Targeting Arthritis

Improving Quality of Life for More Than

46 Million Americans 

2008

AT A GLANCE

U.S. Department of Health and Human Services

Centers for Disease Control and Prevention

Coordinating Center for Health Promotion

“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

3.3%–6.0% 6.1%–7.2% 7.3%–14.6%

CT

DC

DE

MA

MD

NH

NJ

RI

VT

Arthritis-Attributable Work Limitations Affect 1 in 7 Working-Age

Adults in Some States*

* Age-adjusted population prevalence for adults aged 18–64 years.

Source: CDC, Behavioral Risk Factor Surveillance System, 2003.

January 2008
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 (see graph, page 3).

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 visits.

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 activity. 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 physical

function, and improve the quality of life for people with 

arthritis. For example,

 • 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 among participants.

 • 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 activity.

2

Arthritis: The Nation’s Most Common Cause of Disability

Annual Arthritis Burden

in United States

 • 46 million adults with self-reported,

doctor-diagnosed arthritis

 • Nearly 19 million people with

activity limitations

 • $128 billion in total costs

 • $81 billion in medical costs

 • 36 million outpatient visits

 • 750,000 hospitalizations

 • 9,500 deaths
3

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 selfmanagement.

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, as states entered the 

final year of their cooperative agreements with CDC, the agency 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. Current funding averages $140,000 for 28 states 

and $240,000 for 8 states. Funded 

states include Alabama, Alaska, 

Arizona, Arkansas, California, 

Colorado, Connecticut, Florida, 

Georgia, Idaho, Illinois, Indiana, 

Iowa, Kansas, Kentucky, Maryland, 

Michigan, Minnesota, Missouri, Nebraska, Nevada, New 

Mexico, New York, North Carolina, Ohio, Oklahoma,

Oregon, Pennsylvania, Rhode Island, South Carolina,

Tennessee, Texas, Utah, Vermont, Virginia, and Wisconsin.

 • 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.

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.

CDC’s Leadership in Arthritis Prevention and Control

0

10

20

30

40

50

60

70

Adults with Arthritis Adults with Arthritis-Attributable

Activity Limitations

In Millions

2010

52

19

56

21

59

22

63

24 25

67

Year

2015 2020 2025 2030

Projected Number of Adults with Arthritis

and Arthritis-Attributable Activity Limitations, 2005–2030

Source: Arthritis and Rheumatism 2006;54(1):226–229.
4

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 arthritis.

 • 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 life.

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.

Future Directions

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 large employers.

 • 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 populations.

 • 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: ccdinfo@cdc.gov • Web: http://www.cdc.gov/arthritis

State 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.

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