Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
G2S Corporation, San Antonio, Texas.
MMWR Surveill Summ. 2018 Mar 16;67(4):1-28. doi: 10.15585/mmwr.ss6704a1.
PROBLEM/CONDITION: Doctor-diagnosed arthritis is a common chronic condition affecting an estimated 23% (54 million) of adults in the United States, greatly influencing quality of life and costing approximately $300 billion annually. The geographic variations in arthritis prevalence, health-related characteristics, and management among states and territories are unknown. Therefore, public health professionals need to understand arthritis in their areas to target dissemination of evidence-based interventions that reduce arthritis morbidity.
The Behavioral Risk Factor Surveillance System is an annual, random-digit-dialed landline and cellular telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Self-reported data are collected from the 50 states, the District of Columbia, Guam, and Puerto Rico. Unadjusted and age-standardized prevalences of arthritis, arthritis health-related characteristics, and arthritis management were calculated. County-level estimates were calculated using a validated statistical modeling method.
In 2015, in the 50 states and the District of Columbia, median age-standardized prevalence of arthritis was 23.0% (range: 17.2%-33.6%). Modeled prevalence of arthritis varied considerably by county (range: 11.2%-42.7%). In 13 states that administered the arthritis management module, among adults with arthritis, the age-standardized median percentage of participation in a self-management education course was 14.5% (range: 9.1%-19.0%), being told by a health care provider to engage in physical activity or exercise was 58.5% (range: 52.3%-61.9%), and being told to lose weight to manage arthritis symptoms (if overweight or obese) was 44.5% (range: 35.1%-53.2%). Respondents with arthritis who lived in the quartile of states with the highest prevalences of arthritis had the highest percentages of negative health-related characteristics (i.e., arthritis-attributable activity limitations, arthritis-attributable severe joint pain, and arthritis-attributable social participation restriction; ≥14 physically unhealthy days during the past 30 days; ≥14 mentally unhealthy days during the past 30 days; obesity; and leisure-time physical inactivity) and the lowest percentage of leisure-time walking.
The prevalence, health-related characteristics, and management of arthritis varied substantially across states. The modeled prevalence of arthritis varied considerably by county.
The findings highlight notable geographic variability in prevalence, health-related characteristics, and management of arthritis. Targeted use of evidence-based interventions that focus on physical activity and self-management education can reduce pain and improve function and quality of life for adults with arthritis and thus might reduce these geographic disparities.
问题/状况：在美国，医生诊断的关节炎是一种常见的慢性疾病，估计影响了 23%（5400 万）的成年人，极大地影响了生活质量，每年花费约 3000 亿美元。各州和领土之间关节炎的流行率、与健康相关的特征和管理方面的地域差异尚不清楚。因此，公共卫生专业人员需要了解其所在地区的关节炎情况，以针对减少关节炎发病率的基于证据的干预措施进行目标传播。
2015 年。
行为风险因素监测系统是一项针对非机构化成年人的年度、随机数字拨号的陆地和蜂窝电话调查，年龄≥18 岁，居住在美国。从 50 个州、哥伦比亚特区、关岛和波多黎各收集自我报告数据。计算了关节炎、关节炎健康相关特征和关节炎管理的未经调整和年龄标准化的患病率。使用经过验证的统计建模方法计算了县级估计数。
2015 年，在 50 个州和哥伦比亚特区，关节炎的中值年龄标准化患病率为 23.0%（范围：17.2%-33.6%）。县级关节炎患病率的模型差异很大（范围：11.2%-42.7%）。在 13 个实施关节炎管理模块的州中，患有关节炎的成年人中，参加自我管理教育课程的比例中值为 14.5%（范围：9.1%-19.0%），有 58.5%（范围：52.3%-61.9%）的成年人被告知要进行身体活动或锻炼，44.5%（范围：35.1%-53.2%）的成年人被告知要减肥以控制关节炎症状（如果超重或肥胖）。生活在关节炎流行率最高的州的四分位数中的关节炎患者具有最高百分比的负面健康相关特征（即，关节炎导致的活动受限、关节炎导致的严重关节疼痛和关节炎导致的社会参与受限；在过去 30 天内有≥14 天身体不健康，在过去 30 天内有≥14 天精神不健康，肥胖和休闲时间不运动），休闲时间步行的比例最低。
关节炎的流行率、健康相关特征和管理在各州之间存在显著差异。县级关节炎的模型患病率差异很大。
研究结果突出了关节炎在流行率、健康相关特征和管理方面的显著地域差异。有针对性地使用以身体活动和自我管理教育为重点的基于证据的干预措施，可以减轻疼痛，改善关节炎成年人的功能和生活质量，从而减少这些地域差异。
