Objective. Arthritis is the most common chronic condition and the most common cause of disability among older US adults. We studied social participation, disabilities in many life domains, accommodations used (buffers), and accommodations needed (barriers) for US adults with arthritis disability compared with adults with disability from other conditions. Methods. The data source is the National Health Interview Survey Disability Supplement Phase Two. Arthritis-disabled individuals named arthritis as the main cause of >1 disabilities. Other-disabled individuals named only other conditions as causes of their disabilities. We compared outcomes for the groups, taking sample weights and complex variances into account. Results. Arthritis-disabled individuals get out and about less often than other-disabled individuals, but they manage to maintain active social ties. They have more disabilities of all types (personal care, household management, physical tasks, transportation, home, work), and the disabilities often cause fatigue, long task time, and pain. Despite this, arthritis-disabled individuals use less personal assistance than other-disabled individuals; they do use more equipment assistance. Arthritis-disabled individuals report more barriers in getting around outside their home and at their workplace. Conclusion. The distinctive profile of arthritis disability includes extensive and uncomfortable disabilities, yet there are active management strategies to handle these disabilities. Problems away from home and at work should inspire engineers and planners to improve public access and equipment for persons with this high-prevalence disability.

Racial/ethnic and socioeconomic disparities in COVID-19 burden have been widely reported. Using data from the state health departments of Alabama and Louisiana aggregated to residential Census tracts, we assessed the relationship between social vulnerability and COVID-19 testing rates, test positivity, and incidence. Data were cumulative for the period of February 27, 2020 to October 7, 2020. We estimated the association of the 2018 Social Vulnerability Index (SVI) overall score and theme scores with COVID-19 tests, test positivity, and cases using multivariable negative binomial regressions. We adjusted for rurality with 2010 Rural–Urban Commuting Area codes. Regional effects were modeled as fixed effects of counties/parishes and state health department regions. The analytical sample included 1160 Alabama and 1105 Louisiana Census tracts. In both states, overall social vulnerability and vulnerability themes were significantly associated with increased COVID-19 case rates (RR 1.57, 95% CI 1.45–1.70 for Alabama; RR 1.36, 95% CI 1.26–1.46 for Louisiana). There was increased COVID-19 testing with higher overall vulnerability in Louisiana (RR 1.26, 95% CI 1.14–1.38), but not in Alabama (RR 0.95, 95% CI 0.89–1.02). Consequently, test positivity in Alabama was significantly associated with social vulnerability (RR 1.66, 95% CI 1.57–1.75), whereas no such relationship was observed in Louisiana (RR 1.05, 95% CI 0.98–1.12). Social vulnerability is a risk factor for COVID-19 infection, particularly among racial/ethnic minorities and those in disadvantaged housing conditions without transportation. Increased testing targeted to vulnerable communities may contribute to reduction in test positivity and overall COVID-19 disparities.

Introduction Older minority groups are more likely to have poor AED adherence. We describe adherence to antiepileptic drugs (AEDs) among older Americans with epilepsy. Methods In retrospective analyses of 2008–2010 Medicare claims for a 5% random sample of beneficiaries augmented by minority representation, epilepsy cases in 2009 were those with ≥1 claim with ICD-9 345.x or ≥2 with 780.3x, and ≥1 AED. New onset cases had no such claims or AEDs in the year before the 2009 index event. We calculated the Proportion of Days Covered (PDC) (days with ≥1 AED over total follow-up days) and used logistic regression to estimate associations of non-adherence (PDC <0.8) with minority group adjusting for covariates. Results Of 36,912 epilepsy cases (19.2% White, 62.5% African American (AA), 11.3% Hispanic, 5.0% Asian and 2% American Indian/Alaskan Native), 31.8 % were non-adherent (range: 24.1% Whites to 34.3% AAs). Of 3,706 new onset cases, 37% were non-adherent (range: 28.7% Whites to 40.5% AAs). In adjusted analyses, associations with minority group were significant among prevalent cases, and for AA and Asians vs. Whites among new cases. Among other findings, beneficiaries from high poverty ZIP codes were more likely to be non-adherent than their counterparts, and those in cost-sharing drug benefit phases were less likely than those in deductible phases. Conclusion About a third of older adults with epilepsy have poor AED adherence; minorities are more likely than Whites. Investigations of reasons for non-adherence, and interventions to promote adherence, are needed with particular attention to the effect of cost-sharing and poverty.

Genotype-phenotype association studies often combine phenotype data from multiple studies to increase power. Harmonization of the data usually requires substantial effort due to heterogeneity in phenotype definitions, study design, data collection procedures, and data set organization. Here we describe a centralized system for phenotype harmonization that includes input from phenotype domain and study experts, quality control, documentation, reproducible results, and data sharing mechanisms. This system was developed for the National Heart, Lung and Blood Institute’s Trans-Omics for Precision Medicine program, which is generating genomic and other omics data for &gt;80 studies with extensive phenotype data. To date, 63 phenotypes have been harmonized across thousands of participants from up to 17 studies per phenotype (participants recruited 1948-2012). We discuss challenges in this undertaking and how they were addressed. The harmonized phenotype data and associated documentation have been submitted to National Institutes of Health data repositories for controlled-access by the scientific community. We also provide materials to facilitate future harmonization efforts by the community, which include (1) the code used to generate the 63 harmonized phenotypes, enabling others to reproduce, modify or extend these harmonizations to additional studies; and (2) results of labeling thousands of phenotype variables with controlled vocabulary terms.

US adults with arlhritis disability, compared to people with disability due to other conditions. Arthritis-disabled people are defined in two ways, One definition covers a broad range of arthritis and rheumatic conditions, and the other concentrates solely on arthritisThe authors find that arthritis-disabled people have more total disabilities than other-disabled people, However, their disabilities are less severe, have shorter durations, and accumulate more gradually over time. Despite more disabilities, people with arthritis disability use fewer assistive and service accommodations than other-disabled people. They do use more mobility ar ds.Because arlhritis is the leading chronic condition for middle-aged and older adults, this profile of extensive but mild-to-moderate disability is experienced by many millions of adults. Accommodations for arlhritis may also be extensive but aimed more toward self-care than toward assistive and medical services, PUBLIC HEALTH REPORTS .2OO] SUPPLEMENT I . VOLUME 1]6 l)/