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25 May 2012

US Statistics for Arthritis

In the post Waving for World Arthritis Day!, it has some European statistics on arthritis. I wanted to add some of the US statistics but the information I wanted to use made the post much too long. So I decided to add a second post. In this post, I am dealing with information on arthritis as defined below by the CDC. It's not specific to autoimmune arthritis, osteoarthritis, or any one type. I haven't used ALL of their statistical information but a good bit of it.I am finding all of this information very eye opening. Costs of arthritis, the most common types of arthritis and the breakdowns by age/sex/race are all so interesting to me.

 As defined by the CDC:
Arthritis Basics
Although the word arthritis actually means joint inflammation, we use the term arthritis in the public health world to describe more than 100 rheumatic diseases and conditions that affect joints, the tissues which surround the joint and other connective tissue. The pattern, severity and location of symptoms can vary depending on the specific form of the disease. Typically, rheumatic conditions are characterized by pain and stiffness in and around one or more joints. The symptoms can develop gradually or suddenly. Certain rheumatic conditions can also involve the immune system and various internal organs of the body.

More information about common Arthritis Types is available.

National Statistics

Based on 2007-2009 data from the National Health Interview Survey (NHIS)(1), an estimated
  • 50 million (22%) of adults have self-reported doctor-diagnosed arthritis.
  • 21 million (9% of all adults) have arthritis and arthritis-attributable activity limitation.
{And these are just the people that actually have a type of arthritis. The effects go deeper into the family, friends, co-workers, and employers/employees of the one who has a type of arthritis. So the number of people affected is even larger. Arthritis doesn't just affect the person who is diagnosed with it.}
 
Based on 2003 NHIS data (2) a projected
  • 67 million (25%) adults aged 18 years or older will have doctor-diagnosed arthritis by the year 2030.
  • An estimated 37% (25 million adults) of those with arthritis will report arthritis-attributable activity limitations by the year 2030.
Additional Information
The best source for national arthritis prevalence estimates is the National Health Interview Survey (NHIS), an annual survey conducted by the National Center for Health Statistics. Each year, the NHIS samples U.S. households and gathers information on select adult and child members living in each household. Estimates of health conditions and behaviors from the NHIS are representative of the U.S. civilian, non-institutionalized population. Read more about the NHIS surveillance. Specific NHIS Arthritis related questions (ACN.250_00.000 through ACN.295.000) are available Adobe PDF file [PDF - 2.2Mb] .

More on the impact of arthritis and associated health behaviors:
References
  1. Cheng YJ, Hootman JM, Murphy LB, Langmaid GA, Helmick CG. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation — United States, 2007–2009. MMWR 2010;59(39):1261–1265. html  pdf Adobe PDF file [1.61 MB]
  2. Hootman JM, Helmick CG. Projections of U.S. prevalence of arthritis and associated activity limitations. Arthritis Rheum 2006;54(1):266–229. abstractExternal Web Site Icon
The pictures and information below are from the CDC - Arthritis - Data and Statistics - State Data page

Arthritis prevalence estimates by state

State-level Behavioral Risk Factor Surveillance System 2009 prevalence estimates found that arthritis is reported by at least one in five adults in every state.  Only fourteen states, plus the District of Columbia, were in the lowest prevalence group. In the 16 states with the highest prevalence, arthritis affects up to one in three adults.  

Text description provided below



[Text description is available.]
CDC unpublished data. 
Data source: BRFSS 2009.
{Source same as picture}

Arthritis prevalence estimates in women and men by state

State-level Behavioral Risk Factor Surveillance System 2009 prevalence estimates by sex found women reporting a higher prevalence of arthritis than men in every state. When examined by the same prevalence cutoff points (17.1–25.9%; 26.0–27.9%; and 28.0–35.3%), there were only two states in which both women and men were in the highest prevalence group (Kentucky and West Virginia).  For the most part, women were in the middle and high prevalence group, but men were in the lowest prevalence group for all but four states. In the majority of jurisdictions (40 states and D.C.), at least one in every four women report arthritis.

Text description provided below

[Text description is available.]
CDC unpublished data
Data Source: BRFSS 2009

Arthritis prevalence projections through 2030

State-specific projections of arthritis prevalence from 2005 through 2030 show a substantial, average increase of 34% in all states. Ten states are anticipated to have increases from 50%–90%, and three states (Arizona, Florida, and Nevada) are projected to see their numbers more than double. Similar increases are projected for arthritis-attributable activity limitation. The biggest projected increases are expected to occur in the “sunbelt” and western states. These projections highlight the need for wider dissemination of existing evidence-based interventions and strategies that have been shown to decrease pain and increase function.
Text description provided below

[Text description is available.]
| A table offering more detailed state specific data is available.
Freedman M, Hootman JM, Helmick CG. Projected state-specific increases in self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitations—United States, 2005–2030. MMWR 2007;56(7):423–425. errata html; html;  pdf Adobe PDF file [528K]
Data Source: 2005 Behavioral Risk Factor surveillance system, U.S. Census bureau. http:/www.census.gov/population/www/projections/projectionsagesex.htmlExternal Web Site Icon

Prevalence of arthritis-attributable work limitation

In all states, working-age (ages 18-64) U.S. adults face work limitations they attribute to arthritis. The prevalence of arthritis-attributable work limitation varies by state but is generally high, affecting from 4.0% to 12.6% of all working-age adults. For example, a state with a population prevalence of arthritis-attributable work limitation of 7% could be expressed as: approximately 1 out of every 14 working-age adults in the state report doctor-diagnosed arthritis and say that it limits them in their work.
Text description provided below
[Text description is available.]
CDC unpublished data
Data Source: BRFSS 2009

Proportion of arthritis-attributable work limitation

Arthritis-attributable work limitation is very common among working-age (ages 18-64) adults with arthritis. In states with the lowest prevalence of arthritis-attributable work limitations, it is still reported by greater than 1 of every 4 working-age adults with arthritis (25%). In states with the highest prevalence of arthritis-attributable work limitation, that ratio jumps to approximately 1 of every 2 working-age adults with arthritis.
Text description provided below
[Text description is available.]
CDC unpublished data
Data Source: BRFSS 2009

Prevalence of no leisure-time physical activity (LTPA)

In every state, adults with arthritis have significantly higher prevalence of no leisure-time physical activity (LTPA) compared with adults without arthritis. In 23 states, the prevalence of no LTPA among adults with arthritis is particularly high (≥30%). Adults with arthritis comprise a large proportion (≥33%) of all adults reporting no LTPA in every state.
Map of the United States, showing the age-adjusted prevalence (percent) of no leisure-time physical activity among adults with arthritis by state: Alabama (AL) 37.9 percent; Alaska (AK) 25.9 percent; Arizona (AZ) 22.8 percent; Arkansas (AK) 37.1 percent; California (CA) 24.9 percent; Colorado (CO) 19.5 percent; Connecticut (CT) 29.0 percent; Delaware (DE) 24.7 percent; District of Columbia (DC) 25.9 percent; Florida (FL) 27.7 percent; Georgia (GA) 33.9 percent; Hawaii (HI) 24.0 percent; Idaho (ID) 29.2 percent; Illinois (IL) 27.4 percent; Indiana (IN) 33.3 percent; Iowa (IA) 30.2 percent; Kansas (KS) 29.3 percent; Kentucky (KY) 35.1 percent; Louisiana (LA) 32.8 percent; Maine (ME) 27.0 percent; Maryland (MD) 30.0 percent; Massachusetts (MA) 28.0 percent: Michigan (MI) 30.1 percent; Minnesota (MN) 16.5 percent; Mississippi (MS) 36.4 percent; Missouri (MO) 30.2 percent; Montana (MT) 25.1 percent; Nebraska (NE) 28.6 percent; Nevada (NV) 31.7 percent; New Hampshire (NH) 25.9 percent; New Jersey (NJ) 30.1 percent; New Mexico (NM) 26.1 percent; New York  (NY) 29.4 percent; North Carolina (NC) 32.9 percent; North Dakota (ND) 32.4 percent; Ohio (OH) 32.2 percent; Oklahoma (OK) 37.2 percent; Oregon (OR) 26.0 percent; Pennsylvania (PA) 30.8 percent; Rhode Island (RI) 28.5 percent; South Carolina (SC) 34.4 percent; South Dakota (SD) 28.2 percent; Tennessee (TN) 42.0 percent; Texas (TX) 35.5 percent; Utah (UT) 22.2 percent; Vermont (VT) 24.2 percent; Virginia (VA) 30.6 percent; Washington (WA) 25.7 percent; West Virginia (WV) 37.4 percent; Wisconsin (WI) 29.9 percent; Wyoming (WY) 26.6 percent.
A table offering more detailed state specific data is available.
Hootman JM, Barbour KE, Watson KB, Harris C. State-specific prevalence of no leisure-time physical activity among adults with and without doctor-diagnosed arthritis—United States, 2009. MMWR. 2011; 60(48):1641-1645. html  pdf  Adobe PDF file [1.10MB]
Data Source: BRFSS 2009

Arthritis-Attributable activity limitations

The prevalence of adults with arthritis-attributable activity limitation ranges from 7.3% to 16.7%. These high rates of arthritis-attributable activity limitation are projected to increase with the aging of the population, requiring increased intervention measures to reduce this impact. Arthritis-attributable activity limitation can be prevented or reduced in many persons. In fact, both aerobic and strengthening exercises can improve physical function and self-reported arthritis disability. Self-management education classes can also increase confidence in one’s ability to manage arthritis.
Text description provided below
[Text description is available.]

CDC unpublished data
Data Source: BRFSS 2009


Proportion of arthritis-attributable activity limitations

The proportion of adults with arthritis who have arthritis-attributable activity limitations is substantial.  In every state at least one in three adults with arthritis reports arthritis-attributable activity limitations.  In some states, more than one in two adults reports arthritis-attributable activity limitations. 
Text description provided below
[Text description is available.]
CDC unpublished data
Data Source: BRFSS 2009

Proportion of arthritis-attributable social participation restriction

Arthritis-Attributable social participation restriction is defined here as an answer of “a lot” to a question asking how much arthritis has interfered with “normal social activities, such as going shopping, to the movies, or to religious or social gatherings.”  The proportion of adults with arthritis-attributable social participation restriction ranges from about one in twelve to one in three adults across states, indicating that it is a substantial problem caused by arthritis.
Text description provided below
[Text description is available.]

CDC unpublished data
Data Source: BRFSS 2009


Proportion of arthritis-attributable severe joint pain

Pain is a common symptom of arthritis.  Arthritis-Attributable severe joint pain is reported by at least one in seven adults with arthritis in every state.  In states with the highest prevalence of arthritis-attributable severe joint pain, it is more common than every one in three adults with arthritis. 
Text description provided below
[Text description is available.]
CDC unpublished data
Data Source: BRFSS 2009


State-Specific Gross Domestic Product (GDP) Estimates

To demonstrate the economic impact of arthritis and other rheumatic conditions (AORC) in each state, this map shows the proportion of each state economy spent on AORC attributable costs relative to the economy of each state. In 2003, costs attributable to AORC represented between 0.3 to 2.6% of each state’s GDP. For example: in 2003, the costs attributable to AORC in West Virginia were $1.2 billion and this represented 2.6% of West Virginia’s GDP.
Text description provided below
[Text description is available.]
Murphy L, Cisternas M, Yelin E, Trupin L, Helmick C. Update: Direct and indirect costs of arthritis and other rheumatic conditions—United States, 1997. MMWR 2004;53(18):388–389. html; pdf Adobe PDF file [273K] 
Data Source: Medical Expenditure Panel Survey (MEPS) 2003 and BRFSS 2003

State Statistics

State-specific 2003, 2005, 2007 and 2009 BRFSS prevalence estimates

The Behavioral Risk Factor Surveillance System (BRFSS) is the best source for state-specific arthritis prevalence estimates. BRFSS is a state-based, random-digit-dialed telephone survey of the noninstitutionalized, civilian U.S. population ages ≥ 18 years. The survey is administered in all 50 states, the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. Since 1996, selected states have been collecting information on arthritis through BRFSS.

Starting with the 2003 BRFSS and continuing in odd-numbered years, all states collected information on arthritis. Different questions were used to collect data between 1996–2001 and from 2002 forward. For this reason, it is not valid to look at trends that cross from 2001 into 2002. In 2002, the case definition of arthritis changed as well. Beginning in 2002 we have focused on doctor-diagnosed arthritis only. Read more about the BRFSS arthritis-specific questions and the arthritis case definitions.
View the summary of these state-specific ` by using the clickable map or the data list below:
Image of United States Map. Please click on your state to contact your state Arthritis Program Coordinator. Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia District of Columbia Florida Georgia Hawaii Hawaii Hawaii Hawaii Hawaii Idaho Illinois Indiana Iowa Kansas Kentuky Louisiana Maine Maryland Maryland Massachusetts Michigan Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington West Virginia Wisconsin Wyoming
Data Source: BRFSS 2009
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Territorial Statistics

State Statistics For 2003, 2005, 2007, and 2009

(Data Source: Behavioral Risk Factor Surveillance System (BRFSS)
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Note: We have always seen some fluctuation from year-to-year in state-specific BRFSS estimates, such as those for “Adults with arthritis” and “Adults limited by arthritis.”  This is partly a function of using BRFSS samples that by chance are more or less representative of the target population, and we caution against making too much of year-to-year variations and instead look at the long term trend.  State-specific BRFSS arthritis estimates remain the best that are available, and the main point for every state and territory is that arthritis has a large public health impact.

Estimates represented by an asterisk (*) have relative a standard error greater than 30% and do not meet the standards of reliability or precision. 

{I am only copying South Carolina here to show what info is available on the state statistics page because it is where I live, but the links above lead to the other states.}

South Carolina (state data)

2003

2005

2007

2009

Adults with arthritis 934,000 967,000 956,000 1,022,000
Adults limited by arthritis 345,000 370,000 372,000 481,000
% of adults with arthritis 30 31 30 31
% women/men with arthritis 34/26 34/27 34/25 35/26
% whites with arthritis 32 31 32 32
% blacks with arthritis 28 28 25 26
% Hispanics with arthritis 27 21 18 22
% 18–44 year olds with arthritis 14 15 13 15
% 45–64 year olds with arthritis 42 41 40 40
% 65+ year olds with arthritis 58 59 58 55
% with arthritis who are overweight or obese 66 71 71 73
% with arthritis who are physically inactive 21 19 21 21
View a detailed summary of the most current estimates. Adobe PDF file [PDF - 135KB


Cost Statistics

National and state cost estimates

  • The total costs attributable to arthritis and other rheumatic conditions (AORC) in the United States in 2003 was approximately $128 billion. This equaled 1.2% of the 2003 U.S. gross domestic product.
     
    • $80.8 billion were direct costs (i.e., medical expenditures)
    • $47.0 billion were indirect costs (i.e., lost earnings)
       
  • Total costs attributable to AORC, by state, ranged from $226 million in the District of Columbia to $12.1 billion in California.
     
  • National medical costs attributable to AORC grew by 24% between 1997 and 2003. This rise in medical costs resulted from an increase in the number of people with AORC.
     
  • In 2003, costs attributable to AORC represented between 0.3 to 2.6% of each state’s GDP. For example: in 2003, the costs attributable to AORC in West Virginia were $1.2 billion and this represented 2.6% of West Virginia’s GDP.

  • [Note:  CDC is currently updating national cost estimates for AORC  to 2008.  The CDC Arthritis program is also a member of the CDC Chronic Disease Cost Calculator working group which is developing state-level cost estimates.  AORC will be among the conditions included in the next release of the calculator.]
Study reports on arthritis costs:
National and state direct and indirect costs are presented in the January 12, 2007 MMWR entitled: National and State Medical Expenditures and Lost Earnings Attributable to Arthritis and Other Rheumatic Conditions — United States, 2003.
A detailed report on the national cost study, including the study methods and comparisons of 1997 and 2003 costs, was published in:
Yelin E, Murphy L, Cisternas M, Foreman A, Pasta D, Helmick C. Medical Care Expenditures and Earnings Losses Among Persons with Arthritis and Other Rheumatic Conditions in 2003, and Comparisons to 1997. Arthritis and Rheumatism 2007;56(5):1397-1407.

State-Specific Gross Domestic Product (GDP)


Map showing state specific gross domestic product
Yelin E, Cisternas M, Foreman A, Pasta D, Murphy L, Helmick C. National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions — United States, 2003. MMWR 2007;56(1):4–7. html pdf Adobe PDF file [306K]

The table below shows the total costs* (in millions of dollars) attributable to arthritis and other rheumatic conditions for each state in 2003.

Total Costs* (in millions) attributable to Arthritis and Other Rheumatic Conditions, By State, United States, 2003

$225 million to $574 million $650 million to $1.6 billion $1.9 billion to $2.9 billion $3.2 billion to $12.1 billion
District of Columbia 226 Nebraska 757 Colorado 1,920 Indiana 3,181
Wyoming 243 New Mexico 770 Louisiana 2,036 Tennessee 3,271
Alaska 275 Utah 820 South Carolina 2,133 Virginia 3,466
North Dakota 285 Nevada 1,022 Minnesota 2,172 New Jersey 3,544
Vermont 290 Kansas 1,106 Arizona 2,343 Georgia 3,911
South Dakota 351 West Virginia 1,188 Kentucky 2,426 North Carolina 4,112
Delaware 363 Iowa 1,250 Wisconsin 2,445 Michigan 5,557
Hawaii 375 Arkansas 1,441 Maryland 2,479 Ohio 5,745
Montana 396 Connecticut 1,443 Alabama 2,597 Pennsylvania 6,578
Rhode Island 511 Mississippi 1,495 Illinois 2,670 Florida 7,624
Idaho 564 Oregon 1,609 Massachusetts 2,734 Texas 8,706
New Hampshire 574 Oklahoma 1,628 Washington 2,787 New York 8,726
Maine 648

Missouri 2,874 California 12,137
* Total costs = medical expenditures + lost earnings
Yelin E, Cisternas M, Foreman A, Pasta D, Murphy L, Helmick C. National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions — United States, 2003. MMWR 2007;56(1):4–7. html pdf  Adobe PDF file [306K]


National Medical Expenditures among People with Arthritis, 1997 to 2005

From 1997 to 2005, total national expenditures among all US adults with arthritis increased from by 100 billion dollars. Medical expenditures were $252.0 billion in 1997 and $353.0 billion in 2005.  (Cisternas et al 2009)External Web Site Icon
Why did total national medical expenditures among all adults with arthritis increase from 1997 to 2005?
  • The rise in medical expenditures in this time period is attributable to two distinct factors:
    1. The number of people with arthritis and other rheumatic conditions increased by 22%
    2. Medical expenditures for each person with arthritis increased by 15%
Total national medical expenditures among US adults with arthritis, 1997 to 2005
Description of graph in text below

Data source: Medical Expenditure Panel Survey, 1997-2005
Expenditures for each individual are the sum of the following: inpatient, outpatient, office visit, home health, emergency, prescription medications, and other.

The graph above shows that ––
  • From 1995 to 2005, the total national medical expenditures among adults with arthritis only remained stable.
  • However, total medical expenditures rose by 27% among people who had arthritis and one or more co-occurring chronic conditions
    • This increase in expenditures resulted from a rise in number of people with arthritis who also have co-occurring chronic conditions such as diabetes and heart disease. 
    • In 1997, 36.8 million people with arthritis had co-occurring chronic conditions and by 2005, this had risen to 44.9 million people.

Cisternas MG, Murphy LB, Yelin EH, Foreman AJ, Pasta DJ, Helmick CG. Trends in Medical Care Expenditures of US Adults with Arthritis and Other Rheumatic Conditions 1997 to 2005 J Rheumatol 2009;36(11):2531-2538. abstractExternal Web Site Icon


Co-morbidities

What is co-morbidity?
The presence of more than one disease or condition in the same person at the same time.
Conditions described as co-morbidities are often chronic or long-term conditions.  Other names to describe co-morbid conditions are coexisting or co-occurring conditions. 
The CDC Arthritis Program examines co-morbidities in the following two ways:
  • Co-morbidities among people with arthritis.  Everyone in this group has arthritis, plus at least one additional condition.
  • Arthritis among people with other chronic conditions.  A subset of people with other chronic conditions who also have arthritis.

Prevalence of Specific Types of Arthritis

Note: There are different data sources for some of the arthritis related statistics therefore; case definitions and terminology will also vary. Read more.

The most common form of arthritis is osteoarthritis. Other common rheumatic conditions include gout, fibromyalgia and rheumatoid arthritis.

An estimated 27 million adults had osteoarthritis in 2005.
Arthritis Rheum 2008;58(1):26–35. [Data Source: NHANES]

An estimated 1.5 million adults had rheumatoid arthritis in 2007.
Arthritis Rheum. 2010 Jun;62(6):1576-82. [Data source: Patient Cohort, Minnesota]

An estimated 3.0 million adults had gout in 2005, and 6.1 million adults have ever had gout.

Arthritis Rheum 2008;58(1):26–35. [Data Source: 1996 NHIS]

An estimated 5.0 million adults had fibromyalgia in 2005.
Arthritis Rheum 2008;58(1):26–35.

Prevalence of Arthritis by Age/Race/Gender

Note: There are different data sources for some of the arthritis related statistics therefore; case definitions and terminology will also vary. Read more.
Of persons ages 18–44, 7.6% report doctor-diagnosed arthritis. Of persons ages 45–64, 29.8% report doctor-diagnosed arthritis. Of persons ages 65 or older, 50.0% report doctor-diagnosed arthritis.
MMWR 2010;59(39);1261-1265. [Data Source: 2007–2009 NHIS]

25.9% of women and 18.3% men report doctor-diagnosed arthritis.
MMWR 2010;59(39);1261-1265. [Data Source: 2007–2009 NHIS]

An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition; this represents approximately 1 in every 250 children in the U.S.
Arthritis Care Res 2007;57:1439-1445 [Data Source: 2001–2004 National Ambulatory Medical Care Survey and 2001–2004 National Hospital Ambulatory Medical Care Survey]
2.9 million Hispanic adults report doctor-diagnosed arthritis.
Prev Chronic Dis. 2010 May;7(3):A64. [Data source:  NHIS 2002, 2003, 2006]
4.6 million Non-Hispanic Blacks report doctor diagnosed arthritis.
Prev Chronic Dis. 2010 May;7(3):A64. [Data source:  NHIS 2002, 2003, 2006]

667,000 Asian/Pacific Islanders and 280,000 American Indians/Alaska Natives report doctor-diagnosed arthritis.
Prev Chronic Dis. 2010 May;7(3):A64. [Data source:  NHIS 2002, 2003, 2006]

Overweight/Obesity and Arthritis (adults ages ≥18 years)

Note: There are different data sources for some of the arthritis related statistics; therefore, case definitions and terminology will also vary. Read more.
People who are overweight or obese report doctor-diagnosed arthritis more often than people with a lower body mass index (BMI).

16.4% of under/normal weight adults report doctor-diagnosed arthritis.
MMWR 2010;59(39);1261-1265. [Data Source: 2007–2009 NHIS]

21.4% of overweight and 31.1% of obese Americans report doctor-diagnosed arthritis.
MMWR 2010;59(39);1261-1265. [Data Source: 2007–2009 NHIS]

66% of adults with doctor-diagnosed arthritis are overweight or obese (compared with 53% of adults without doctor-diagnosed arthritis).
Am J Prev Med 2006;30(5):385–393. [Data Source: 2002 NHIS]

Weight loss of as little as 11 pounds reduces the risk of developing knee osteoarthritis among women by 50%
Arthritis Rheum 1998;41(8):1343–1355. [Data source: Framingham Osteoarthritis Study]

Physical Activity and Arthritis

Note: There are different data sources for some of the arthritis related statistics; therefore, case definitions and terminology will also vary. Read more.

Almost 44% of adults with doctor-diagnosed arthritis report no leisure time physical activity compared with 36% of adults without arthritis.

Am J Prev Med 2006;30(5):385-393.
Among older adults with knee osteoarthritis, engaging in moderate physical activity at least 3 times per week can reduce the risk of arthritis-related disability by 47%.

Arch Intern Med 2001;161(19):2309–2316. [Data Source: FAST Trial]

Disability/Limitations and Arthritis

Note: There are different data sources for some of the arthritis related statistics; therefore, case definitions and terminology will also vary. Read more.

Most Common Cause of Disability
Arthritis and other rheumatic conditions are the most common cause of disability among U.S. adults and have been for the past 15 years.

MMWR 2009;58(16):421-426. [Data Source: 2005 Survey of Income and Program Participation (SIPP)]

Activity Limitation
Among all civilian, non-institutionalized U.S. adults 9.4% (21 million) report both doctor-diagnosed and arthritis attributable activity limitations.

MMWR 2010;59(39);1261-1265. [Data Source: 2007–2009 NHIS] 

42% of adults with doctor-diagnosed arthritis report arthritis-attributable activity limitations.

MMWR 2010;59(39);1261-1265. [Data Source: 2007–2009 NHIS] 
Among adults with doctor-diagnosed arthritis, many report significant limitations in vital activities such as:
  • walking 1/4 mile—6 million
  • stooping/bending/kneeling—8 million
  • climbing stairs—5 million
  • social activities such as church and family gatherings—2 million
Arthritis Rheum 2004;50(9, suppl):5641.  [Data Source: 2002 NHIS] 
Work Limitation
Approximately 1 in 3 people with arthritis (31%) in between the ages of 18 and 64 report arthritis-attributable work limitation.

MMWR 2005;54(5):119–123. [Data Source: 2002 NHIS]
Among all civilian, non-institutionalized U.S. adults ages 18-64, 5% (8.2 million) report both doctor diagnosed arthritis and arthritis-attributable work limitations.

MMWR 2005;54(5):119–123. [Data Source: 2002 NHIS]
State-specific prevalence estimates of arthritis-attributable work limitation show a high impact of arthritis on working-age (18-64 years) adults in all U.S. states, ranging from a low of 3.4% to a high of 15% of adults in this age group.

MMWR 2007;56(40):1045-1049. [Data Source: 2003 BRFSS]

Health Related Quality of Life (HRQOL) and Arthritis

Note: There are different data sources for some of the arthritis related statistics; therefore, case definitions and terminology will also vary. Read more.

People with doctor-diagnosed arthritis have significantly worse HRQOL than those without arthritis. Adults with arthritis report two to four times as many unhealthy days in the past month than those without arthritis.

Arthritis Care Res 2011;63(6):788-99. [Data Source: 2005, 2007, 2009 BRFS
 

Arthritis Healthcare Utilization

Note: There are different data sources for some of the arthritis related statistics; therefore, case definitions and terminology will also vary. Read more.

Hospitalizations
In 2004, there were an estimated 744,000 hospitalizations with a principal diagnosis of arthritis (3% of all hospitalizations). Overall, 5 million hospitalizations had a principal or secondary diagnosis of arthritis.

[Data source: 2004 NHDS]
Ambulatory Care
There were 78 million ambulatory care visits with a primary diagnosis of arthritis or other rheumatic conditions, or nearly 5% of all ambulatory care visits that year. Overall, there were 66 million ambulatory care visits with a primary or secondary diagnosis of arthritis or other rheumatic conditions.

Arthritis Care Res 2010;62(4):460-4. [Data Source: 2001–2005 National Ambulatory Medical Care Survey and 2001–2005 National Hospital Ambulatory Medical Care Survey]

Arthritis-Related Mortality

Note: There are different data sources for some of the arthritis related statistics; therefore, case definitions and terminology will also vary. Read more.

From 1979-1998, the annual number of arthritis and other rheumatic conditions (AORC) deaths rose from 5,537 to 9,367.

J Rheumatology 2004;31(9):1823–1828. [Data Source: 1979–1998 National Vital Statistics System]
Three categories of AORC account for almost 80% of deaths: diffuse connective tissue diseases (34%), other specified rheumatic conditions (23%), and rheumatoid arthritis (22%).

J Rheumatology 2004;31(9):1823–1828. [Data Source: 1979–1998 National Vital Statistics System]
In 1979, the crude death rate from AORC was 2.46 per 100,000 population. In 1998, it was 3.48 per 100,000 population; rates age-standardized to the year 2000 population were 2.75 and 3.51, respectively.

J Rheumatology 2004;31(9):1823–1828. [Data Source: 1979–1998 National Vital Statistics System]

Arthritis Costs

Note: There are different data sources for some of the arthritis related statistics; therefore,; case definitions and terminology will also vary. Read more.

In 2003, the total cost attributed to arthritis and other rheumatic conditions in the United States was 128 billion dollars, up from 86.2 billion dollars in 1997.

MMWR 2007;56(01):4-7. [Data Source: 2003 Medical Expenditure Panel Survey]
Medical expenditures (direct costs) for arthritis and other rheumatic conditions in 2003 were 80.8 billion dollars, up from 51.1 billion in 1997.

MMWR 2007;56(01):4-7. [Data Source: 2003 Medical Expenditure Panel Survey]
Earnings losses (indirect costs) for arthritis and other rheumatic conditions in 2003 were 47 billion dollars, up from 35.1 billion in 1997.

MMWR 2007;56(01):4-7. [Data Source: 2003 Medical Expenditure Panel Survey]

Mental/Emotional Health and Arthritis

Note: There are different data sources for some of the arthritis related statistics; therefore,; case definitions and terminology will also vary. Read more.

Arthritis is strongly associated with major depression (attributable risk of 18.1%), probably through its role in creating functional limitation.

Medical Care 2004;42(6):502–511. [Data Source: 1996 Health and Retirement Survey]

6.6% of adults with arthritis report severe psychological distress.
Int. J Public Health, 2009;S4:S75-83 [Data Source: 2007 Behavioral Risk Factor Surveillance System]

Total Joint Replacements in Arthritis

Note: There are different data sources for some of the arthritis related statistics; therefore,; case definitions and terminology will also vary. Read more.

In 2004, there were 454,652 total knee replacements performed, primarily for arthritis.

United States Bone and Joint Decade: The Burden of Musculoskeletal Diseases in the United States. Rosemont, IL: American Academy of Orthopaedic Surgeons;2008.
In 2004, there were 232,857 total hip replacements, 41,934 shoulder, and 12,055 other joint replacements, primarily for arthritis.

United States Bone and Joint Decade: The Burden of Musculoskeletal Diseases in the United States. Rosemont, IL: American Academy of Orthopaedic Surgeons;2008.

About the CDC

Our vision — a world where people with arthritis live the fullest life possible, with the ability to pursue valued life activities with minimal pain.
Our mission — to improve the quality of life of people affected by arthritis.
CDC and its partners are working to implement recommendations in the National Arthritis Action Plan: A Public Health Strategy Adobe PDF file [PDF–394K]External Web Site Icon and A National Public Health Agenda for Osteoarthritis  Adobe PDF file [PDF - 3.33MB]. Each of these landmark public health plans were developed by CDC, the Arthritis Foundation, and a diverse group of other organizations. Each recommends a variety of activities to reduce pain, disability, and improve the quality of life of persons affected by arthritis.
Our Goals:
Short-Term Goals
  • Improve and increase self-management attitudes and behaviors among persons with arthritis.
  • Increase early diagnosis and appropriate pain management.
Long-Term Goals
  • Decrease pain and disability among persons with arthritis.
  • Improve physical, psychosocial, and work function among persons with arthritis.
NationalObjectives for Arthritis are available in the Healthy People 2020 report. More information is available on Healthy People 2020.External Web Site Icon

Our Work

The Arthritis Program is working to
  • Measure the burden of arthritis. At the national level, CDC uses surveys of the National Center for Health Statistics to define the burden of arthritis, monitor trends, and assess how arthritis affects quality of life. At the state level, CDC and states (all 50, District of Columbia, and the 3 territories) use the Behavioral Risk Factor Surveillance System to obtain arthritis burden data.
     
  • Strengthen the science base. CDC conducts or supports research to define the impact of arthritis in the United States. We also support research to both develop and evaluate interventions to help people with arthritis improve their quality of life.
     
  • Increase Awareness. CDC, working with the Arthritis Foundation, states, and other partners is supporting two health communications campaigns promoting physical activity among people with arthritis: Physical Activity. The Arthritis Pain Reliever for English speaking audiences, and Buenos Días, Artritis for Hispanic audiences.
     
  • Build State Arthritis Programs. State Health Departments, with CDC support, are working to strengthen partnerships, increase public awareness, and expand the reach of interventions that have been proven to improve the quality of life of people with arthritis.

Arthritis Program Staff

The Arthritis Program has a staff with expertise in behavioral science, epidemiology, health communication, health education, and project management. Currently, there are 14 full-time staff devoting their efforts to the Arthritis Program at the CDC. Program staff are involved in providing technical assistance for research and programmatic efforts, collaborating with state programs, analyzing data, and producing scientific reports.

Partnerships

Addressing the burden of arthritis requires coordinated and collaborative efforts among many organizations, including governmental and public health agencies, private organizations such as the Arthritis Foundation and the Lupus Foundation of America, aging agencies, health systems, and others. These types of alliances help to assure the needed comprehensive approach to arthritis.
Find out more about our arthritis program partners.

Intervention Programs

The CDC Arthritis Program recommends evidence-based programs that are proven to improve the quality of life of people with arthritis. The programs currently being promoted are —
Each Program description also includes information about how to locate these programs in your state. Self-management education programs like the Arthritis Self Management Program (ASMP) and Chronic Disease Self-Management (CDSMP) help teach people with arthritis techniques to manage arthritis on a day-to-day basis. Research has shown that appropriate physical activity offers substantial benefits to people with arthritis and can decrease arthritis pain and disability. Preliminary studies have shown the Arthritis Foundation Exercise Program (formerly People with Arthritis Can Exercise or PACE), the Arthritis Foundation Aquatic Program, EnhanceFitness, Walk With Ease, Active Living Every Day, and Fit and Strong! to be both safe and effective for people with arthritis.  In addition to these physical activity programs, self-directed physical activity can be beneficial. A physical activity fact sheet and information detailing the importance of physical activity for people with arthritis are available. Intervention programs with promising evaluation data and which are building the infrastructure to support program delivery across the country are labeled “Promising Programs”.  There are currently four intervention programs on our list of Promising Programs. There are currently two physical activity interventions on our “Watch List” for possible recommendation; Watch List programs are currently undergoing evaluation to determine their effects on the health of people with arthritis.
A journal article outlining the CDC Arthritis Program's screening criteria and selection process for recommending interventions for people with arthritis has been published. An overview of each recommended intervention and the implementation details is also included.
Brady TJ,  Jernick SL, Hootman JM, Sniezek JE. Public health interventions for arthritis: expanding the toolbox of evidence-based interventions. Journal of Women’s Health 2009;18(12):1905–1917. abstractExternal Web Site Icon

Quick Stats on Arthritis

Prevalence

  • 50 million adults in the United States have doctor-diagnosed arthritis (just over 1 in 5 adults). Read more.

  • The percentage of adults with arthritis ranges from 20% in California to 36% in Kentucky. State median is 26% in 2009. View the prevalence data for each state – list of states clickable map.

  • Arthritis affects all race and ethnic groups: 36 million whites, 4.6 million blacks, 2.9 million Hispanics, 280,000 American Indians/Alaska Natives, 667,000 Asian/Pacific Islanders, and 469,000 multiracial/others. Read more.

  • The risk of arthritis increases with age and is more common among women than men. Read more.

  • In all U.S. states, 1 in 3 working-age adults (18-64 years old) face work limitations they attribute to arthritis; the prevalence of work limitations due to arthritis varies by state. Read more.

  • An estimated 294,000 children under age 18 have some form of arthritis or rheumatic condition, this represents approximately 1 in every 250 children. abstractExternal Web Site Iconarthritis type tablestate table

Impact

  • Arthritis is the most common cause of disability in the United States. Read more. View graph.

  • Number of U. S. Adults Reporting a Disability is Increasing — A new CDC study shows that 47.5 million US adults (21.8%) reported a disability 1 in 2005, an increase of 3.4 million from 1999. Arthritis or rheumatism (8.6 million) continues to be the most common cause of disability, while back or spine problems (7.6 million) and heart trouble (3.0 million) round out the top three causes. Read more in the MMWR and CDC Feature.

  • Nearly 21 million adults say that arthritis limits their usual activities in some way. Read more.

  • State-specific prevalence estimates of arthritis-attributable work limitation show a high impact of arthritis on working-age (18-64 years) adults in all U.S. states, ranging from a low of 3.4% to a high of 15% of 1 in 2 adults with arthritis in this age group. Read more. State maps relating to this publication are available. Map 1 and Map 2

  • 8.2 million working aged U.S. adults (about 1 in 20) report work limitations due to arthritis or joint symptoms. Read more.

  • Blacks and Hispanics with arthritis have almost twice the prevalence of work limitation and severe pain compared to Whites. Read more.

Cost

  • In 2003, the total cost attributed to arthritis and other rheumatic conditions in the United States was 128 billion dollars, up from 86.2 billion dollars in 1997. ($80.8 billion in medical care expenditures and $47 billion in earnings losses). Read more.

  • Medical expenditures (direct costs) for arthritis and other rheumatic conditions in 2003 were 80.8 billion dollars, up from 51.1 billion in 1997. Read more.

  • Earnings losses (indirect costs) for arthritis and other rheumatic conditions in 2003 were 47 billion dollars, up from 35.1 billion in 1997. Read more.

  • States ranged from $121 million in Wyoming to $8.4 billion in California. Read more.

Interventions

  • Effective strategies exist to reduce the impact of arthritis. Read more.

  • Anticipating employment disability due to arthritis and addressing employment barriers through increased education, awareness, workplace accommodations, and other interventions can help reduce arthritis disability in the U.S. workforce. Read moreExternal Web Site Icon.

Co-morbidity

  • A new CDC study shows that arthritis may be an unrecognized barrier for adults with heart disease attempting to manage their condition through physical activity; 29% of people with both conditions are physically inactive compared to 21% with heart disease alone. Read more in the MMMWR and CDC Feature.

  • More than half of adults with diagnosed diabetes also have arthritis. The study found that 29.8% of adults with arthritis and diabetes were physically inactive, compared with 21% of people with diabetes alone. Among people with diabetes, the high frequency of arthritis appears to be an under recognized barrier to increasing physical activity, a recommended diabetes intervention. Engaging in joint friendly activities; such as, walking, swimming, biking, and participating in available arthritis-specific exercise interventions can help manage both conditions.  Read more.
 
Are you surprised by any of these statements? If so, you’re not alone. Most of us don’t realize the significant and serious impact arthritis has on a person’s quality of life, our country’s economy, and the health of our nation. It is more than “just aches and pains.”

Simple Steps for People with Arthritis

Taking just a few simple steps can help keep pain away:
  • Learn how to apply self-management strategies and techniques.
  • Engage in regular physical activity.
  • Keep weight under control.
  • See your doctor for early diagnosis and appropriate treatment.
  • Avoid joint injury to reduce your risk of developing osteoarthritis. 

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