Juvenile arthritis prevalence increases with age, depression, food insecurity
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Key takeaways:
- Arthritis prevalence among children increased with age.
- When accounting for comorbidities, the strongest associations were found in children with depression, anxiety, a heart condition or were overweight.
Approximately 220,000 children in the United States were diagnosed with arthritis between 2017 and 2021, with a higher prevalence among those aged 12 to 17 years or living in a food-insecure household, according to data.
Non-Hispanic Black or African American children and adolescents, those with anxiety or depression, and those who were physically inactive, overweight or had a heart condition additionally demonstrated an increased prevalence of arthritis, said the researchers, who published their data in Morbidity and Mortality Weekly Report.
“Previous estimates of the number of arthritis cases and prevalence among U.S. children and adolescents aged <18 years range from 13,400 (21 per 100,000 population) in one 1978 study, using a very narrow definition of juvenile arthritis, to 294,000 (403 per 100,000) during 2001-2004, using a much broader definition of pediatric arthritis and other rheumatologic conditions,” Tyler D. Lites, MPH, of the division of population health at the National Center for Chronic Disease Prevention and Health Promotion at the CDC, and colleagues wrote.
“The National Survey of Children’s Health (NSCH) is an annual household survey conducted by the U.S. Census Bureau designed and funded by the Health Resources and Services Administration’s Maternal and Child Health Bureau,” they added. “NSCH asks parents about the physical and emotional health, well-being, and related factors of one randomly selected child or adolescent aged <18 years from their household.”
To estimate the prevalence of juvenile arthritis, Lites and colleagues analyzed data from the NSCH from 2017 to 2021. The response rates for the years of interest were 37.4% for 2017, 43.1% for 2018, 42.4% for 2019, 42.4% for 2020 and 40.3% for 2021. Patients were classified as having arthritis if the survey respondent reported that their child had received a diagnosis of arthritis. Meanwhile, prevalence estimates were completed by accounting for various factors such as demographic and household characteristics. All variables were weighed to be representative of the average U.S. population.
The analysis included a total of 173,406 children aged younger than 18 years. from 2017 to 2021, an estimated 220,000 children and adolescents in the United States received a diagnosis of arthritis, resulting in a rate of 305 diagnoses per 100,000, according to the researchers. Among those aged younger than 6 years, the prevalence rate was 77 cases per 100,000 children, compared with 592 per 100,000 in those aged 12 to 17 years.
In addition, non-Hispanic Black or African American children and adolescents demonstrated a prevalence rate of 571 per 100,000, compared with 260 per 100,000 for non-Hispanic white children and adolescents.
When accounting for comorbidities, the strongest associations were found for depression, heart conditions and children who are overweight. Additionally, arthritis prevalence was higher in households with food insecurity issues or smoking. Finally, parents’ education levels correlated with rates of diagnosis, with prevalence decreasing as educational levels of attainment increased.
“The findings from this report highlight children and adolescents to prioritize for arthritis prevention and treatment by identifying risk factors for arthritis among children and adolescents, developing self-management interventions to improve childhood arthritis, physical activity or weight control, and screening and linking children and adolescents to needed mental health services,” Lites and colleagues wrote.
“Addressing social determinants of health and systemic factors that might contribute to disparities in arthritis prevalence needs to be prioritized,” they added. “Health systems and payors can take steps to ensure equitable access to therapies (eg, physical therapies and medications).”
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