from logistic regression models to estimate associations with: (1) receiving a health care provider recommendation to take a self-management education class; and (2) attending a self-management education class. RESULTS: Among all adults with arthritis: 9.9% received a health care provider recommendation to take an self-management education class; 9.7% attended a self-management education class. Of those receiving a recommendation, 52.0% attended a self-management education class. The strongest association with self-management education class attendance was an health care provider recommendation to take one (PR = 8.9; 95% CI = 6.6-12.1). CONCLUSIONS: For adults with arthritis, a health care provider recommendation to take a self-management education class was strongly associated with self-management education class attendance. Approximately 50% of adults with arthritis have ≥1 other chronic conditions; by recommending self-management education program attendance, health care providers may activate patients' self-management behaviors. If generalizable to other chronic conditions, this health care provider recommendation could be a key influencer in improving outcomes for a range of chronic conditions and patients' quality of life.
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Artritis , Automanejo , Adulto , Artritis/terapia , Personal de Salud , Encuestas Epidemiológicas , Humanos , Calidad de VidaRESUMEN
PURPOSE: To examine primary care providers' (PCPs) physical activity assessment and recommendation behaviors for adults with arthritis. DESIGN: Cross-sectional. SETTING: 2018 DocStyles online national market research survey of US physicians and nurse practitioners. SAMPLE: 1,389 PCPs seeing adults with arthritis. MEASURES: 2 independent behaviors (assessment and recommendation) as 3 non-mutually exclusive groups: "always assesses," "always recommends," and "both" ("always assesses and recommends"). ANALYSIS: Calculated percentages of each group (overall and by PCP characteristics), and multivariable-adjusted prevalence ratios (PRs) using binary logistic regression. RESULTS: Among PCPs, 49.2% always assessed and 57.7% always recommended physical activity; 39.7% did both. Across all 3 groups, percentages were highest for seeing ≥20 adults with arthritis weekly ("both": 56.4%; "always assesses": 66.7%; "always recommends": 71.3%) and lowest among obstetrician/gynecologists ("both": 26.9%; "always assesses": 36.8%; "always recommends": 40.7%). Multivariable-adjusted associations were strongest for seeing ≥20 adults with arthritis weekly (referent: 1-9 adults) and each of "always assesses" (PR = 1.5 [95% confidence interval (CI): 1.3-1.8] and "both" (PR = 1.6 [95% CI: 1.4-1.9]). CONCLUSIONS: Approximately 40% of PCPs sampled always engaged in both behaviors (assessing and recommending physical activity) with adults with arthritis; seeing a high volume of adults with arthritis was consistently related to engaging in each behavior. Evidence-based approaches to support PCP counseling include offering provider education and training, raising awareness of available resources, and using health system supports.
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Artritis , Personal de Salud , Adulto , Estudios Transversales , Ejercicio Físico , Humanos , Atención Primaria de SaludRESUMEN
INTRODUCTION: Limited estimates of prescribed opioid use among adults with arthritis exist. All-cause (i.e., for any condition) prescribed opioid dispensed (referred to as opioid prescription in the remainder of this abstract) in the past 12 months among U.S. adults aged ≥18 years (n=35,427) were studied, focusing on adults with arthritis (n=12,875). METHODS: In 2018-2019, estimates were generated using Medical Expenditure Panel Survey data: (1) 2015 prevalence of 1 or more opioid prescriptions to U.S. adults overall and by arthritis status and (2) in 2014-2015, among adults with arthritis, multivariable-adjusted associations between 1 or more opioid prescriptions and sociodemographic characteristics, health status, and healthcare utilization characteristics. RESULTS: In 2015, the age-standardized prevalence of 1 or more opioid prescriptions among adults with arthritis (29.6%) was almost double of that for all adults (15.4%). Adults with arthritis represented more than half of all adults (55.3%) with at least 1 opioid prescription; among those with 1 or more prescriptions, 43.2% adults had 4 or more prescriptions. The strongest multivariable-adjusted associations with 1 or more opioid prescriptions were ambulatory care visits (1-4: prevalence ratios=1.9-2.0, 5-8: prevalence ratios=2.5-2.7, 9 or more: prevalence ratios=3.4-3.7) and emergency room visits (1: prevalence ratios=1.6, 2-3: prevalence ratios=1.9-2.0, 4 or more: prevalence ratios=2.4); Ref for both: no visits. CONCLUSIONS: Adults with arthritis are a high-need target group for improving pain management, representing more than half of all U.S. adults with 1 or more opioid prescriptions. The association with ambulatory care visits suggests that providers have routine opportunities to discuss comprehensive and integrative pain management strategies, including low-cost evidence-based self-management approaches (e.g., physical activity, self-management education programs, cognitive behavioral therapy). Those with multiple opioid prescriptions may need extra support if transitioning to nonopioid and nonpharmacologic pain management strategies.
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Analgésicos Opioides , Artritis , Adolescente , Adulto , Analgésicos Opioides/uso terapéutico , Artritis/tratamiento farmacológico , Artritis/epidemiología , Prescripciones de Medicamentos/estadística & datos numéricos , Humanos , Manejo del Dolor/métodos , Prescripciones , PrevalenciaRESUMEN
BACKGROUND: Patients only benefit from clinical management of arthritis if they are under the care of a physician or other health professional. OBJECTIVES: We profiled adults who reported doctor-diagnosed arthritis who are not currently being treated for it to understand better who they are. METHODS: Individuals with no current treatment (NCT) were identified by "no" to "Are you currently being treated by a doctor or other health professional for arthritis or joint symptoms?" Demographics, current symptoms, physical functioning, arthritis limitations and interference in life activities, and level of agreement with treatment and attitude statements were assessed in this cross-sectional, descriptive study of noninstitutionalized US adults aged 45 years or older with self-reported, doctor-diagnosed arthritis (n = 1793). RESULTS: More than half of the study population, 52%, reported NCT (n = 920). Of those with NCT, 27% reported fair/poor health, 40% reported being limited by their arthritis, 51% had daily arthritis pain, 59% reported 2 or more symptomatic joints, and 19% reported the lowest third of physical functioning. Despite NCT, 83% with NCT agreed or strongly agreed with the importance of seeing a doctor for diagnosis and treatment. CONCLUSIONS: Greater than half of those aged 45 years or older with arthritis were not currently being treated for it, substantial proportions of whom experienced severe symptoms and poor physical function and may benefit from clinical management and guidance, complemented by community-delivered public health interventions (self-management education, physical activity). Further research to understand the reasons for NCT may identify promising intervention points to address missed treatment opportunities and improve quality of life and functioning.
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Actividades Cotidianas , Artritis , Pacientes Desistentes del Tratamiento , Rendimiento Físico Funcional , Calidad de Vida , Adulto , Artritis/diagnóstico , Artritis/epidemiología , Artritis/psicología , Actitud Frente a la Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Necesidades , Atención al Paciente/psicología , Pacientes Desistentes del Tratamiento/psicología , Pacientes Desistentes del Tratamiento/estadística & datos numéricos , Estados UnidosRESUMEN
An estimated 54.4 million (approximately one in four) U.S. adults have doctor-diagnosed arthritis (arthritis) (1). Severe joint pain and physical inactivity are common among adults with arthritis and are linked to adverse mental and physical health effects and limitations (2,3). CDC analyzed 2017 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate current state-specific prevalence of arthritis and, among adults with arthritis, the prevalences of severe joint pain and physical inactivity. In 2017, the median age-standardized state prevalence of arthritis among adults aged ≥18 years was 22.8% (range = 15.7% [District of Columbia] to 34.6% [West Virginia]) and was generally highest in Appalachia and Lower Mississippi Valley regions.* Among adults with arthritis, age-standardized, state-specific prevalences of both severe joint pain (median = 30.3%; range = 20.8% [Colorado] to 45.2% [Mississippi]) and physical inactivity (median = 33.7%; range = 23.2% [Colorado] to 44.4% [Kentucky]) were highest in southeastern states. Physical inactivity prevalence among those with severe joint pain (47.0%) was higher than that among those with moderate (31.8%) or no/mild joint pain (22.6%). Self-management strategies such as maintaining a healthy weight or being physically active can reduce arthritis pain and prevent or delay arthritis-related disability. Evidence-based physical activity and self-management education programs are available that can improve quality of life among adults with arthritis.
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Artralgia/epidemiología , Artritis/epidemiología , Conducta Sedentaria , Índice de Severidad de la Enfermedad , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto JovenRESUMEN
BACKGROUND: Quantifying the number of people with and types of disabilities is helpful for medical, policy, and public health planning. OBJECTIVE/HYPOTHESIS: To update prior estimates on types, prevalence, and main causes of disability among U.S. adults using the Survey of Income and Program Participation (SIPP) data. METHODS: We used cross-sectional data from the SIPP 2008 Panel Wave 6 interviews collected May-August 2010. Analyses were restricted to non-institutionalized adults ages ≥18 years (nâ¯=â¯66,410). Disability was ascertained via five non-mutually exclusive components: 1) specific activity difficulties, 2) selected impairments, 3) use of an assistive aid, 4) household work limitations, and 5) paid work limitations. Prioritized main cause of disability was established for the 95% of respondents with a disability type eligible for health condition questions. We generated weighted population estimates (number and percentage, with 95% confidence intervals (CIs)), accounting for the complex sample survey design. RESULTS: 50 million U.S. adults (21.8%) experienced a disability in 2010. Mobility-related activity limitations were the most prevalent disabilities across all five components. The most common main causes of disability were arthritis/rheumatism, 9.1 million (19.2%, 95% CIâ¯=â¯18.4-20.0) and back or spine problems, 8.9 million (18.6%, 95% CIâ¯=â¯17.9-19.3). CONCLUSIONS: A growing population with disabilities has the potential to put considerable and unsustainable demand on medical, public health, and senior service systems. Strengthening clinical community linkages and expanding the availability of existing evidence-based public health interventions to prevent, delay, and mitigate the effects of disability could improve health and outcomes for people with disabilities.
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Personas con Discapacidad/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Artritis/epidemiología , Dorso/patología , Estudios Transversales , Personas con Discapacidad/clasificación , Empleo , Femenino , Humanos , Renta , Masculino , Persona de Mediana Edad , Limitación de la Movilidad , Prevalencia , Enfermedades Reumáticas/epidemiología , Columna Vertebral/patología , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Trabajo , Adulto JovenRESUMEN
OBJECTIVE: Walking is a joint-friendly activity for adults with arthritis. The aim of this study was to estimate, among adults with arthritis, the prevalence of leisure and transportation walking overall (by arthritis status and by sociodemographic and health characteristics), the number of total minutes walking per week in each domain, and the distributions of walking bout length (i.e., short periods of activity) in minutes. METHODS: Data were obtained from the 2010 National Health Interview Survey. Prevalence estimates (percentages and 95% confidence intervals [95% CIs]) of leisure and transportation walking in the past 7 days and walking bout times were calculated (in minutes), as were multivariable Poisson regression models, which account for the complex sample design. RESULTS: Prevalence of leisure walking was 45.9% (95% CI 44.2-47.6) for adults with arthritis versus 51.9% (95% CI 50.9-52.9) for those without. Transportation walking prevalence was 23.0% (95% CI 21.7-24.4) for adults with arthritis versus 32.0% (95% CI 31.0-33.0) for those without. The total time of leisure walking per week did not differ in adults with arthritis compared to those without (77.3 versus 78.3 minutes, respectively; P = 0.62), while total time of transportation walking did differ (49.8 versus 58.1 minutes, respectively; P = 0.03). The most common walking bout length differed between leisure (26-40 minutes) and transportation (10-15 minutes) walking, but not by arthritis status. In separate adjusted multivariable models, obesity was consistently negatively associated with both walking outcomes, and being physically active was positively associated with both; lower extremity joint pain was not associated. CONCLUSION: By adding short bouts, leisure and transportation walking could be adopted by large proportions of adults with arthritis. Existing evidence-based programs can help increase physical activity.
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Artritis/epidemiología , Artritis/terapia , Actividades Recreativas , Transportes/métodos , Caminata/fisiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Artritis/psicología , Estudios Transversales , Ejercicio Físico/fisiología , Femenino , Encuestas Epidemiológicas/métodos , Humanos , Actividades Recreativas/psicología , Masculino , Persona de Mediana Edad , Autoinforme , Estados Unidos/epidemiología , Caminata/psicología , Adulto JovenRESUMEN
An estimated 54.4 million (22.7%) U.S. adults have doctor-diagnosed arthritis (1). A report in 2012 found that, among adults aged ≥45 years with arthritis, approximately one third reported having anxiety or depression, with anxiety more common than depression (2). Studies examining mental health conditions in adults with arthritis have focused largely on depression, arthritis subtypes, and middle-aged and older adults, or have not been nationally representative (3). To address these knowledge gaps, CDC analyzed 2015-2017 National Health Interview Survey (NHIS) data* to estimate the national prevalence of clinically relevant symptoms of anxiety and depression among adults aged ≥18 years with arthritis. Among adults with arthritis, age-standardized prevalences of symptoms of anxiety and depression were 22.5% and 12.1%, respectively, compared with 10.7% and 4.7% among adults without arthritis. Successful treatment approaches to address anxiety and depression among adults with arthritis are multifaceted and include screenings, referrals to mental health professionals, and evidence-based strategies such as regular physical activity and participation in self-management education to improve mental health.
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Ansiedad/epidemiología , Artritis/psicología , Depresión/epidemiología , Adolescente , Adulto , Anciano , Artritis/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Estados Unidos/epidemiología , Adulto JovenRESUMEN
In the United States, 54.4 million adults report having doctor-diagnosed arthritis (1). Among adults with arthritis, 32.7% and 38.1% also have overweight and obesity, respectively (1), with obesity being more prevalent among persons with arthritis than among those who do not have arthritis (2). Furthermore, severe joint pain among adults with arthritis in 2014 was reported by 23.5% of adults with overweight and 31.7% of adults with obesity (3). The American College of Rheumatology recommends weight loss for adults with hip or knee osteoarthritis and overweight or obesity,* which can improve function and mobility while reducing pain and disability (4,5). The Healthy People 2020 target for health care provider (hereafter provider) counseling for weight loss among persons with arthritis and overweight or obesity is 45.3%. Adults with overweight or obesity who receive weight-loss counseling from a provider are approximately four times more likely to attempt to lose weight than are those who do not receive counseling (6). To estimate changes in the prevalence of provider counseling for weight loss reported by adults with arthritis and overweight or obesity, CDC analyzed National Health Interview Survey (NHIS) data.§ Overall, age-standardized estimates of provider counseling for weight loss increased by 10.4 percentage points from 2002 (35.1%; 95% confidence interval [CI] = 33.0-37.3) to 2014 (45.5%; 95% CI = 42.9-48.1) (p<0.001). Providing comprehensive behavioral counseling (including nutrition, physical activity, and self-management education) and encouraging evidence-based weight-loss program participation can result in enhanced health benefits for this population.
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Artritis/terapia , Consejo Dirigido/estadística & datos numéricos , Obesidad/terapia , Sobrepeso/terapia , Pérdida de Peso , Adolescente , Adulto , Anciano , Artritis/epidemiología , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Obesidad/epidemiología , Sobrepeso/epidemiología , Estados Unidos/epidemiología , Adulto JovenRESUMEN
PROBLEM/CONDITION: Doctor-diagnosed arthritis is a common chronic condition affecting an estimated 23% (54 million) of adults in the United States, greatly influencing quality of life and costing approximately $300 billion annually. The geographic variations in arthritis prevalence, health-related characteristics, and management among states and territories are unknown. Therefore, public health professionals need to understand arthritis in their areas to target dissemination of evidence-based interventions that reduce arthritis morbidity. REPORTING PERIOD: 2015. DESCRIPTION OF SYSTEM: The Behavioral Risk Factor Surveillance System is an annual, random-digit-dialed landline and cellular telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Self-reported data are collected from the 50 states, the District of Columbia, Guam, and Puerto Rico. Unadjusted and age-standardized prevalences of arthritis, arthritis health-related characteristics, and arthritis management were calculated. County-level estimates were calculated using a validated statistical modeling method. RESULTS: In 2015, in the 50 states and the District of Columbia, median age-standardized prevalence of arthritis was 23.0% (range: 17.2%-33.6%). Modeled prevalence of arthritis varied considerably by county (range: 11.2%-42.7%). In 13 states that administered the arthritis management module, among adults with arthritis, the age-standardized median percentage of participation in a self-management education course was 14.5% (range: 9.1%-19.0%), being told by a health care provider to engage in physical activity or exercise was 58.5% (range: 52.3%-61.9%), and being told to lose weight to manage arthritis symptoms (if overweight or obese) was 44.5% (range: 35.1%-53.2%). Respondents with arthritis who lived in the quartile of states with the highest prevalences of arthritis had the highest percentages of negative health-related characteristics (i.e., arthritis-attributable activity limitations, arthritis-attributable severe joint pain, and arthritis-attributable social participation restriction; ≥14 physically unhealthy days during the past 30 days; ≥14 mentally unhealthy days during the past 30 days; obesity; and leisure-time physical inactivity) and the lowest percentage of leisure-time walking. INTERPRETATION: The prevalence, health-related characteristics, and management of arthritis varied substantially across states. The modeled prevalence of arthritis varied considerably by county. PUBLIC HEALTH ACTION: The findings highlight notable geographic variability in prevalence, health-related characteristics, and management of arthritis. Targeted use of evidence-based interventions that focus on physical activity and self-management education can reduce pain and improve function and quality of life for adults with arthritis and thus might reduce these geographic disparities.
Asunto(s)
Artritis , Disparidades en el Estado de Salud , Características de la Residencia/estadística & datos numéricos , Actividades Cotidianas , Adolescente , Adulto , Anciano , Artralgia/epidemiología , Artritis/complicaciones , Artritis/epidemiología , Artritis/prevención & control , Sistema de Vigilancia de Factor de Riesgo Conductual , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Estados Unidos/epidemiología , Adulto JovenRESUMEN
BACKGROUND: Chronic conditions are among the major causes of work disability (WD), which is associated with lower employment, less economic activity, and greater dependence on social programs, while limiting access to the benefits of employment participation. OBJECTIVE/HYPOTHESIS: We estimated the overall prevalence of WD among working-age (18-64 years) U.S. adults and the most common causes of WD overall and by sex. Next, we estimated the prevalence and most common causes of WD among adults with 12 common chronic conditions by sex and age. We hypothesized that musculoskeletal conditions would be among the most common causes of WD overall and for individuals with other diagnosed chronic conditions. METHODS: Data were obtained from years 2011, 2012, and 2013 of the National Health Interview Survey. WD was defined by a "yes" response to one or both of: "Does a physical, mental, or emotional problem NOW keep you from working at a job or business?" and "Are you limited in the kind OR amount of work you can do because of a physical, mental or emotional problem?" RESULTS: Overall, 20.1 million adults (10.4% (95% CI = 10.1-10.8) of the working-age population) reported WD. The top three most commonly reported causes of WD were back/neck problems 30.3% (95% CI = 29.1-31.5), depression/anxiety/emotional problems 21.0% (19.9-22.0), and arthritis/rheumatism 18.6 (17.6-19.6). Musculoskeletal conditions were among the three most common causes of WD overall and by age- and sex-specific respondents across diagnosed chronic conditions. CONCLUSIONS: Quantifying the prevalence and causes of work disability by age and sex can help prioritize interventions.
Asunto(s)
Enfermedad Crónica , Personas con Discapacidad , Empleo , Enfermedades Musculoesqueléticas , Adolescente , Adulto , Anciano , Ansiedad , Trastornos de Ansiedad , Artritis , Dolor de Espalda , Depresión , Trastorno Depresivo , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Dolor de Cuello , Prevalencia , Enfermedades Reumáticas , Estados Unidos , Adulto JovenRESUMEN
Rural populations in the United States have well documented health disparities, including higher prevalences of chronic health conditions (1,2). Doctor-diagnosed arthritis is one of the most prevalent health conditions (22.7%) in the United States, affecting approximately 54.4 million adults (3). The impact of arthritis is considerable: an estimated 23.7 million adults have arthritis-attributable activity limitation (AAAL). The age-standardized prevalence of AAAL increased nearly 20% from 2002 to 2015 (3). Arthritis prevalence varies widely by state (range = 19%-36%) and county (range = 16%-39%) (4). Despite what is known about arthritis prevalence at the national, state, and county levels and the substantial impact of arthritis, little is known about the prevalence of arthritis and AAAL across urban-rural areas overall and among selected subgroups. To estimate the prevalence of arthritis and AAAL by urban-rural categories CDC analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). The unadjusted prevalence of arthritis in the most rural areas was 31.8% (95% confidence intervals [CI] = 31.0%-32.5%) and in the most urban, was 20.5% (95% CI = 20.1%-21.0%). The unadjusted AAAL prevalence among adults with arthritis was 55.3% in the most rural areas and 49.7% in the most urban. Approximately 1 in 3 adults in the most rural areas have arthritis and over half of these adults have AAAL. Wider use of evidence-based interventions including physical activity and self-management education in rural areas might help reduce the impact of arthritis and AAAL.