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VBCR - June 2016, Vol 5, No 3 - Rheumatology Update
Sophie Granger

According to a recently published analysis of 2014 Behavioral Risk Factor Surveillance System (BRFSS) data, approximately 1 in 4 adults is currently living with physician-diagnosed arthritis in the United States.1,2 A primary cause for disability that affects approximately 52.5 million US adults, arthritis is expected to affect 78.4 million adults in 2040.1

Although national data on the prevalence of physician-diagnosed arthritis has been well-documented, little information has been published on the state and county levels, where interventions are implemented and can have the greatest effect. Seeking to estimate the frequency of physician-diagnosed arthritis among adults, researchers from the Centers for Disease Control and Prevention (CDC) analyzed data from the 2014 BRFSS, an annual, randomized phone survey representative of noninstitutionalized US adults aged ≥18 years.

Notably, respondents to the 2014 BRFSS were classified as having physician-diagnosed arthritis if they responded to, “Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?” with “yes.”

The CDC’s analysis, which used an age-standardized model to predict the prevalence of physician-diagnosed arthritis by county, summarized data for respondents from all 50 states, the District of Columbia, Puerto Rico, and Guam. Overall, the analysis revealed that, across all 50 states and the District of Columbia, the age-standardized median frequency of physician-diagnosed arthritis was 24% (range, 18.8%-35.5%). According to the model, physician-diagnosed arthritis prevalence varied significantly by county, ranging from 15.8% to 38.6%.

“The high prevalence of arthritis in all counties, and the high frequency of arthritis-attributable limitations among adults with arthritis, suggests that states and counties might benefit from expanding underused, evidence-based interventions for arthritis that can reduce arthritis symptoms and improve self-management,” stated lead author Kamil E. Barbour, PhD, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, and colleagues in a published report of the analysis’ results.

A multilevel regression and poststratification approach—including 2014 BRFSS individual-level data on age, sex, and race/ethnicity—was used to estimate model-predicted arthritis frequency for counties.

A higher prevalence of arthritis was observed in people identifying as American Indians/Alaska Natives or multiracial compared with whites or black non-Hispanics, and a lower frequency of the condition was noted in Hispanics and Asians compared with whites or black non-Hispanics.

Among patients from a combined sampling, arthritis frequency ranged from 8.8% to 53.3% for respondents aged 18 to 44 years and ≥65 years, respectively. Arthritis frequencies standardized for age were higher among women than men, and among people with less versus more education.

Estimated age-standardized arthritis prevalence varied among states and counties. For states and territories, physician-diagnosed arthritis ranged from 18.8% in Hawaii to 35.5% in West Virginia (median, 24.0%). The District of Columbia, Guam, and 47 states had an age-standardized prevalence of doctor-diagnosed arthritis of ≥20% in 2014; 4 states had an arthritis prevalence of ≥30%. Counties along the Appalachian Mountains, Mississippi River, and Ohio River tended to be in the highest quintiles of age-standardized model-predicted arthritis prevalence, as were the majority of counties in Alabama, Kentucky, Michigan, Tennessee, and West Virginia.

According to the report, physical activity (ie, walking, biking, swimming, and other low-impact activities) can reduce joint pain in patients with arthritis, and community programs, such as EnhanceFitness and Walk With Ease, provide guidance on how to safely remain physically active. Furthermore, confidence in adults with arthritis can be improved when they manage their arthritis symptoms with community self-management education interventions.

“Given the high prevalence of arthritis, health care providers and public health professionals can address arthritis by prioritizing self-management education and appropriate physical activity interventions as effective ways to improve health outcomes,” the authors of the CDC report concluded.




References

  1. Barbour KE, Helmick CG, Boring M, et al. Prevalence of doctor-diagnosed arthritis at state and county levels—United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65:489-494.
  2. New CDC Survey Analysis: Nearly One in Four U.S. Adults Now Live with Doctor-Diagnosed Arthritis. Atlanta, GA: American College of Rheumatology; May 19, 2016. www.rheumatology.org/About-Us/Newsroom/Press-Releases/ID/747/New-CDC-Survey-Analysis-Nearly-One-in-Four-US-Adults-Now-Live-with-Doctor-Diagnosed-Arthritis. Accessed May 25, 2016.
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Last modified: July 12, 2016
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