Health status, arthritis risk factors, and medical care use among respondents with joint symptoms or physician diagnosed arthritis: Findings from the 2001 Behavioral Risk Factor Surveillance System

Objective. The Behavioral Risk Factor Surveillance System (BRFSS) telephone interview study provides estimates indicating that approximately one-third of US adults meet the Centers for Disease Control and Prevention (CDC) case definition for arthritis. However, this population includes very diverse groups with major differences in health status, risk factors and disability. Methods. BRFSS data for 2001 were compared for 4 roughly equal size groups of respondents reporting joint symptoms or a physician's diagnosis of arthritis: those with transient joint symptoms (TJS), chronic joint symptoms (CJS), a physician diagnosis of arthritis (PDA), and those with both PDA and CJS. Results. By far the greatest burden of arthritis related disability is concentrated among individuals reporting both CJS and PDA. After controlling for age, sex, race, ethnicity, and education, this group had over 7 times the likelihood of fair to poor health status compared to the general adult population without arthritis. About one-third of those with undiagnosed CJS reported activity limitations, one-quarter were without health insurance at some point during the previous year, and this group had over 3 times the likelihood of reporting fair to poor health compared to the general population. Obesity was an even more prevalent arthritis risk factor than physical inactivity. Conclusion. The results support the validity of the CDC case definition of arthritis, which excludes TJS. However, a previous PDA in the absence of current symptoms was in itself a poor predictor of activity limitations due to arthritis. Findings will be useful in evaluating subsequent revisions of the CDC arthritis case definition and monitoring the burden of arthritis.