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Show Arthritis Prevalence and Risk in Utah Randy Tanner, M.P.A., Richard Bullough, Ph.D., Michael Friedrichs, M.S., Kathie Marti, R.N., M.P.H., LaDene Larsen, R.N. Abstract This study represents the first comprehensive analysis of arthritis prevalence and risk data in Utah adults. 2,891 Utahans (49% male, 51% female) were sampled from all 12 local health districts in Utah using the 2000 Utah Behavioral Risk Factor Surveillance System (BRFSS). All reported data are weighted to adjust for the probability of selection, and the age and sex distribution of Utah's estimated population in 2000. Approximately 31% of Utah adults have arthritis and 29% of these are undiagnosed by a physician. Prevalence is higher in females (35%) than males (27%), older age groups, those with lower income, non-Hispanics, the overweight or obese, and those with lower physical activity. No prevalence differences were observed by education but those with lower education suffered increased negative health outcomes associated with arthritis. Additionally, those with arthritis reported increased fair or poor health and mental health days. These data should be utilized to educate the public and decision-makers about arthritis burden in Utah and to focus limited arthritis resources to those most in need. Arthritis is a major contributor to morbidity and poor quality of life in the United States and is the number one cause of disability (CDC, 1999). In 1997, arthritis affected nearly 43 million Americans and the Centers for Disease Control and Prevention (CDC) estimates that it will affect 60 million Americans by 2020 (CDC, 2001a). It is conservatively estimated that one of six Americans has arthritis, but the number may be as high as one in three. By the year 2020, nearly 12 million Americans will experience activity limitation because of arthritis (CDC, 2001b). Additionally, arthritis creates enormous costs for individuals, their families and the nation. The annual cost to our society in medical costs and lost wages is estimated to be $65 billion (CDC, 1999). Nationally, there are clear indicators of arthritis risk. These risk factors may be classified as non-modifiable, potentially modifiable, and modifiable (Arthritis Foundation et al., 1999). Non-modifiable risk factors include 1) age, with arthritis prevalence increasing with age; 2) gender, with women demonstrating higher arthritis prevalence; and 3) race/ ethnicity, with non-Hispanic whites and blacks perhaps having higher arthritis prevalence than Hispanic whites. However, the relationship of race and ethnicity to arthritis prevalence remains unclear. Potentially modifiable risk factors include 1) income, with arthritis prevalence decreasing as income increases; and 2) education, with arthritis prevalence decreasing as years of education increases. The relationships between these potentially modifiable risk factors and arthritis prevalence, and the impact of modifying these risk factors on arthritis prevalence, remain uncertain. Modifiable risk factors include: 1) overweight and obesity, with arthritis prevalence increasing as body mass index increases, and 2) physical activity, with arthritis prevalence increasing as physical activity decreases (US HHS, 1996). Because of changing national demographics and behaviors, age, body weight, and physical activity may be of increasing significance. There are effective interventions for arthritis that may serve as adjuncts to conventional medical therapy but these interventions appear to be greatly underutilized. One of the most promising and longest-evaluated interventions is the Arthritis Self-Help Course (ASHC). Unfortunately, this course reaches only 8,000 to 12,000 adults annually, representing less than one percent of those with arthritis. Research by the Utah Arthritis Program (Bissonette et al., 2000), suggests that the low participation in this course may be due to low provider and patient awareness of the course and to low patient referral into the course. The ASHC includes components on medications, nutrition, patient-physician communication, types of arthritis and appropriate use of injured joints. Also, ASHC in- Utah's Health: An Annual Review Volume VIII 13 |
