What Is Arthritis?

Arthritis literally means joint inflammation but is often used to refer to more than 100 different diseases and conditions that affect joints, surrounding tissues, and other connective tissues. Diseases or conditions falling under the broad label of arthritis can be characterized as inflammatory, degenerative, metabolic, or infectious. Some types of arthritis are not easily categorized.

Two common types of arthritis are osteoarthritis (OA), a degenerative disease affecting cartilage and rheumatoid arthritis (RA), an inflammatory disease affecting the synovium or the lining of the joint. Some other types of arthritis include:

• fibromyalgia
• systemic lupus erythematosus (SLE or lupus)
• ankylosing spondylitis
• gout
• bursitis tendinitis
• lyme arthritis (assosciated with lyme disease infection)
• juvenile rheumatoid arthritis (JRA)
• polymyalgia rheumatica
• polymyositis
• psoriatic arthritis

Why is Arthritis a Public Health Problem?

Arthritis is a serious public health challenge. Based on 2003–2005 data, 46.4 million (21.6%) U.S. adults reported being told by a doctor that they have arthritis, [Hootman J, Bolen J] making arthritis one of the nation’s most common health problems. As the U.S. population ages, these numbers are likely to increase dramatically. The number of people who report having doctor-diagnosed arthritis is projected to increase to 67 million in 2030. [Hootman JM, Helmick CG]

Arthritis is the most common cause of disability in the United States, limiting the everyday activities of nearly 19 million American adults [Hootman JM, Brault MW, Helmick CG, Theis KA, Armour BS] and causing negative physical, psychological, social, and economic effects.

Arthritis can affect anyone regardless of age, gender, or racial/ethnic group. Because arthritis is more common among older adults, many people think arthritisis an "old person's disease." In fact, children are also affected, and nearly two-thirds of people with arthritis are younger than 65. Arthritis is more common in women compared with men at all ages. It is important to note that the disabling effects of arthritis (e.g. arthritis-attributable activity limitations, work limitations, and severe pain) affect racial/ethnic minorities disproportionately. [Bolen J, Sniezek J]

Arthritis-attributable work limitation is very common among working-age adults with arthritis. In states with the lowest prevalence of work limitations due to arthritis, it is still reported by greater than 1 out of every 4 working-age adults with arthritis. In states with the highest prevalence of arthritis-attributable work limitation, that ratio jumps to approximately 1 out of every 2 working-age adults with arthritis.[Theis KA, Hootman JM]

In 2003, arthritis and other rheumatic conditions (AORC) cost the United States $127.8 billion ($80.8 billion in medical care expenditures and $47.0 billion in lost earnings), up from $86.2 billion in 1997. These national medical costs attributable to arthritis and other rheumatic conditions grew by 24% between 1997 and 2003 (in constant 2003 dollars).[Yelin E, Cisternas M]

Source: CDC. Prevalence of disabilities and associated health conditions among adults—United States, 1999. MMWR 2001;50:120-5

Effects of Arthritis

The National Arthritis Action Plan (NAAP) [Arthritis Foundation]: A Public Health Strategy—prepared under the leadership of the Arthritis Foundation, the Association of State and Territorial Health Officials (ASTHO), and CDC—lists the physical, psychological, social, and economic effects of arthritis.

Physical symptoms of arthritis include pain, loss of joint motion, and fatigue. Even after accounting for the expected effects of the symptoms, people with arthritis are significantly less physically active than the rest of the adult population and more inactive than can be explained by their disability alone.[Felson DT, Zhang Y] This level of inactivity puts them at higher risk for a variety of other diseases and conditions, including premature death, heart disease, diabetes, high blood pressure, colon cancer, overweight, depression, and anxiety. In fact, in its severe forms, arthritis can shorten life expectancy. The 1.3 million Americans with rheumatoid arthritis, for example, are at risk for premature death because of systemic complications of the disease and complications of its treatment.

Psychological stress, depression, anger, and anxiety often accompany arthritis. People with arthritis may experience difficulty coping with pain and disability, which in turn can lead to feelings of helplessness, low self-efficacy, and changes in self-esteem and self-image.

Social well-being is affected by arthritis. People with arthritis frequently experience decreased community involvement, difficulties in school, and sexual problems. These social problems are often aggravated by a lack of understanding and empathy among co-workers, employers, teachers, school nurses, and others.

Economic implications of arthritis include inadequate access to care, and financial burdens due to health care costs and income loss resulting from work limitations. More detail about costs relating to arthritis will be available in the next section.