Date of Award

Winter 1-9-2015

Degree Type


Degree Name

Doctor of Philosophy (PhD)


Public Health

First Advisor

Douglas W. Roblin, PhD

Second Advisor

Ruiyan Luo, PhD

Third Advisor

Charles G. Helmick, MD


Background: Arthritis affects 53 million U.S. adults, more than two-thirds of whom are younger than age 65. Approximately 1/3 of working-age (18-64 years) U.S adults with arthritis report arthritis-attributable work limitation.

Objectives: First, to take a population-based perspective to evaluate the association of arthritis with employment participation among U.S. adults. Next, to examine whether this association differs by sex, age, or other characteristics. Finally, to investigate effects of the Great Recession (December 2007 to June 2009) on employment and to determine if arthritis status moderated its effects.

Methods: All three studies were conducted using the National Health Interview Survey (NHIS). The third study also used longitudinal data from the Medical Expenditures Panel Survey (MEPS) linked to NHIS.

Results: These manuscripts are under peer-review for publication; limited results are presented:

Study 1- Employment participation was always statistically significantly and substantially lower (e.g., >10 percentage points) among adults with arthritis compared with those without arthritis.

Study 2- Overall, 20.1 million adults (10.4% [95% CI=10.1-10.8] of the working-age population) reported work disability.

Study 3- During the period of the Great Recession, people with arthritis stopped work at higher rates and started work at lower rates than those without arthritis, suggesting at least some differential effect among those with arthritis.

Conclusion: This work contributes new knowledge by establishing long-term patterns and benchmark information for employment participation, work disability, transitions, and macro economic effects among adults with and without arthritis in the U.S. A population-based, non-condition-specific approach of this type has not been previously reported.