Social determinants of health and arthritis pre- and post- COVID

Introduction: This study aims to determine changes in social determinants of health (SDoH) and symptoms affecting patients with arthritis pre- and post- COVID-19. Methods: The National Health Interview Survey (NHIS) publicly available data was analyzed via SPSS statistical software. Chi-square and Fisher exact test were utilized for comparison of survey questions related to arthritis symptoms and SDoH, comparing survey results in 2019 vs. 2023. Results: 61,519 respondents were included, of whom 8214 (2019) and 7731 (2023) reported arthritis diagnoses. Arthritis prevalence did not differ between survey years (p = 0.151). Overall, those with arthritis were significantly less likely to be working for pay (p < 0.001) and were more likely to report food insecurity, including inability to afford balanced meals (p < 0.001), hunger due to insufficient funds (p = 0.026), and weight loss related to food affordability (p < 0.001). Difficulty paying medical bills was more frequently reported among those with arthritis (p < 0.001). Arthritis was also associated with poorer self-reported general health (p < 0.001), increased emergency department (ED) utilization (p < 0.001), and greater pain burden (all p < 0.001). Disability status was more common among individuals with arthritis (p < 0.001). From 2019 to 2023, the general population experienced increased food insecurity and reduced employment (p < 0.001), whereas patients with arthritis demonstrated fewer changes in SDoH. Among those with arthritis, physical and rehabilitative therapy utilization increased (p = 0.047), while activity limitations (p < 0.001), work limitations (p < 0.001), and disability status (p = 0.005) decreased. Conclusion: Patients with arthritis represent a vulnerable population, with higher rates of food insecurity, difficulty paying medical bills, pain affecting daily life, poorer self-reported health status, and increased ED utilization. However, individuals with arthritis experienced fewer changes in SDoH than the general population during COVID-19.