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Arthritis linked to lower education, earlier employment in young adults
Among young adults, arthritis appears to be associated with lower education levels and earlier transitioning into employment, according to recent findings.
In the study, researchers obtained and pooled data from the National Health Interview Survey (NHIS) between 2009 and 2015. The NHIS is a continuing health survey of patients at a wide range of ages. Data were gathered from in-home interviews conducted by trained personnel.
Eligible study subjects were aged 18 to 29 years and had a diagnosis of arthritis (n = 1,393) or did not have arthritis (n = 40,537). The researchers compared the frequency and correlates of employment and education by arthritis status. The study’s primary outcomes, participation in employment and education, were determined by asking participants about their employment within the past week. Unemployed respondents were asked about their primary reason for not being employed.
The following variables were included as covariates: demographic characteristics, social participation limitations, health factors and health system utilization. The researchers stratified the study subjects by age (18-23 years vs. 24-29 years) and health by self-report. Individuals with restricted social participation were defined as finding it “very difficult” or “can’t do it at all” regarding at least two basic social activities outside the home, such as shopping, attending a movie, sporting events, parties, meetings or visits with friends.
They calculated weighted proportions and univariate and multivariate associations to analyze the correlations between arthritis, education and employment participation.
The researchers found that the young cohort of arthritis patients were more frequently female (58.5% vs. 49.7% male), and married/cohabitating (48% vs. 34.9%) but reported comparable education attainment as their non-arthritic peers. Participants with arthritis acknowledged more restricted social participation vs. those without arthritis, although these reports were generally in low numbers (5.5% arthritis patients vs. 0.8% non-arthritis patients). Higher rates of self-reported fair or poor health were found in patients diagnosed with arthritis as young adults vs. those without arthritis (19.6% vs. 4.2%). Compared with patients without arthritis, those with arthritis also had higher percentages of obesity (37.1% vs. 19.9%), one or more comorbidities (41.9% vs. 15.6%), one or more functional limitations (23.2% vs. 2.7%), serious psychological distress (9.7% vs. 2.4%) and current smoking habit (35.4% vs. 20.2%). Moreover, a diagnosis of arthritis was linked to a higher rate of reporting six doctor visits in the past year, as well as a slightly higher rate of health insurance coverage vs. those without arthritis.
In a multivariate model, patients with arthritis were found to have a significantly lower rate of education participation vs. those with no health condition (prevalence ratio [PR] = 0.75; 95% CI, 0.57-0.98). The prevalence of education participation in the group aged 18 to 23 years was 24% lower in the arthritis group vs. those without arthritis (PR = 0.76; 95% CI, 0.56-1.06), although this was found to be nonsignificant.
An analysis controlling for the covariates that fulfilled model-building criteria revealed an association between arthritis diagnosis in young adults and a higher prevalence of employment participation in the overall study population (PR = 1.07; 95% CI, 1.03-1.12) and among participants aged 18 to 23 years (PR =1.17; 95% CI, 1.07 to –1.29).
In stratified multivariable models comparing results by higher vs. lower self-rated health, young adults with arthritis who reported higher self-rated health had a higher prevalence of employment participation vs. those without arthritis, both in the overall population (PR = 1.09; 95% CI, 1.03-1.14) and in the participants aged 18 to 23 years (PR = 1.18; 95% CI, 1.08-1.3).
“Young adulthood is a time of life in which a person typically establishes their career,” the researchers wrote. “By utilizing population-level data of young adults with and without arthritis, this study was the first to compare participation in education and employment roles. Young adults with arthritis may experience an earlier transition to the labor market. Our findings suggest that young adults with arthritis may be less likely to participate in education roles.” – by Jennifer Byrne
Disclosure: One of the authors reports he is an employee of Johnson Consulting DBA Cutting Edge Technologies and Solutions.
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Jetha A, et al. Arthritis Care Res. 2017;doi:10.1002/acr.23175.