Background/Purpose: US rural populations have well documented health disparities, including higher prevalence of chronic health conditions; however, arthritis prevalence among those with other chronic conditions is unknown. We estimated prevalence of arthritis and arthritis-attributable activity limitations (AAAL), among those with chronic health conditions in rural areas using 2015 Behavioral Risk Factor Surveillance System (BRFSS) data.

Methods: BRFSS is an ongoing, state-based, random-digit–dialed landline and cellphone survey of the noninstitutionalized adult population aged ≥18 years of the 50 states, the District of Columbia (DC), and the U.S. territories. Respondents had arthritis if they answered “yes” 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?” Among adults with arthritis, AAAL was identified by a “yes” to “Are you now limited in any way in any of your usual activities because of arthritis or joint symptoms?” Rural categories were created using the National Center for Health Statistics 2013 Urban-Rural Classification Scheme for Counties; we used 2 rural county classification categories: micropolitan (large rural [LR]) and noncore (small rural [SR]). Age-standardized prevalence of arthritis and AAAL were estimated by rural categories among those with each of 9 common chronic health conditions (hypertension, coronary artery disease [CAD], obesity, diabetes, chronic obstructive pulmonary disease [COPD], depression, asthma, cancer, and chronic kidney disease [CKD]). All analyses accounted for BRFSS’ complex sampling design.

Results: Overall, arthritis prevalence was high in rural populations with chronic health conditions (range = 36.0-56.0%). In SR areas, arthritis prevalence was particularly high among those with CKD (53.6%), COPD (51.6%), stroke (49.5%), and CAD (49.5%). In LR areas, arthritis prevalence was highest among those with CAD (56.0%), COPD (54.8%), and CKD (50.7%). Overall, AAAL prevalence among those with arthritis and ≥ 1 chronic condition ranged from 58.4 to 76.5%. In SR areas, age-standardized AAAL prevalence was highest among those with arthritis and depression (71.2%), COPD (68.8%), CAD (65.8%), and stroke (65.5%). In LR areas, AAAL prevalence was highest among those with depression (66.1%), COPD (71.9%), CAD (69.9%), and stroke (76.3%).

Conclusion: In rural areas, arthritis commonly occurs with other chronic conditions; for some more than half had arthritis. Individuals with arthritis and chronic conditions in rural areas are significantly impacted by arthritis with roughly 2 in 3 reporting AAAL. Strategies that reduce arthritis impact include weight loss, routine physical activity and participation in self-management education courses (e.g., Chronic Disease Self-Management Program); these approaches also reduce adverse effects of co-occurring chronic conditions. By recommending these strategies to their patients, health care providers can simultaneously manage the impact of arthritis and other chronic conditions. Our results indicates the high need for these self-management strategies among rural adults.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-arthritis-among-populations-with-chronic-health-conditions-in-rural-counties-of-the-united-states-2015/