Abstract
Rural populations in the United States have well documented health disparities, including higher prevalences of chronic health conditions (1,2). Doctor-diagnosed arthritis is one of the most prevalent health conditions (22.7%) in the United States, affecting approximately 54.4 million adults (3). The impact of arthritis is considerable: an estimated 23.7 million adults have arthritis-attributable activity limitation (AAAL). The age-standardized prevalence of AAAL increased nearly 20% from 2002 to 2015 (3). Arthritis prevalence varies widely by state (range=19%-36%) and county (range=16%-39%) (4). Despite what is known about arthritis prevalence at the national, state, and county levels and the substantial impact of arthritis, little is known about the prevalence of arthritis and AAAL across urban-rural areas overall and among selected subgroups. To estimate the prevalence of arthritis and AAAL by urban-rural categories CDC analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). The unadjusted prevalence of arthritis in the most rural areas was 31.8% (95% confidence intervals [CI]=31.0%-32.5%) and in the most urban, was 20.5% (95% CI=20.1%-21.0%). The unadjusted AAAL prevalence among adults with arthritis was 55.3% in the most rural areas and 49.7% in the most urban. Approximately 1 in 3 adults in the most rural areas have arthritis and over half of these adults have AAAL. Wider use of evidence-based interventions including physical activity and self-management education in rural areas might help reduce the impact of arthritis and AAAL.
Highlights
Because of the high prevalence of arthritis in the rural adult population, rural residents should be targeted for interventions including physical activity and self-management education programs that help adults with arthritis manage their condition and reduce symptoms
Changes in land use, destination locations and transportation infrastructure have been associated with environments that facilitate increased walking in many geographic areas and some of these components might apply in smaller rural areas [9]
These changes could provide an environment that facilitates walking among rural residents
Summary
Prevalence of Arthritis and Arthritis-Attributable Activity Limitation by Urban-Rural County Classification — United States, 2015. To estimate the prevalence of arthritis and AAAL by urban-rural categories CDC analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). The unadjusted AAAL prevalence among adults with arthritis was 55.3% in the most rural areas and 49.7% in the most urban. Wider use of evidence-based interventions including physical activity and self-management education in rural areas might help reduce the impact of arthritis and AAAL. Age-standardized prevalence by urban-rural categories was further stratified by selected demographic (sex, race/ethnicity, highest education level, and employment status) and health (body mass index, leisure time physical activity, self-rated health, disability, and smoking status) characteristics. In the most rural areas (noncore) nearly 1 in 3 adults (unadjusted prevalence 31.8%) reported having doctor-diagnosed arthritis (Table 1).
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