Background/Purpose: Previous research has shown arthritis-attributable work limitation to be high (~30%) among U.S. adults with arthritis and for employment to be ~20% lower among adults with arthritis compared with those without arthritis.  Women with arthritis typically are less likely to be employed than women without arthritis and all men.  The purpose of this study is to estimate, for the first time, the overall and sex-specific prevalence of employment participation restriction (PR) among adults ≥18 years with and without arthritis and also to examine differences by occupational groups.

Methods: 2011 National Health Interview Survey (NHIS) data were analyzed (Adult Functioning and Disability Supplement and Sample Adult Core [n = 16,540; response rate = 63%]).  NHIS is an annual, multistage probability survey by in-person interview designed to represent the U.S. civilian, non-institutionalized population.  Arthritis diagnosis was identified by “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?”  Several activities were queried with the root: “For each of the following activities, please tell me if you do the activity, don’t do the activity, or are unable to do the activity.” Employment PR was ascertained by a response of “unable to do” for the activity: “Working outside the home to earn an income.”  Five major occupational groups were categorized according to Bureau of Labor Statistics classifications: 1) management, professional, and related; 2) service; 3) sales and office; 4) natural resources, construction, and maintenance; 5) production, transportation, and material moving.  Occupation among those who were working/had ever worked was classified based on their current/most recent job.  Weighted proportions with 95% confidence intervals (CI) were calculated accounting for complex sample design (SAS 9.2).

Results: Overall, 5.9% (5.4-6.4) of respondents reported employment PR; the proportion was approximately four times higher among those with arthritis (17.5% [5.8 million]) compared with those without arthritis (3.5% [5.5 million]).  For each occupational group, employment PR was 2.5-8 times greater among those with arthritis(Table).  Among those with arthritis, the group with the greatest sex-specific difference was production, transportation, and material moving, with employment PR approximately double among women (32.0%) compared with men (14.9%).

Conclusion:  High prevalence of employment PR for people with arthritis across all occupational groups compared with their non-arthritis peers indicates greater employment PR burden; women have higher employment PR burden than men.  Exploration of effective interventions to reduce employment PR, including potential differences in benefits by sex, is necessary to mitigate the negative effects of employment PR.