Depressive symptoms and the arthritis‐employment interface. A population‐level study
Objectives: To examine the relationship between depressive symptoms, arthritis, and employment participation. To determine if this relationship differs across young, middle, and older working-age adults with arthritis.
Methods: Data from the US National Health Interview Survey, years 2013-2017, were analyzed. Analyses were restricted to those with doctor-diagnosed arthritis of working age (18-64 years) with complete data on depressive symptoms (n=11,380). Covariates were sociodemographic, health, and health system use variables. Employment prevalence was compared by self-reported depressive symptoms. We estimated percentages, univariable, and multivariable logistic regression models to examine the relationship between depression and employment among young (18-34 years), middle (35-54 years), and older adults (55-64 years).
Results: Among all working-age US adults with arthritis, prevalence of depressive symptoms was 13%. Those reporting depressive symptoms had higher prevalence of fair/poor health (60%) and arthritis-attributable activity limitations (70%) compared with those not reporting depression (23% and 39%, respectively). Respondents with depressive symptoms reported significantly lower employment prevalence (30%) when compared with those not reporting depressive symptoms (66%) and lower multivariable-adjusted association with employment (PR=0.88, 95% CI [confidence interval] 0.83-0.93). Middle-age adults reporting depression were significantly less likely to be employed compared with their counterparts without depression (PR=0.83, 95% CI 0.77-0.90); similar but borderline statistically significant relationships were observed for both younger (PR=0.86, 95% CI 0.74-0.99) and older adults (PR=0.94. 95% CI 0.86-1.03).
Conclusion: For adults with arthritis, depressive symptoms are associated with not participating in employment. Strategies to reduce arthritis-related work disability may be more effective if they simultaneously address mental health.