Prevalence, characteristics, and health burden of rheumatoid arthritis in the US veteran population

Objective: To examine the prevalence, characteristics, and physical and mental health burden of rheumatoid arthritis (RA) in a nationally representative sample of U.S. military veterans. Methods: Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a contemporary, nationally representative sample of 4,069 U.S. veterans. Veterans with RA (n = 227) were compared to veterans with any other medical condition(s) (n = 3,444) on measures of sociodemo-graphic, military, trauma, medical and psychiatric characteristics. Multivariable analyses were then conducted to examine independent associations between RA and health conditions. Results: A total of 5.3% (95% confidence interval = 4.5-6.2%) of primarily male U.S. veterans reported having been diagnosed with RA. Relative to controls, veterans with RA were older, and more likely to be racial/ethnic minorities, unpartnered, lower income, and combat veterans. They also reported greater cumulative trauma burden, more medical conditions (i.e., osteoarthritis, chronic pain, respiratory and cardiovascular conditions), and greater severity of somatic symptoms, and were more likely to screen positive for current insomnia and subthreshold posttraumatic stress disorder (PTSD), and lifetime alcohol use disorder (AUD). In adjusted analyses, RA remained associated with number of medical conditions, more severe somatic symptoms, insomnia, sub-threshold PTSD, and AUD. Conclusions: One of 20 U.S. veterans has RA, which is more prevalent among certain sociodemographic subsets, and is associated with elevated physical and mental health burden. Results provide insight into risk correlates of RA and underscore the importance of assessing, monitoring, and treating medical and psychiatric conditions/ symptoms that co-occur with RA in this population.