Arena Ross, Pronk Nicolaas P, Gertner Elie, Foucher Kharma C, Woodard Colin
Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, USA (RA, KCF, CW).
Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA (RA, NPP).
Am J Lifestyle Med. 2024 Sep 12:15598276241283762. doi: 10.1177/15598276241283762.
Health indices vary widely within the United States (U.S.), with clear "belts and epicenters" where the prevalence of unhealthy lifestyle behaviors, chronic disease, and disability are all high. Arthritis is a significant, well-established risk factor for developing chronic disease. In this paper, we hypothesize that the prevalence and patterns of arthritis in the U.S. will mirror that of other leading health issues across the country. We merged county-level data on arthritis, disability, and depression prevalence, the Lifestyle Health Index (LHI), the Social Vulnerability Index (SVI) and the American Nations regional cultures schematic. Data was available from 3073 U.S. counties. We found age-adjusted arthritis prevalence has statistically significant and generally strong Pearson product correlations (r ≈ 0.70, < 0.001) with (1) LHI sub scores and overall score; (2) Depression prevalence; (3) Disability prevalence; and (4) SVI. The geographic distribution of age-adjusted arthritis prevalence according to the American Nations regional cultures model demonstrated clear heterogeneity across regions. The status of population health in the U.S. is disconcerting and the current model of health care delivery, which is often approached from a siloed (condition-specific vs holistic care), reactionary, secondary prevention model, is inadequate to the challenge.
美国国内的健康指数差异很大，存在明显的“高发区和中心地带”，不健康生活方式行为、慢性病和残疾的患病率都很高。关节炎是导致慢性病的一个重要且已确定的风险因素。在本文中，我们假设美国关节炎的患病率和模式将反映该国其他主要健康问题的情况。我们合并了县级关节炎、残疾和抑郁症患病率数据、生活方式健康指数（LHI）、社会脆弱性指数（SVI）以及美国民族区域文化示意图。数据来自美国3073个县。我们发现，年龄调整后的关节炎患病率与以下各项存在统计学上显著且通常较强的皮尔逊积矩相关性（r≈0.70，<0.001）：（1）LHI子分数和总分；（2）抑郁症患病率；（3）残疾患病率；以及（4）SVI。根据美国民族区域文化模型得出的年龄调整后关节炎患病率的地理分布显示出各地区明显的异质性。美国的人口健康状况令人担忧，当前的医疗服务模式往往是从孤立的（针对特定疾病而非整体护理）、被动的二级预防模式入手，不足以应对这一挑战。
