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NHIS Arthritis Surveillance

Arthritis Prevalence in Women and Men

The CDC combined data from the National Health Interview Survey years 2007–2009 Sample Adult Core components to estimate average annual arthritis prevalence in the civilian, non-institutionalized U.S. population age 18 years or older. Overall, 22.2% (49.9 million) of adults reported arthritis, with significantly higher age-adjusted prevalence in women than in men (24.3%, [95% confidence interval (CI) 23.8–24.8] vs. 18.3% [17.7–18.7]). Arthritis prevalence increased with age and was higher among women than men in every age group.

Sex-specific prevalence of doctor-diagnosed arthritis by 10 year age groups, National Health Interview Survey, 2003-2005

Sex-specific prevalence of doctor-diagnosed arthritis by 10 year age groups, National Health Interview Survey, 2007-2009

[A text description of this graph is also available.]

Data Source

  1. Theis KA, Helmick CG, Hootman JM. Arthritis burden and impact are greater among U.S. women than men: intervention opportunities. J Women’s Health 2007;16(4):441–453.

  2. 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 [1.61 MB]

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Future Arthritis Burden

With the aging of the U.S. population, the prevalence of doctor-diagnosed arthritis is expected to increase in the coming decades. By the year 2030, an estimated 67 million (25% of the projected total adult population) adults aged 18 years and older will have doctor-diagnosed arthritis, compared with the 50 million adults in 2007–2009. Figure 1 shows that two-thirds of those with arthritis will be women. Also by 2030 an estimated 25 million adults (37% of adults with arthritis or 9.3% of all U.S. adults) will report arthritis-attributable activity limitations. These estimates may be conservative as they do not account for the current trends in obesity, which may contribute to future cases of osteoarthritis.

Figure 1. Projected Prevalence of Doctor-Diagnosed Arthritis Among U.S. Adults Ages 18+ Years, 2005-2030 (1)

Figure 1. Projected Prevalence of Doctor-Diagnosed Arthritis Among U.S. Adults Ages 18+ Years, 2005-2030 (1)

[A text description of this graph is also available.]

Data Source: 2003 National Health Interview Survey; 2030 Census projected population

  1. Hootman JM, Helmick CG. Projections of U.S. prevalence of arthritis and associated activity limitations. Arthritis Rheum 2006;54(1):226–229.

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Arthritis-Attributable Limitations

The impact of arthritis on individuals is significant. Almost 42.4% (21.1 million) of the 50 million adults with doctor-diagnosed arthritis report limitations in their usual activities due to their arthritis. Figures 2 a and b shows that in addition to activity limitations, 31% (8.3 million) of working age adults with doctor-diagnosed arthritis report being limited in work due to arthritis.

Figure 2. (1) Arthritis-Attributable Activity Limitation Among Adults with Arthritis (NHIS 2003-2005) and (2) Arthritis-Attributable Work Limitation Among Adults with Arthritis 18-64 Years Old (NHIS 2002)

Figure 2a. (1) Arthritis-Attributable Activity Limitation Among Adults with Arthritis (NHIS 2007-2009) and (2) Arthritis-Attributable Work Limitation Among Adults with Arthritis 18-64 Years Old (NHIS 2002)

Figure 2. Arthritis-Attributable Activity Limitation Among Adults with Arthritis, NHIS 2003-2005 (1) and Arthritis-Attributable Work Limitation Among Adults with Arthritis Ages 18-64 Years, NHIS 2002 (2)

Figure 2b. (1)Arthritis-Attributable Activity Limitation Among Adults with Arthritis, NHIS 2007-2009 and (2) Arthritis-Attributable Work Limitation Among Adults with Arthritis Ages 18-64 Years, NHIS 2002.

[A text description of this graph is also available.]

Data Source: 2007-2009 National Health Interview Survey; 2002 National Health Interview Survey

  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 [1.61 MB]
  2. Bolen J, Schieb L, Hootman JM, Helmick CG, Theis K, Murphy LB, et al. Differences in the prevalence and impact of arthritis among racial/ethnic groups in the United States, National Health Interview Survey, 2002, 2003, and 2006. Prev Chronic Dis 2010;7(3). html pdf [319k]

NOTE: Arthritis-Attributable Activity Limitation = responding “yes” to “Are you now limited in any way in any of your usual activities due to arthritis or joint symptoms”; Arthritis-Attributable Work Limitation = among working age population (18–64 years), responding “yes” to being limited in the type, amount, or whether they work due to arthritis.

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Specific Functional Limitations Among People with Arthritis

Functional limitations in common daily activities are common among adults with arthritis; 40% report it is “very difficult” or they “cannot do” at least 1 of 9 important daily functional activities. For example, almost 8 million adults who report an activity limitation due to their arthritis also report severe limitation in their ability to stoop, bend or kneel, and 6 million cannot walk ¼ mile. Figure 3 shows the prevalence of specific functional limitations. Impairment in the ability to perform essential daily living activities may interfere with the ability of people with arthritis to work, function in their community, or care for their family.

Figure 3. Functional limitation is defined as 'very difficult' or 'cannot do' for the following activities: grasp small objects; reach above ones head; sit more than 2 hours; lift or carry 10 pounds; climb a flight of stairs; push a heavy object; walk a 1/4 mile; stand more than 2 hours; stoop, bend, or kneel, NHIS 2002.

Figure 3. Functional limitation is defined as "very difficult" or "cannot do" for the following activities: grasp small objects; reach above ones head; sit more than 2 hours; lift or carry 10 pounds; climb a flight of stairs; push a heavy object; walk a 1/4 mile; stand more than 2 hours; stoop, bend, or kneel, NHIS 2002.

Data Source: 2002 National Health Interview Survey

  1. Hootman JM, Jeffrey Sacks JJ, Helmick CG. Prevalence of arthritis-attributable activity limitations among adults with doctor-diagnosed arthritis, United States, 2002. Arthritis Rheum 2004;50(9, suppl):5641.

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Excess Body Weight Among People With Arthritis

Obesity is a known risk factor for the development and progression of knee osteoarthritis and possibly osteoarthritis of other joints. For example, obese adults are up to 4 times more likely to develop knee osteoarthritis than normal weight adults1. About 35% of adults with doctor-diagnosed arthritis are obese compared to only 21% of those without arthritis. Reducing body weight may result in significant improvements in the health-related quality of life of people with arthritis.

Figure 4. Distribution of Body Mass Index among adults with and without arthritis, NHIS 2002

Figure 4. Distribution of Body Mass Index* Among Adults With and Without Arthritis, NHIS 2002

[A text description of this graph is also available.]

Data source: 2002 National Health Interview Survey

  1. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum 1998;41(8):1343–1355.

*NOTE: Body Mass Index (BMI) calculated using the formula weight in kilograms/height in meters2. Underweight/normal=BMI < 25; Overweight = BMI 25-29.99; Obese = BMI ≥ 30.

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Arthritis prevalence and impact by body weight

The prevalence of arthritis increases as body weight increases from 16.9% among normal/underweight adults to 29.6% among obese adults. Excess weight also contributes to activity limitations. Among normal/underweight adults with arthritis, 34.7% report arthritis-attributable activity limitations compared to 44.8% among obese adults with arthritis. Losing even modest amounts of weight (~11 pounds) can reduce your risk of getting arthritis and improve arthritis pain, function and quality of life if you are living with arthritis.

Figure 5A – A graph showing the prevalence of arthritis where under/normal weight adults is 16.9%, among overweight adults is 19.8% and among obese adults is 29.6%.

Figure 5a. Arthritis Prevalence by body weight, NHIS 2007-2009

Data source: 2007-2009 National Health Interview Survey

  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 [1.61 MB]

Figure 5B – A graph showing the prevalence of arthritis-attributable activity limitations where under/normal weight adults with arthritis is 34.7%, among overweight adults with arthritis is 35.0% and among obese adults with arthritis is 44.8%.

Figure 5b. Arthritis-attributable activity limitations among adults with arthritis by body weight, NHIS 2007-2009.

Data source: 2007-2009 National Health Interview Survey

  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 [1.61 MB]

*NOTE: Body Mass Index (BMI) calculated using the formula weight in kilograms/height in meters2. Underweight/normal=BMI < 25; Overweight = BMI 25-29.99; Obese = BMI ≥ 30.

Physical Activity Levels Among People With Arthritis

Although physical activity and exercise have been shown to benefit people with arthritis by improving pain, function, and mental health, many people with arthritis report no leisure time physical activity. Almost 44% of adults with doctor-diagnosed arthritis report no leisure time physical activity, a considerably higher proportion compared with adults without arthritis (36%). Low levels of physical activity place individuals with arthritis at further risk of inactivity-associated conditions such as cardiovascular disease, diabetes, obesity, and functional limitations.

Figure 5. Prevelance of physical inactivity among adults with and without arthritis, NHIS 2002

Figure 6. Prevalence of Physical Inactivity Among Adults with and without Arthritis, NHIS 2002

[A text description of this graph is also available.]

Data Source

  1. Shih M, Hootman JM, Kruger J, Helmick CG. Physical activity in men and women with arthritis, National Health Interview Survey, 2002. Am J Prev Med 2006;30(5):385-93.

*NOTE: Inactive = no reported leisure-time physical activity.

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Causes of Disability Among US Adults

A 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 continues to be the most common cause of disability, while back or spine problems and heart trouble round out the top three causes. Among adults reporting a disability, the most commonly identified limitations were difficulty climbing a flight of stairs (21.7 million, 10.0%) and walking 3 city blocks (22.5 million, 10.3%). That means that 1 in 10 adults have trouble walking a distance equal to walking from the parking lot to the back of a large store or through a mall.

Text description below

[Text description is available.]

Data Source: U.S. Census Bureau, 2004 Survey of Income and Program Participation, Wave 5, June-September 2005. as reported in: Hootman JM, Brault MW, Helmick CG, Theis KA, Armour BS. Prevalence and Most Common Causes of Disability Among Adults — United States, 2005. MMWR 2009;58(16):421-426. html; pdf [1.3Mb]

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