Depressive Symptoms and the Arthritis–Employment Interface: A Population‐Level Study
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ObjectiveTo examine the relationship between depressive symptoms, arthritis, and employment, and to determine whether this relationship differs across young, middle‐age, and older working‐age adults with arthritis.MethodsData from the US National Health Interview Survey from 2013–2017 were analyzed. Analyses were restricted to adults with doctor‐diagnosed arthritis of working age (ages 18–64 years) with complete data on depressive symptoms (n = 11,380). Covariates were sociodemographic information, health, and health system utilization variables. Employment prevalence was compared by self‐reported depressive symptoms. We estimated percentages, as well as univariable and multivariable logistic regression models, to examine the relationship between depression and employment among young adults (ages 18–34 years), middle‐age adults (ages 35–54 years), and older adults (ages 55–64 years).ResultsAmong all working‐age US adults with arthritis, the prevalence of depressive symptoms was 13%. Those reporting depressive symptoms had a higher prevalence of fair/worse health (60%) and arthritis‐attributable activity limitations (70%) compared to those not reporting depression (23% and 39%, respectively). Respondents with depressive symptoms reported significantly lower employment prevalence (30%) when compared to those not reporting depressive symptoms (66%) and lower multivariable‐adjusted association with employment (prevalence ratio 0.88 [95% confidence interval (95% CI) 0.83–0.93]). Middle‐age adults reporting depression were significantly less likely to be employed compared to their counterparts without depression (prevalence ratio 0.83 [95% CI 0.77–0.90]); similar but borderline statistically significant relationships were observed for both young adults (prevalence ratio 0.86 [95% CI 0.74–0.99]) and older adults (prevalence ratio 0.94 [95% CI 0.86–1.03]).ConclusionFor 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.
