Improving Quality of Life for More Than
46 Million Americans
At A Glance
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“Public health in the future will be increasingly about
improving the quality of life, not merely its length. Arthritis, with the
pain and limitation it inflicts on millions of our people, young and old,
sits right in the center of that future.”
James S. Marks, MD, MPH
Senior Vice President and Director, Health Group
Robert Wood Johnson Foundation
Arthritis: The Nation’s Most Common Cause of Disability
What Is Arthritis?
Arthritis comprises over 100 different diseases and conditions. The most
common is osteoarthritis. Other frequently occurring forms of arthritis
include rheumatoid arthritis, lupus, fibromyalgia, and gout. Arthritis also
affects children. A recent study estimated that 1 in 250 children has some
form of arthritis or related condition.
Common 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.
Why Is Arthritis a Public Health Problem?
An estimated 46 million U.S. adults (about 1 in 5) reported
doctor-diagnosed arthritis, according to annual estimates from combined
2003–2005 data. As the U.S. population ages, these numbers are likely to
increase sharply. The number of adults with doctor-diagnosed arthritis is
projected to increase to 67 million by 2030, and a good proportion of U.S.
adults will have limited activity as a result.
Arthritis is the nation’s most common cause of disability. Nearly 19
million U.S. adults reported activity limitations because of arthritis each
year during 2003–2005. Among adults of working age (18–64 years), work
limitations attributable to arthritis affect about 1 in 20 adults in the
general population and one-third of those with arthritis. Each year,
arthritis results in 750,000 hospitalizations and 36 million outpatient
In 2003, the total cost of arthritis was $128 billion—nearly $81 billion
in direct costs and $47 billion in indirect costs, equal to 1.2% of the 2003
U.S. gross domestic product. Arthritis is not just an old person’s disease.
Nearly two-thirds of people with arthritis are younger than 65. Although
arthritis affects children and people of all racial and ethnic groups, it is
more common among women and older adults.
More than half of adults with diabetes or heart disease also have
arthritis. Physical activity is a crucial element of managing these chronic
conditions, but having arthritis presents barriers to increasing physical
Research shows that pain, fear of pain, and lack of information on
how to exercise safely prevents people with arthritis from exercising.
Effectively managing diabetes or heart disease in people with arthritis will
require targeting these barriers to encourage increased physical activity.
What Can Be Done to Target Arthritis?
There are effective ways to reduce symptoms, improve
function, and improve the quality of life for people with arthritis. For
Self-management education programs can reduce pain and
costs. The Arthritis Foundation’s Self-Help Program teaches people how
to manage arthritis and lessen its effects. This 6-week course reduces
arthritis pain by 20% and physician visits by 40%. However, courses are
not offered in all areas of the country.
More widespread use of this course and similar
programs, such as the Chronic Disease Self-Management Program, which
addresses arthritis along with other chronic diseases, could save money
and improve quality of life for people with arthritis.
Physical activity has been shown to have significant
benefits for people with arthritis, including reductions in pain and
improvements in physical function, mental health, and quality of life.
Community exercise programs, such as the Arthritis Foundation’s Exercise
Program or EnhanceFitness, have been shown to improve health status
Weight control and injury prevention measures can lower
a person’s risk for developing osteoarthritis. Weight loss can reduce
symptoms for people with knee osteoarthritis.
The pain and disability that accompany arthritis can be
decreased or avoided through early diagnosis and appropriate management,
including self-management activities such as weight control and physical
CDC's Leadership in Arthritis Prevention and Control
What Are CDC and Its Partners Doing About Arthritis?
CDC is committed to leading strategic public health efforts to promote
well-being, prevent chronic disease, and achieve health equity. With $13
million in fiscal year 2008 funding, CDC is working with the Arthritis
Foundation and other partners to improve the quality of life for adults with
arthritis and to change people’s attitudes and behaviors related to
For example, the National Arthritis Action Plan: A Public Health
Strategy was developed by CDC, the Arthritis Foundation, the Association
of State and Territorial Health Officials, and 90 other organizations to
address the growing problem of arthritis. By implementing the goals of the
action plan, CDC and its partners are moving toward achieving the first-ever
arthritis-related national objectives outlined in Healthy People 2010.
What Activities Does CDC’s Arthritis Program Support?
The primary goal of CDC’s arthritis program is to improve
the quality of life for people affected by arthritis. The program achieves
this goal by supporting the following five key activities:
1. Building state programs.
Over the past 5 years, state health departments have
successfully used CDC funding to build capacity in their arthritis programs.
These efforts include creating new partnerships, increasing public
awareness, improving their ability to monitor the burden of arthritis, and
delivering evidence-based interventions.
In Spring 2007, CDC convened national experts to guide
future program directions. These experts made several important
recommendations, including the following:
Fund state programs at higher levels to address
arthritis through broader public health efforts (previous funding
averaged $160,000 per state in 36 states).
Work to expand evidence-based interventions. Develop new
interventions and expand existing ones to provide services to more
people with arthritis.
Create and expand innovative partnerships at local,
state, and national levels.
Consider national campaigns, marketing and health
communications, and policy interventions.
These recommendations will drive future state program
activities, building on the lessons learned by the 36 states funded during
2003–2008. For the next cooperative agreement period, 2008–2011, CDC
has funded 12 states, with average funding of about $500,000. This funding
level is on par with other major chronic disease programs.
CDC also is working with the National Association of Chronic
Disease Directors (NACDD) to support efforts in other states to integrate
arthritis interventions into existing chronic disease programs.
2. Reaching the Public.
CDC, working with state health departments and Arthritis
Foundation chapters, developed a communications campaign that promotes
physical activity among people with arthritis who are aged 45–70 and of low
socioeconomic status. The “Physical Activity. The Arthritis Pain Reliever.”
campaign has been used by state health departments and several Arthritis
Foundation chapters. A similar campaign for Hispanic audiences is now
available, and a new physical activity campaign is being developed.
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3. Improving the science base.
CDC supports research to learn more about arthritis and effective
management strategies. For example,
- Systemic lupus erythematosus is a serious autoimmune inflammatory
disease that affects multiple systems in the body. It can be difficult
to diagnose, and prevalence estimates vary widely. CDC is supporting
researchers at the University of Michigan and Emory University, through
the Michigan and Georgia state health departments, to establish
registries to produce more reliable estimates of lupus.
- Physical activity is crucial for arthritis self-management. CDC is
evaluating existing physical activity programs and developing new ones
for people who have arthritis. Walking is one of the most feasible forms
of physical activity for most people, since it is low impact, requires
no special equipment or facilities, and can be done anywhere and
at anytime. CDC is supporting researchers at the University of North
Carolina at Chapel Hill to evaluate group-based and self-directed
walking programs among a culturally diverse sample of adults with
- Self-management education programs have been proven to reduce pain
and costs, yet not all people with arthritis are able to participate.
CDC is supporting researchers at the University of North Carolina at
Chapel Hill and Stanford University to develop and evaluate programs
that can be delivered by mail or online, making self-management
education more widely available.
4. Measuring the burden of arthritis.
At the national level, CDC uses surveys to define the burden
of arthritis, monitor trends, and assess how arthritis affects quality of
life. At the state level, CDC and states use the Behavioral Risk Factor
Surveillance System (BRFSS) to collect arthritis data. In addition, the
Arthritis Conditions Health Effects Survey (ACHES), a national telephone
survey completed in 2006 among adults aged 45 years or older who reported
arthritis, collected information about the effects of arthritis on everyday
5. Making policy and systems changes.
CDC’s epidemiology and surveillance activities collect data
useful to policy decision makers. Examples include cost estimates and data
on arthritis-attributable work limitations at state and national levels. CDC
researchers also collect and analyze data on the occurrence of arthritis
among people with diabetes and heart disease, as well as related risk
factors. Future CDC and state efforts will include attention to these risk
factors as starting points for policy changes that support public health
approaches to addressing arthritis. In partnership with the Arthritis
Foundation, CDC is convening science, program, and policy leaders to develop
a national public health agenda for addressing osteoarthritis, the most
common type of arthritis and a frequent cause of disability. The agenda will
develop strategies for making osteoarthritis a major public health issue in
the next 5 years.
Programs in Action: Minnesota
The Minnesota Arthritis
Program partnered with the Elderberry Institute Living at Home Block
Nurse Program, which delivers community services that help older
adults remain at home as long as possible. This partnership allowed
the arthritis program to significantly expand the reach of
self-management education and exercise programs across the state.
For example, the number of new participants in the Arthritis
Foundation Self-Help Program increased 229% in 2006. The number of
new participants in the Arthritis Foundation Exercise Program
increased 125%. These programs are now available in 50 of the
state’s 87 counties.
With funded states and other partners, CDC aims to
- Create a nationwide program to improve the quality of life for
people affected by arthritis.
- Build on expert recommendations to move state programs from building
capacity to implementing programs on a wider scale. CDC will focus on
providing effective programs through groups that already work with
people with arthritis. Examples include networks of aging services
agencies, cooperative extension programs, large health care systems, and
- Identify model dissemination efforts that can be replicated in other
states, as well as models for working with partners at state, regional,
and national levels.
- Develop innovative interventions that meet the needs of diverse
- Work collaboratively with other chronic disease programs at federal
and state levels.
For more information or copies of the
National Arthritis Action Plan: A Public Health Strategy, please contact
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
4770 Buford Highway NE, Mail Stop K–51, Atlanta, GA 30341-3717
Telephone: 770-488-5464 • E-mail: firstname.lastname@example.org • Web:
Page last reviewed: July 29, 2008
Page last modified: July 29, 2008
Content source: National Center for
Chronic Disease Prevention and Health Promotion