Severe joint pain more prevalent in Black, Hispanic, Indigenous patients vs white patients
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Key takeaways:
- Severe joint pain was significantly higher among Black, Hispanic and American Indian/Alaska Native patients with arthritis.
- Providers counseled fewer than 60% of patients of any race on physical activity.
Among adults with arthritis, severe joint pain is significantly more prevalent in Black, Hispanic, American Indian and Alaska Native patients vs. white patients, according to data published in Arthritis Care & Research.
In addition, the researchers found that fewer than 60% of any of these groups receive counseling on physical activity.
“Health care providers often underestimate the influence they have on their patients,” Erica L. Odom, DrPH, leader of the CDC Division of Population Health’s Arthritis Management and Wellbeing Program, and study co-author, told Healio. “Clinicians can do more to encourage physical activity among patients to help reduce their arthritis symptoms and limitations.”
To analyze racial and ethnicity differences among arthritis diagnoses, severe joint pain and physical activity counseling, Odom and colleagues examined data from the CDC 2019 National Health Interview Survey. In all, the researchers assessed self-reported health and socioeconomic data from 31,977 adults. Arthritis status and provider counseling were determined via yes or no survey questions, while severe joint pain was classified using a 10-point scale. Likelihood of arthritis, severe joint pain and provider counseling were determined using logistic regression models.
After adjusting for age, American Indian/Alaska Native adults demonstrated a significantly higher prevalence of arthritis, compared with white adults — at 30.3% vs. 22.9% — a finding Odom said was in line with previous studies. According to the researchers American Indian/Alaska Native patients also reported the most severe joint pain, at 39.1%, followed by Black adults at 36.4%, and Hispanic adults at 35.7% — all significantly elevated compared with white adults, at 22.5%.
“These significant racial/ethnic differences remained after controlling for socioeconomic characteristics, BMI, depression status and comorbid conditions,” the researchers wrote. “Additional models, including inability to pay medical bills and food insecurity, did not explain the racial/ethnic differences.”
Meanwhile, health care provider counseling for physical activity was significantly more common among Black and Hispanic adults compared with white adults — 57.5% and 57.6% vs. 51.7%, respectively. This persisted after adjusting for socioeconomics, BMI, depression, comorbidities, food insecurity and ability to pay medical bills.
“Reasons for these disparities in physician counseling for physical activity are unclear, but providers may perceive certain subgroups to have a greater need for physical activity advice and focus on these patients,” Odom and colleagues wrote.
Odom told Healio future research should investigate social and structural factors driving arthritis prevalence and disparities in outcomes such as severe joint pain.
“For example, why are non-Hispanic Black adults more likely to experience greater pain and disability from arthritis compared with their non-Hispanic white counterparts who have a higher arthritis prevalence?” she said.
“Additionally, more research is needed to identify effective strategies to reduce the burden of arthritis on individuals, employers and communities, as well as eliminate health disparities,” Odom added. “[Research should also] guide development of interventions at the policy, neighborhood and health care system level to reduce barriers to physical activity among populations that are disproportionately affected by arthritis, such as the [American Indian/Alaska Native] population.”
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