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ARTHRITIS
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Common disability. Arthritis is the nation’s most common cause of disability. Nearly 19 million U.S. adults report activity limitations because of arthritis each year. Among all U.S. adults of working age (18–64 years), about 1 in 20 report that they have arthritis that limits their work. Among the 23 million adults with arthritis in this age group, arthritis-attributable work limitations affect about 1 in 3 people.
High lifetime risk. A recent community study estimated that the lifetime risk of developing knee osteoarthritis serious enough to cause painful symptoms is 45%. Risk increases to 57% among people with a past knee injury. Lifetime risk for knee osteoarthritis also goes up with increased weight, and 3 in 5 people who are obese are at risk.
High costs. In 2003, the total cost of arthritis was $128 billion, including $81 billion in direct costs (medical) and $47 billion in indirect costs (lost earnings). This total is equal to 1.2% of the 2003 U.S. gross domestic product. Each year, arthritis results in 992,100 hospitalizations and 44 million outpatient visits.
Risky complications. Arthritis makes it more difficult for people to be physically active, and not being physically active is a risk factor for many chronic diseases. More than half of adults with diabetes or heart disease also have arthritis. Research shows that pain, fear of pain, fear of worsening symptoms or damaging joints, and lack of information on how to exercise safely prevent people with arthritis from being physically active. To effectively manage chronic conditions such as diabetes, heart disease, and obesity, people with arthritis need help finding ways to overcome arthritis-specific barriers to physical activity.
Learn techniques to manage arthritis. Self-management education programs such as the Arthritis Foundation’s Self-Help Program can teach people how to manage arthritis and lessen its effects. This 6-week course reduces arthritis pain by 20% and physician visits by 40% for participants. Unfortunately, this program is not available in all areas of the country. More widespread use of this program and similar courses, 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.
Be physically active. For people with arthritis, physical activities such as walking, bicycling, and swimming have been shown to have significant benefits, including reducing pain and improving physical function, mental health, and quality of life. The Arthritis Foundation Exercise Program, the Arthritis Foundation Aquatics Program, and EnhanceFitness are three examples of community exercise programs that have been shown to improve health among participants.
Control your weight. Weight control and injury prevention measures can lower a person’s risk of developing osteoarthritis. Weight loss also can reduce symptoms for people with knee osteoarthritis.
Consult a physician. Early diagnosis and appropriate management are especially important for people with inflammatory arthritis. Recommendations from health care providers are the most influential factor in convincing people to take an arthritis self-management course.
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 (FY 2008) funding, CDC is working with the Arthritis Foundation, the National Association of Chronic Disease Directors (NACDD), state arthritis program directors, and other partners to improve quality of life for adults with arthritis.
These efforts include the National Arthritis Action Plan: A Public Health Strategy, 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.
In addition, CDC is convening science, program, and policy leaders in partnership with the Arthritis Foundation to develop a national public health agenda for addressing osteoarthritis, the most common type of arthritis and a frequent cause of disability and expensive joint replacement. The agenda will develop strategies for addressing osteoarthritis as a major public health issue in the next 5 years. CDC also will identify model dissemination efforts that can be replicated in other states, as well as models for working with partners and other chronic disease programs at state, regional, and national levels.
The primary goal of CDC’s Arthritis Program is to improve quality of life for people affected by arthritis. The program achieves this goal by supporting the following five key activities:
Working with its partners, CDC aims to expand arthritis programs and interventions nationwide to improve quality of life for people affected by arthritis and move state programs from building capacity to widespread implementation of effective programs through systems such as aging services agencies, cooperative extension programs, large health care systems, and large employers. CDC also is working to develop innovative interventions that meet the needs of diverse populations.
Modern medical knowledge and technology have greatly improved our nation’s overall health. However, not all people have benefited equally. Some racial and ethnic groups continue to experience persistent and escalating health disparities. Individuals in these groups face many barriers to getting medical care and staying healthy.
Cuídate is Spanish for “take care of yourself.” Cuídate is also a collaborative initiative designed to improve the health of Hispanics living in Florida by promoting good health practices and linking residents with community resources, such as self-management classes and low-cost clinics. It is funded by Florida Hospital’s Community Health Impact Council. Cuídate is offered in collaboration with the Central Florida Partnership on Health Disparities, a broad network of organizations in central Florida that serve and represent ethnic and racial groups in Orange, Osceola, Seminole, and Brevard counties.
Many partners support the initiative by providing materials, training, and funding. For example, the Arthritis Prevention and Education Program and the Heart Disease and Stroke Prevention Program in the Florida Department of Health provide educational materials for self-management workshops and facilitator trainings. The Centers for Health Futures at Florida Hospital trains leaders from other organizations, and the Arthritis Prevention and Education Program provides financial assistance for master-level training.
These collaborative efforts allow organizations to embed chronic disease self-management programs into health delivery systems throughout Florida, which helps the state build a sustainable infrastructure for future programs. The Heart of Apopka Project, for example, is working to reach at least 10,000 people with its self-management programs, which are in Spanish and English.
In late 2005, Michigan Partners on the PATH (MI-PATH) began as a collaborative effort to implement evidence-based interventions to address chronic diseases, including arthritis. Partners include the Michigan Office of Services to the Aging, the Michigan State University Extension, and the Michigan Department of Community Health (MDCH).
PATH (Personal Action Toward Health) is Michigan’s name for Stanford University’s Chronic Disease Self-Management Program, an evidence-based intervention CDC recommends for people with arthritis. PATH teaches self-management skills to people with arthritis, as well as to those with other chronic diseases, such as asthma, heart disease, diabetes, and chronic lung diseases.
[A text description of this map is also available.]
MI-PATH now has more than 40 partner organizations, including the Arthritis Foundation Michigan Chapter, the National Kidney Foundation of Michigan, the Healthy Asian Americans Project, Medical Network One, the Michigan State University College of Nursing, the Health Alliance Plan, Senior Neighbors, and Access Health.
Since its inception, the Michigan Arthritis Program has played a vital role in the development of MI-PATH infrastructure to support statewide implementation and dissemination of the PATH program. MI-PATH has since evolved into regional PATH groups throughout Michigan. The support, partnership, and integration of chronic disease programs within the MDCH Chronic Disease Program are critical because of the many state residents who have arthritis and other chronic diseases. In 2007, 58.9% of residents with arthritis also had diabetes, 65.4% also had cardiovascular disease, 53.9% also had high blood pressure, and 46.7% also had high cholesterol.
In addition, several programs in the MDCH Division of Chronic Disease and Injury Control have demonstrated their commitment to MI-PATH by sharing resources and integrating PATH into their initiatives and work plans. Examples include programs that target arthritis, asthma, diabetes, cardiovascular health, people with disabilities, and osteoporosis. As a result, the number of counties offering workshops or leadership trainings increased 144% from September 2007 to September 2008, with more than half of the state’s 83 counties represented. In addition, the number of PATH workshops has doubled in the last year.
More than one-half of adults aged 65 years or older in Wisconsin have arthritis. Many are also obese, physically inactive, and have additional chronic conditions. The Wisconsin Arthritis Program, with CDC funding and in collaboration with the Arthritis Foundation Wisconsin Chapter and the state’s Aging Network, are using two evidence-based interventions to improve the health of state residents with arthritis. These interventions are the Arthritis Foundation Exercise Program and Living Well, a chronic disease self-management program.
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To ensure that these programs are reaching as many people as possible, Wisconsin officials created a statewide community resource map to identify interventions at the county level. This resource was used to identify gaps in services and ways for programs to collaborate and expand their services locally through promotion, referral, and cross-training.
At present, 20 instructors from nine facilities in Central Wisconsin have been cross-trained, and most are teaching both the Arthritis Foundation Exercise Program and Living Well. A recent workshop for public health and aging services professionals was designed to increase awareness and dialogue about how these programs can be used to effectively reach people with chronic conditions. Within 6 months of the cross-training, the number of people with arthritis who participated in the Arthritis Foundation Exercise Program more than doubled. These efforts have improved the availability and accessibility of evidence-based programs and expanded community infrastructure and capacity to address the barriers and needs of state residents with arthritis and other chronic conditions.
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Page last reviewed: January 15, 2009
Page last modified: January 15, 2009
Content source: National Center for
Chronic Disease Prevention and Health Promotion
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