A ground-breaking, community-based study of Chronic Fatigue Syndrome (CFS), headed by a DePaul University professor of psychology, explodes the myth that individuals with the condition are largely white, middle-class women who don’t really have a serious malady.
Leonard Jason’s "Community-Based Study of Chronic Fatigue Syndrome," which appears in the October 11th issue of the American Medical Association’s Archives of Internal Medicine, reports that there is greater prevalence of CFS among African Americans, Latinos and women, and affects 422 of every 100,000 Americans. The rate of prevalence is twice as high as rates previously reported by the Centers for Disease Control, which means as many as 800,000 people nationwide may suffer from the condition.
CFS is a chronic condition with symptoms that are severe, but often difficult to detect upon physical examination. They include debilitating fatigue, headaches and unrefreshing sleep. For years the condition went undiagnosed or misdiagnosed because physicians weren’t able to differentiate between common fatigue and CFS.
"This is the first random sampling with full medical work-up of an ethnically diverse population," said Jason. "Data from our study indicate that CFS is one of the more common chronic conditions."
The random telephone sampling of 28,673 adults in Chicago not only found the highest levels of CFS among people of color and women, but individuals with CFS were more likely to have lower levels of education and occupational status.
According to the study, previous findings that falsely indicated that patients with CFS come from upper social classes were based upon those individuals’ access to particular health care settings. "Studies that relied on referrals from physicians and medical clinics have under-estimated prevalence because many low-income individuals lack access to the health care system and many patients with fatigue drop out of the medical care system," explained Jason.
The study began with telephone questioning of randomly selected residents in eight Chicago communities that offered racial/ethnic and socioeconomic diversity. Those persons who indicated during the survey that they had suffered from unexplained, persistent or relapsing chronic fatigue for six months or longer and did not have a disease that might cause fatigue, were defined as having chronic fatigue syndrome-like illness. This group participated in the second phase of the study, which included a detailed medical examination at Mercy Hospital and Medical Center.
According to Jason, more than 90 percent of those sampled and found to have CFS were previously undiagnosed. "This indicates that there are many people in the general population who are not currently diagnosed or under adequate medical care," he said.
In the community-based study, Latinos demonstrated the highest CFS prevalence at 726 cases per 100,000 people versus 310 per 100,000 for whites. The Latino population sampled within the study was primarily comprised of Mexican Americans and Puerto Ricans.
African Americans, previously thought to be far less afflicted by CFS than whites, account for a prevalence rate of 337 per 100,000.
Jason indicated that the elevated rates of CFS in African Americans and Latinos may be attributable to poor or deteriorating health status among under-served ethnic groups. The study indicates that factors contributing to poorer health status among low-income ethnic groups may include psychological and social stress, behavioral risk factors, poor nutrition, inadequate health care, more hazardous occupations and environmental exposures.
Chronic fatigue syndrome prevalence among women in the study was considerably higher than for men, with 522 women afflicted per 100,000 as compared to 291 men per 100,000. The prevalence rate for women with CFS is higher than it is for AIDS, breast and lung cancer. "When comparing the prevalence of CFS in women to the prevalence of other diseases, CFS emerges as a serious women’s health concern," said Jason.
Jason concludes that greater numbers of people of color are affected by CFS. In addition, his study indicated CFS is now one of the more common chronic health conditions. CFS usually affects people in the prime of their life and, consequently, has a significant impact on the nation’s productivity. People with CFS have a health condition that frequently results in marked interruption of work and family life, therefore the syndrome carries important implications related to public health and policy.
"It is our hope that these data might influence funding decisions because current funding for CFS research is less than $10 million a year, which is small given the dollars devoted to less prevalent illnesses," said Jason.
The study was conducted by a team of researchers from DePaul, Northern Illinois and Northwestern universities, the University of Illinois at Chicago, and Mercy Hospital and Medical Center. Financial support for the study was provided by a $2.5 million grant from the National Institute of Allergy and Infectious Diseases of the National Institutes of Health.
Jason, leader of the study team, has served in the psychology department at DePaul University since 1975. During his tenure at DePaul, Jason has established an impressive record of scholarship. He is the author of 12 books and more than 300 scholarly articles on chronic fatigue syndrome, smoking and prevention, media intervention, community building, school transitions and substance abuse. More information on Jason’s current work is available at his Web site: http://condor.depaul.edu/~ljason/cfs.