Dagmawi Shimeles, BS
Medical Student
Macon & Joan Brock Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USA
Alexandria, Virginia, United States
Maryam Elhabashy, BA
Research Fellow
Division of Intramural Research, National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
Bethesda, Maryland, United States
David Adzrago, PhD
Research Fellow
Division of Intramural Research, National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
Bethesda, MD, Maryland, United States
Faustine Williams, PhD
Stadtman Tenure-Track Investigator
Division of Intramural Research, National Institute of Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
Bethesda, MD, Maryland, United States
While previous studies have linked arthritis to Serious Psychological Distress (SPD) in the general U.S. adult population, the relationship within specific subgroups, particularly immigrants and racial/ethnic minorities, remains unexamined. We analyzed nationally representative 2002-2018 National Health Interview Survey (NHIS) data on U.S. adults aged ≥ 18 years (n=439,996) to examine how immigration status and race/ethnicity interact with arthritis to influence the risk of SPD.
Design:
We fitted multivariable logistic regression models to assess associations, included interaction terms to examine moderating effects, and adjusted for sociodemographic (sex, age, employment status) and health/behavioral factors (health insurance status, BMI, smoking status, drinking status, comorbidities, functional limitation, social limitation, marital status). For statistically significant interactions, we calculated predicted marginal probabilities.
Results:
Immigrants (n= 79,156) had higher odds of experiencing SPD than non-immigrants (n=35,840);(p< 0.05). Individuals with arthritis (n=95,337) had higher odds of SPD than individuals without arthritis (n=335,659); (p< 0.001). There were significant interactions between arthritis and immigration status as well as arthritis and race/ethnicity (p< 0.05). Immigrants with arthritis were more likely to experience SPD compared to non-immigrants with arthritis as well as immigrants and non-immigrants without arthritis. NH Mixed individuals without arthritis had the highest likelihood of SPD among any racial/ethnic group, with or without arthritis, followed by Hispanic individuals with arthritis. A dose-response was observed between SPD and the number of functional and social limitations, with more limitations associated with higher SPD risk.
Conclusions:
Immigrants and racial/ethnic minorities with arthritis experience disparities in poor health outcomes, particularly in relation to SPD. The observed relationship between SPD and functional/social limitations underscores the integration of physical and mental health. To better understand these disparities and inform the development of targeted interventions, further research is necessary to investigate how common arthritic implications, such as functional and social limitations, may mediate the relationship between arthritis and SPD.
