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Regional distribution of fatiguing illnesses in the United States: a pilot study.

Bierl C, Nisenbaum R, Hoaglin D, Randall B, Jones AB, Unger ER, Reeves WC.
Regional distribution of fatiguing illnesses in the United States: a pilot study.
Population Health Metrics 2:1, 2004. The complete electronic version of this article is available at http://www.pophealthmetrics.com/content/2/1/1

Summary

Only two studies have examined CFS in the general population. These studies survey the populations of Wichita and Chicago and estimated similar risks for illness (142 to 560 per 100,000 adults). In both studies, CFS primarily affected women, but the distribution of CFS by other descriptive characteristics differed between the two cities. These differences may reflect the geographic and urbanization characteristics of the two metropolitan areas. A national survey of CFS would be necessary to resolve questions raised by these two studies and to obtain information that could be generalized to CFS in the United States. An understanding of the national occurrence of CFS is necessary to focus etiologic research, to target health-care and educational programs, and to help frame health policy.

With this purpose, CDC researchers surveyed 884 persons 18-69 years of age living across four regions of the nation. Overall, 12% of the studied population suffered from fatigue lasting for at least 6 months (chronic fatigue), and 1% described a "CFS-like" illness, which needed medical evaluation for confirmation of the CFS diagnosis. These fatiguing illnesses were similarly distributed in the four regions, somewhat more common in rural than in urban areas, and significantly more common in persons with incomes less than $40,000 and in those with no more than a high school education. By projecting these figures to the general US population, we estimate that nearly 2.2 million American adults suffer from CFS-like illness.

Abstract

Background: Chronic fatigue syndrome (CFS) is a debilitating illness with no known cause or effective therapy. Population-based epidemiologic data on CFS prevalence are critical to put CFS in a realistic context for public health officials and others responsible for allocating resources.

Methods: We conducted a pilot random-digit-dialing survey to estimate the prevalence of fatiguing illnesses in different geographic regions and in urban and rural populations of the United States . This report focuses on 884 of 7,317 respondents 18 to 69 years old. Fatigued (440) and randomly selected non-fatigued (444) respondents completed telephone questionnaires concerning fatigue, other symptoms, and medical history.

Results: We estimated 12,186 per 100,000 persons 18 to 69 years of age suffered from fatigue lasting for at least 6 months (chronic fatigue), and 1,197 per 100,000 described an illness that, though lacking clinical evaluation, met criteria for CFS (CFS-like). Chronic fatigue and CFS-like illness were more common in rural than in urban populations, although the differences were not significant. The prevalence of these fatiguing illnesses did not differ meaningfully among the four regions surveyed, and no significant geographic trends were observed.

Conclusion: This investigation estimated that nearly 2.2 million American adults suffer from CFS-like illness. The study also suggested the need to focus future investigations of fatigue on populations with lower incomes and less education. There was no evidence for regional differences in the occurrence of fatiguing illnesses.

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