Fewer minorities have arthritis but they feel its impact far more acutely in terms of pain severity and limitations on function, compared with whites, according to National Health Interview Survey data.
The greater impact of arthritis on minorities may result from their having more physically demanding jobs, limited access to health care, increased willingness to report pain and limitations, unwillingness to use medication, and higher rates of obesity, among other plausible explanations, according to Julie Bolen, Ph.D., of the Centers for Disease Control and Prevention and her associates in their report in the journal Preventing Chronic Disease.
The investigators examined combined data from the 2002, 2003, and 2006 National Health Interview Surveys for the study. Taken together, these annual, CDC-conducted surveys include nationally representative data based on interviews with nearly 86,000 individuals from across the United States.
The 2004 and 2005 surveys were excluded from this study because they did not assess arthritis-attributable work limitation and joint pain, the investigators noted (Prev. Chronic Dis. 2010;7:1–5).
The annualized prevalence of arthritis based on the survey data was 24% for whites, 19% for blacks, 11% for Hispanics, 25% for American Indians/Alaska Natives, 8% for Asians and Pacific Islanders, and 21% for multiracial and “other” respondents.
Overall, 38% of those reporting doctor-diagnosed arthritis also reported activity limitations, 31% of those aged 18-64 years reported work limitations, and 26% reported severe joint pain in the prior month.
Blacks, Hispanics, and multiracial/other individuals were disproportionately affected in regard to limitations and pain: Compared with whites, and after adjusting for age, sex, and body mass index, blacks and Hispanics were about 1.3 times as likely to have activity limitations, 1.6-1.7 times as likely to have work limitations, and 1.8-1.9 times as likely to have severe joint pain.
Multiracial/other individuals were 1.7 times as likely to report activity limitations, 2.2 times as likely to report work limitations, and 1.9 times as likely to report severe joint pain, the investigators found.
No significant differences were noted between whites and American Indians/Alaska Natives, or between whites and Asians and Pacific Islanders on these measures, but the sample sizes for these groups were small and therefore statistical power for detecting differences was limited.
The findings show that although the prevalence of arthritis is lower in blacks and Hispanics, the impact of the disease is worse in these populations, compared with whites, the investigators said.
Although the reasons for the racial and ethnic differences demonstrated by the survey data remain unclear, the development of effective and culturally sensitive interventions tailored to the needs of specific populations are needed and could be aided by the findings, they concluded.
“We must address these stark differences in arthritis impact by using what we know,” Jennifer M. Hootman, Ph.D., an epidemiologist for the CDC National Center for Chronic Disease Prevention and Health Promotion and a coauthor on the study, said in a press statement.
“We can educate those with arthritis about increasing physical activity and self-management and reducing obesity, especially those in groups bearing a disproportionate burden from arthritis,” she added.
The investigators noted that additional study would be useful for examining whether health care access, language barriers, differences in the prevalence of risk factors, and/or cultural differences in understanding the survey questions played a role in the disproportionate effects of arthritis seen in this study.
Efforts to increase the reach of evidence-based public health interventions for improving pain and functional limitations are also needed, they said.
“Future efforts to increase reach should use appropriately tailored interventions such as the Spanish-language health communication campaign Buenos Dias Artritis,” they noted.