Disclosures: The researchers report no relevant financial disclosures.
March 09, 2021
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Arthritis among most common chronic conditions for US veterans

Disclosures: The researchers report no relevant financial disclosures.
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Arthritis and hypertension are the two most prevalent chronic conditions among U.S. veterans aged 25 years and older, according to data published by CDC researchers in National Health Statistics Report.

In addition, arthritis was the only chronic condition more common in veterans than nonveterans across all age groups and sexes, the researchers said. The findings are part of a larger report that found veterans aged 25 years and older demonstrated a higher prevalence of multiple chronic conditions than nonveterans, even after adjusting for age, smoking status and weight.

“The elevated prevalence of arthritis among veterans was another key takeaway for us, as arthritis was the only chronic condition more prevalent among veterans than nonveterans across both age groups and both sexes,” Peter Boersma, MPH, told Healio Rheumatology. Data derived from Boersma P, et al. Natl Health Stat Rep. 2021;doi:10.15620/cdc:101659.

“The presence of multiple chronic conditions in an individual has implications for health care delivery and cost,” Peter Boersma, MPH, a health statistician at the CDC National Center for Health Statistics, told Healio Rheumatology. “Prior research had found a higher prevalence of multiple chronic conditions among veterans than nonveterans. This study was important because it looked at whether differences by veteran status could be explained by differences in demographics, smoking and obesity between veterans and nonveterans.”

To analyze the prevalence of multiple chronic conditions among veterans, compared with nonveterans, in the United States, and whether these differences could be explained by sociodemographics, smoking status or BMI, Boersma and colleagues examined data from the 2015-2018 National Health Interview Survey (NHIS). According to the researchers, the NHIS is a multipurpose health survey of noninstitutionalized civilians in the United States, with interviews conducted both in person and via telephone.

Peter Boersma

For this study, researchers based their analysis on a sample of 108,723 adults aged 25 years and older who completed the survey from 2015 to 2018. Data from this time period were pooled to better analyze consistent measurements of multiple chronic conditions prior to the survey’s redesign in 2019. Boersma and colleagues used this data to estimate the prevalence of multiple chronic conditions based on veteran status and sex. They also provided age-stratified and -adjusted estimates based on race/ethnicity, education, income, smoking status and BMI.

Lastly, they used multivariate logistic regression models to analyze the odds of developing multiple chronic conditions based on veteran status after age stratification, adjusting for age and other covariates.

According to the researchers, the three most prevalent chronic conditions for male veterans aged 25 to 64 years, after adjusting for age, were hypertension, at 32.2%; arthritis, at 24.1% and diabetes, at 8.2%. For male veterans aged 65 years and older, the prevalence figures were 64.9% for hypertension, 47.3% for arthritis and 31.6% for cancer. Among female veterans aged 25 to 64 years, the most common age-adjusted conditions were arthritis, at 29%; hypertension, at 25.6%; and asthma, at 9.7%. For female veterans aged 65 years and older, the most prevalent conditions were hypertension, at 69.8%; arthritis, at 62.8%; and cancer, at 30.9%.

“The elevated prevalence of arthritis among veterans was another key takeaway for us, as arthritis was the only chronic condition more prevalent among veterans than nonveterans across both age groups and both sexes,” Boersma said. “This finding further demonstrates the high burden of arthritis in this population and may further inform ongoing efforts to improve veterans’ health and health care needs.”

In all, the age-adjusted prevalence of multiple chronic conditions was 22.2% among veterans, compared with 17% among nonveterans, for men aged 25 to 64 years; 66.9% compared with 61.9% for men aged 65 years and older; 25.4% compared with 19.6% for women aged 25 to 64 years; and 74.1% compared with 61.8% for women aged 65 years and over.

This higher prevalence for veterans compared with nonveterans remained after stratification for age and adjusting for sociodemographic factors. Additional adjustments for smoking status and BMI reduced this difference slightly, but ultimately the findings remained statistically significant, except for men aged 65 years and older.

“Regarding prevalence of individual chronic conditions, differences between veterans and nonveterans were observed for a number of different chronic conditions,” Boersma said. “Differences between veterans and nonveterans differed by age and sex.”

“In addition, after adjusting for selected demographic measures, the odds of multiple chronic conditions remain higher among veterans than among nonveterans,” he added. “This indicates that these included measures cannot fully explain the difference between veterans and nonveterans and that there may be something else contributing to the difference.”