The Effects of Race/Ethnicity and Physician Recommendation for Physical Activity on Physical Activity Levels and Arthritis Symptoms Among Adults With Arthritis

Background: Among U.S. adults with physician-diagnosed arthritis, we examined the effects of race/ethnicity and receiving physician exercise recommendation on meeting aerobic and strengthening physical activity guidelines, and arthritis symptoms, and whether race/ethnicity moderates the effects of physician recommendation on activity levels and symptoms.Methods: Retrospective, cross-sectional study of National Health Interview Survey pooled data from 2002, 2006, 2009, and 2014. The study included 27,887 U.S. adults aged ≥18 years with arthritis. Outcomes were meeting aerobic (yes/no) and strengthening guidelines (yes/no), arthritis-associated activity limitations (yes/no) and arthritis-related pain (0-10; higher score=more pain). Predictors were race/ethnicity (White, African American, Latino, and Asian) and receipt of physician recommendation for exercise (yes/no). Covariates included demographic and health characteristics and U.S. region.Results: Controlling for covariates, physician exercise recommendation was independently associated with meeting aerobic (AOR=1.14; 95% CI 1.06, 1.24) and strengthening (AOR=1.17; 95% CI 1.06, 1.28) guidelines; effects did not differ by race/ethnicity. African Americans were more likely than Whites to meet strengthening guidelines (AOR=1.22; 95% CI 1.07, 1.40) and Asians were less likely to meet aerobic (AOR=0.80; 95% CI 0.65, 0.99) and strengthening (AOR=0.76; 95% CI 0.60, 0.96) guidelines. Compared to Whites, African Americans (B=0.51; 95% CI 0.26, 0.76) and Latinos (B=0.43; 95% CI 0.14, 0.72) reported more severe, while Asians reported less severe (B=-0.60; 95% CI -1.17, -0.04) joint painConclusions: Disparities in pain exist for African Americans and Latinos with arthritis. Physician exercise recommendation is critical among patients with arthritis to relieve symptom burden.