Rural Residents More Likely to Limit Activities Due to Arthritis

A new study in Morbidity and Mortality Weekly Report found that people with arthritis are more likely to limit their activities due to their symptoms if they live in a rural county, indicating the need to offer targeted interventions to this population.

The study used data from the Behavioral Risk Factor Surveillance System to determine the prevalence of arthritis and arthritis-attributed activity limitation (AAAL) in US counties categorized as urban, suburban, metropolitan, micropolitan, and rural. These urban-rural classifications were based on census data and other definitions of metropolitan statistical areas.

Researchers found that that unadjusted rate of respondents reporting that they had been diagnosed with arthritis was nearly one-third (31.8%) in the most rural areas, compared with 20.5% in the most urban. After standardizing for age, residents of rural areas were still significantly more likely to report having arthritis. The prevalence of arthritis decreased as the county classification became more urban.

The rural dwellers were also more likely to report that their activities were limited by their arthritis or joint symptoms. In age-adjusted analyses, 47.1% of those in the most urban category reported AAAL, while prevalence in the most rural areas was 56.9%. The highest prevalence of AAAL at 79.1% was observed among respondents in the most rural areas who reported having functional limitations, meaning they had difficulty completing everyday activities such as reading, climbing stairs, or bathing.

According to the researchers, rural populations may be more at risk of developing arthritis because residents of these regions tend to be older, more likely to be obese, and have lower socioeconomic status. The high reports of AAAL could arise in part from the lack of evidence-based programs available to teach patients how to manage their diabetes in rural areas. Also, there may be barriers to regular walking, which can improve arthritis symptoms, in non-urban settings, which are often spread out and without sidewalks.

These obstacles do not indicate that arthritis cannot be successfully managed in rural areas, the study authors emphasized. Instead, these barriers call for creative solutions, like downloadable self-management toolkits or group education programs hosted by community organizations already present in these regions, such as churches or veterans’ groups. Public planning efforts to make walking more feasible in rural areas, like sidewalks and convenient destination locations, could encourage residents to become more active.

Considering the high prevalence of AAAL among those with functional limitations, the researchers suggested linking them to free resources provided by the federal Job Accommodation Network, which provides information and legal advice and connects people to vocational rehabilitation or job retraining programs.

“Healthcare providers and community organizations that serve rural residents can help adults with arthritis in rural areas increase access to and participation in interventions that are proven to reduce pain, improve function and quality of life, and maintain workforce participation,” the study concluded.