Definition

Individuals with arthritis who reported having poor mental health defined as seven or more days when their mental health was not good during the past 30 days.

Numerator

Number of survey respondents who reported doctor-diagnosed arthritis and seven or more days when their mental health was not good in the past 30 days.

Denominator

Total number of respondents who reported they had some form of arthritis. Responses of "Don't know/Not Sure," "Refused," and those with "Missing" responses were excluded.

Data Interpretation Issues

The estimates used in this report are based on self-reported data. Such reported information has been shown to be acceptable for surveillance purposes.

Why Is This Important?

Having a long-term illness such as arthritis may contribute to stress, depression, and problems with emotions. Adults with arthritis are limited in their everyday activities, have lower employment than those without arthritis, and have other chronic diseases such as diabetes or heart disease.^1^ All of these integrated factors may impact their mental and emotional well-being. In addition, poor mental health can exacerbate functional disabilities, affect adherence to treatment, and be a barrier to self-care. Health care providers can help by screening all adults with arthritis for depression, anxiety, and other emotional problems. Health care providers can also refer those suffering from arthritis and other chronic conditions to a Living Well with Chronic Disease Workshop or exercise classes that help participants learn techniques to deal with problems such as frustration, fatigue, pain, and isolation and that improve their quality of life. These workshops are not meant to replace existing treatment, but rather to support it. Schedules and locations of the workshops and classes can be found at: [https://healthyaging.utah.gov].[[br]] [[br]] ---- 1. Centers for Disease Control and Prevention (2017, March 7). Arthritis in America. Retrieved from [https://www.cdc.gov/vitalsigns/pdf/2017-03-vitalsigns.pdf]

How Are We Doing?

In 2021-2023, adults with arthritis were significantly more likely to report seven or more days of poor mental health in the past 30 days (37.7%) compared to adults without arthritis (21.6%). Women with arthritis are more likely to report poor mental health (43.3%) than men (30.2%). The increased risk of poor mental health for women with arthritis compared to men with arthritis is seen across all age groups. Younger persons with arthritis report poor mental health more often than their older counterparts. Among adults aged 18-34 with arthritis, 58.9% reported seven or more days of poor mental health compared to 15.4% among adults aged 65 and older with arthritis (2021-2023 combined data).

What Is Being Done?

The Healthy Aging Program focuses on measuring the occurrence of arthritis in Utah, increasing arthritis awareness and educational opportunities, and promoting participation in programs proven to help persons with arthritis, pain, and other chronic conditions. Additionally, the Healthy Aging Program supports health systems, clinics, and physicians use strategies and resources that support healthcare provider-patient counseling to increase physical activity and referrals to the evidence-based workshops and exercise classes [https://selfmanagementresource.com/programs/] proven to help patients improve their mental and physical health. Physicians can use the [https://healthyaging.utah.gov/find-workshop/#/ Find a Workshop Feature] to refer patients to the evidence-based classes.

Evidence-based Practices

The Healthy Aging Program partners with healthcare, nonprofit, and government organizations across Utah to deliver evidence-based workshops to help people better manage arthritis, pain, and other chronic conditions. Schedules and locations of these workshops can be found at [https://healthyaging.utah.gov/find-workshop/#/]. The Healthy Aging Program recommends and supports the *Chronic Disease Self-Management Education programs, EnhanceFitness, Walk With Ease, Tai Chi, Stepping On and the Arthritis Foundation Exercise Program which have been proven to improve the quality of life for people with arthritis and other chronic conditions. *Chronic Disease Self-Management Education programs include:[[br]] - Chronic Disease Self-Management Program (CDSMP) as known as Living Well with Chronic Conditions[[br]] - Diabetes Self-Management Program (DSMP) also known as Living Well with Diabetes[[br]] - Chronic Pain Self-Management Program (CPSMP) also known as Living Well with Chronic Pain[[br]] - Tomando Control de su Salud (Spanish CDSMP)[[br]] - Programa de Manejo Personal del Dolor Crnico (Spanish CPSMP)[[br]] - Programa de Manejo Personal de la Diabetes (Spanish DSMP) [[br]] [[br]] For additional information on these programs visit [https://www.cdc.gov/arthritis/caring/index.html] or [https://healthyaging.utah.gov/livingwell/].

Available Services

To find and register for an evidence-based program in your area please visit:[[br]] [https://healthyaging.utah.gov/find-workshop/#/][[br]] or call the Health Resource Line at:[[br]] 1-888-222-2542[[br]] [[br]] Utah Department of Health and Human Services[[br]] Healthy Aging Program[[br]] Bureau of Health Promotion and Prevention[[br]] P.O. Box 142107[[br]] Salt Lake City, Utah 84114-2107[[br]] (801) 538-9458[[br]] [https://healthyaging.utah.gov/][[br]] [[br]] Arthritis Foundation[[br]] 1355 Peachtree Street, Suite 600[[br]] Atlanta, Georgia 30309[[br]] 1(800) 283-7800[[br]] [[br]] Utah Division of Aging and Adult Services[[br]] Department of Health and Human Services[[br]] 195 North 1950 West[[br]] SLC, Utah 84116[[br]] (801) 538-3910[[br]] [https://daas.utah.gov/][[br]] [[br]]

Health Program Information

The vision of the Healthy Aging Program is to increase self-management skills and improve the quality of life for all Utahns affected by arthritis and other chronic conditions. The Healthy Aging Program provides technical assistance and coordination to increase awareness, expand reach, and achieve sustainability of evidence-based self-management programs for all Utahns affected by arthritis and other chronic conditions through statewide [https://healthyaging.utah.gov/list-of-partners/ partners]. Contact healthyaging@utah.gov for questions about providing, referring, or increasing physician counseling for patients into evidence-based programs.

Relevant Population Characteristics

The likelihood of reporting arthritis and poor mental health (defined as seven or more days of poor mental health in the past 30 days) is related to age, sex, income, education, and ethnicity.

Health Care System Factors

Health insurance coverage for mental health problems is often inadequate. Given the fact that poor mental health may keep individuals from adhering to recommended arthritis regimes, its high prevalence among people with arthritis is a major public health problem.^2,3^

Risk Factors

Depression is common in persons with all types of arthritis and other rheumatic conditions, but depression is most clearly documented among persons with rheumatoid arthritis. Persons with chronic diseases are also at an increased risk for depression.^2^

Health Status Outcomes

The Centers for Disease Control and Prevention has stated, "Feelings of sadness or worry can interfere with a person's ability and motivation to care for themselves properly and manage daily life, let alone manage their arthritis or other health conditions. That's why it's important for people who have arthritis to take care of their mental health symptoms as well as their arthritis symptoms."^4^

Data for all age groups show Utah adults with arthritis were significantly more likely to report having 7 or more days of poor mental health in the past 30 days compared to Utah adults without arthritis. The percent of individuals with arthritis reporting 7 or more days of poor mental decreased as they increased in age.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

Women with arthritis are significantly more likely than men with arthritis to report having poor mental health for all age groups. Women aged 18-34 years old with arthritis have the highest reports of poor mental health at 65.9%. Men aged 18-34, by contrast, had 49.1% reporting poor mental health. This decreased to 17.6% for females and 12.3% for males 65 years and older.

Data Source

Utah Department of Health and Human Services Behavioral Risk Factor Surveillance System (BRFSS) [https://ibis.utah.gov/ibisph-view/query/selection/brfss/BRFSSSelection.html]

References and Community Resources

References: [[br]] 1. Centers for Disease Control and Prevention (2017, March 7). Arthritis in America. Retrieved from [https://www.cdc.gov/vitalsigns/pdf/2017-03-vitalsigns.pdf] 2. Margaretten M, Julian L, Katz P, Yelin E. Depression in patients with rheumatoid arthritis: description, causes and mechanisms. Int J Clin Rheumtol. 2011;6(6):617-623. doi:10.2217/IJR.11.6 3. Sambamoorthi U, Shah D, Zhao X. Healthcare burden of depression in adults with arthritis. Expert Rev Pharmacoecon Outcomes Res. 2017;17(1):53-65. doi:10.1080/14737167.2017.1281744 4. Centers for Disease Control and Prevention. State-Specific Prevalence and Characteristics of Frequent Mental Distress and History of Depression Diagnosis Among Adults with Arthritis. (2020, January 3) [https://www.cdc.gov/mmwr/volumes/68/wr/mm685152a1.htm] Resources:[[br]] [https://www.cdc.gov/arthritis/caring/index.html][[br]] [https://sumh.utah.gov/][[br]] [https://healthyaging.utah.gov/][[br]] [https://daas.utah.gov/][[br]] [http://namiut.org/][[br]]