Arthritis: The Nation's Most Common Cause of Disability
Chronic diseases are the leading causes of death and disability in the United States. CDC’s National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) is at the forefront of the nation’s efforts to prevent and control chronic diseases such as arthritis.
What Is Arthritis?
Arthritis includes more than 100 different rheumatic diseases and conditions, the most common of which is osteoarthritis. Other forms of arthritis that occur often are rheumatoid arthritis, lupus, fibromyalgia, and gout. Symptoms include pain, aching, stiffness, and swelling in or around the joints. Some forms of arthritis, such as rheumatoid arthritis and lupus, can affect multiple organs and cause widespread symptoms.
Arthritis is more common among adults aged 65 years or older, but people of all ages (including children) can be affected. Nearly two-thirds of people with arthritis are younger than 65. Arthritis is more common among women (24.3%) than men (18.7%) in every age group, and it affects members of all racial and ethnic groups. Arthritis is also more common among adults who are obese than among those who are normal weight or underweight.
Why Is Arthritis a Public Health Problem?
High prevalence. An estimated 50 million U.S. adults (about 1 of 5) report having doctor-diagnosed arthritis. As the U.S. population ages, the number of adults with arthritis is expected to increase sharply to 67 million by 2030.
High lifetime risk. One community study estimated that the lifetime risk of developing knee osteoarthritis that causes pain is 45%. Researchers estimate that 57% of people who have had a knee injury and 60% of people who are obese will develop osteoarthritis.
Common disability. Arthritis is the nation’s most common cause of disability. It limits the activities of 21 million Americans—for example, preventing them from being able to climb stairs or walk more than short distances. For 1 of 3 adults of working age (18–65 years) with arthritis, it can limit the type or amount of work they do or whether they can work at all.
Occurs with other chronic conditions. Among U.S. adults with arthritis, nearly half (47%) have at least one other disease or condition. In addition, more than half of adults with heart disease (57%) or diabetes (52%) and more than one-third with high blood pressure (44%) or obesity (36%) also have arthritis.
Discourages physical activity. Research has shown that people with arthritis are less likely to be physically active. Some people believe that being active will cause pain, make their symptoms worse, or damage their joints. Others don’t know how to exercise safely. Nearly 44% of adults with arthritis report no leisure-time physical activity (compared with about 36% of those without arthritis). Not being physically active is a risk factor for other chronic diseases (e.g., heart disease, diabetes, obesity) and makes it harder to manage these conditions.
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What Can People Do to Prevent and Control Arthritis?
People can manage and reduce the symptoms of arthritis in many ways. For example, they can:
Learn ways to manage arthritis. Self-management education interventions, such as the Arthritis Self-Management Program or the Chronic Disease Self-Management Program, can teach people with arthritis how to manage their condition, lessen its effects, and improve their quality of life.
Be physically active. For people with arthritis, physical activities such as walking, bicycling, and swimming can have many benefits. These benefits include less pain and better physical function, mental health, and quality of life. The Walk with Ease Program, the Arthritis Foundation Exercise Program, and the Senior Services’ EnhanceFitness program are examples of community exercise interventions that have been shown to improve health among participants with arthritis.
Maintain a healthy weight and protect your joints. People can reduce their risk of developing osteoarthritis by controlling their weight and avoiding injuries. Weight loss also can reduce symptoms for people with knee osteoarthritis who are overweight or obese.
Ask a doctor. Recommendations from health care providers are among the most influential factors in convincing people to be physically active and join a self-management program. People with inflammatory arthritis will have a better quality of life if they are diagnosed early and learn how to manage this condition.
CDC is committed to leading strategic public health efforts to prevent chronic conditions, help people be healthier, and end health disparities. To be more effective, the NCCDPHP is working to coordinate its efforts in four key areas or domains: Epidemiology and Surveillance, Environmental Approaches, Health System Strategies, and Community-Clinical Links. Better coordination will lead to more effective interventions and more efficient use of resources.
With $12.3 million in FY 2013 funding, CDC is working with state arthritis program directors, the Arthritis Foundation, the National Association of Chronic Disease Directors (NACDD), and other partners to improve quality of life for adults with arthritis. These efforts are based on strategies in the National Arthritis Action Plan: A Public Health Strategy and recommendations from A National Public Health Agenda for Osteoarthritis (OA Agenda). CDC’s Arthritis Program supports these efforts by focusing its activities in three of NCCDPHP’s four domains: Epidemiology and Surveillance, Environmental Approaches, and Community-Clinical Links.
Epidemiology and Surveillance
CDC collects a wealth of data on arthritis, including information on incidence, deaths, trends, and how the disease affects quality of life for people with multiple conditions. Tools used
to collect these data include the Behavioral Risk Factor Surveillance System and the National Health Interview Survey. Public health practitioners use these data to make the most of limited resources and focus their efforts to help people with arthritis.
CDC also supports surveillance research on lupus (systemic lupus erythematosus), an autoimmune inflammatory disease that affects multiple systems in the body. The condition is difficult to diagnose, and prevalence estimates vary widely. CDC is supporting research at four universities and the Indian Health Service as a way to produce better estimates of the incidence and prevalence of lupus among blacks, whites, Hispanics/Latinos, Asians, and American Indians/Alaska Natives in the United States.
Identifying Best Practices
CDC supports research to learn what interventions and practices are most effective in helping people with arthritis. A recent analysis of the Arthritis Self-Management Program and Chronic Disease Self-Management Program that looked at results from multiple studies found that these programs could have lasting positive effects on people’s quality of life. These findings will help clinical and public health practitioners and decision makers decide whether to use these types of interventions. For more information about this analysis, visit http://www.cdc.gov/arthritis/interventions/marketing-support/self-management/index.htm.
CDC is a sponsor and member of the Osteoarthritis (OA) Action Alliance. The Arthritis Foundation created this national coalition to promote and respond to the goals and recommendations in the OA Agenda. Through this coalition, CDC, the Arthritis Foundation, and 44 other partners are working together to reduce the negative health effects of osteoarthritis by coordinating and promoting evidence-based strategies. Examples include transportation, land use, and community design policies that promote the creation of active living environments that make it easier for adults with arthritis to be physically active.
Supporting State Health Departments
State health departments use funding from CDC to expand the reach of evidence-based interventions. To help ensure long-term success, interventions are delivered at the community level through existing and new partners and organizations, such as YMCAs, cooperative extension service programs, and state and local recreation and parks associations. In 2012, CDC began a new 5-year cooperative agreement that gave 12 states an average of $427,000 a year to use innovative, system-based strategies and communication approaches to reach adults with arthritis. State programs will build on the successes and lessons learned from previous efforts. For example, health workers have found that coordinating their efforts across chronic disease programs helps them reach people with multiple conditions. They also found that interventions are more sustainable when they are embedded into community-based organizations and that existing delivery systems can be used to make interventions more accessible.
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Reaching the Public
During 2008–2012, state arthritis programs funded by CDC reached more than 132,000 people with arthritis. The interventions used by these programs are expected to reach even more people by the end of the current cooperative agreement. In 2012, the YMCA moved to phase II of its pilot project to expand the use of the EnhanceFitness program at YMCA facilities across the country. The EnhanceFitness program has been proven to help people with arthritis increase strength and endurance. CDC and the NACDD are supporting this project. CDC is also working with other partners, including the Arthritis Foundation, the National Recreation and Parks Association, and the American Physical Therapy Association, to expand access to other arthritis interventions.
CDC will continue to work with its partners to make sure more people have access to interventions that will help them manage their arthritis. We will also continue to help state programs promote the use of environmental approaches that help people with arthritis be more physically active and improve the quality of their lives. In addition, CDC is working to develop self-study interventions that can be downloaded from the Internet or mailed to people’s homes.
For more information, please contact the Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
4770 Buford Highway NE, Mail Stop F-76, Atlanta, GA 30341-3717
Telephone: 800-CDC-INFO (232-4636) • TTY: 888-232-6348