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Arthritis By
The Numbers
TABLE OF CONTENTS
Introduction.......................................................................................................... 3
Section 1: General Arthritis Facts........................................................................... 5
Section 2: Osteoarthritis (OA)................................................................................ 9
o Prevalence.......................................................................................................................................10
- U.S. Military Prevalence...........................................................................................................10
- Global Prevalence.....................................................................................................................11
o Human and Economic Burdens.....................................................................................................11
- Economic Burden.......................................................................................................................12
- Knee, Hip and Shoulder OA Burden.......................................................................................13
- Global Burden...........................................................................................................................15
Section 3: Autoimmune and Inflammatory Arthritis............................................... 17
•Rheumatoid Arthritis (RA)...................................................................................... 18
o Prevalence ......................................................................................................................................18
o Human and Economic Burdens.....................................................................................................18
o Comorbidities..................................................................................................................................19
•Spondyloarthritis (SpA).......................................................................................... 20
o Prevalence ......................................................................................................................................20
o Human and Economic Burdens.....................................................................................................20
•Psoriatic Arthritis (PsA)........................................................................................... 21
o Prevalence ......................................................................................................................................21
o Human and Economic Burdens.....................................................................................................21
•Systemic Lupus Erythematosus (SLE or Lupus)......................................................... 23
o Prevalence ......................................................................................................................................23
o Human and Economic Burdens.....................................................................................................23
Section 4: Juvenile Idiopathic Arthritis (JIA)........................................................... 27
o Prevalence.......................................................................................................................................28
o Human and Economic Burdens.....................................................................................................28
Section 5: Gout..................................................................................................... 31
o Prevalence.......................................................................................................................................32
o Human and Economic Burdens.....................................................................................................32
Section 6: Fibromyalgia........................................................................................ 35
o Prevalence.......................................................................................................................................36
o Human and Economic Burdens.....................................................................................................36
o Juvenile-Onset Fibromyalgia.........................................................................................................36
Conclusion............................................................................................................ 37
References ........................................................................................................... 38
Appendix 1: Types of Arthritis............................................................................... 44
Appendix 2: Arthritis Prevalence in the U.S........................................................... 45
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INTRODUCTION
Arthritis is creating a serious health crisis that affects millions of people of all ages, genders, races and ethnic groups – and it’s
growing. As America’s number one cause of disability, arthritis can seriously limit people’s mobility – preventing them from
walking, climbing stairs, bathing, getting dressed, preparing meals and living live to its fullest. Arthritis is a group of serious
diseases that steals people’s quality of life.
Arthritis is a large and very complex family of diseases. No matter what type, it can cause damage in ways most people don’t
realize – physically, emotionally and financially. There are more than 100 types of arthritis and related conditions. But the
common thread is that they all attack joints and connective tissues, making everyday life challenging, often very difficult – and
some tasks are impossible.
By the numbers, more than 50 million adults in the United States have been doctor-diagnosed with some type of arthritis. By
2030, the number of adults in the U.S. with arthritis is expected to increase to 67 million. While estimates vary by location, about
one child in every 1,000 children in the U.S. (or a total of 70,000 children) has been diagnosed with juvenile idiopathic arthritis.
The estimates are higher when other childhood forms of arthritis and other rheumatic conditions are included. The thing we can be
certain of is that the prevalence of all types of arthritis will increase as the population increases – unless a cure is found.
The Arthritis Foundation is a leader among health organizations. We have been helping people with arthritis for seven decades,
and we’re behind many advances in both research and today’s clinical treatments. Our pursuit of a cure continues today through
our ongoing support of innovative research.
As an advocacy organization, the Arthritis Foundation is the voice of people with arthritis. We are a volunteer-driven organization that reaches and touches the lives of a broad cross-section of patients. The Foundation routinely partners with organizations
conducting value assessments to inform their methodology and to ensure that treatment needs of people who suffer from arthritis
are included. To fully integrate the patient perspective, it is vital to acknowledge the diversity of patient populations, include
outcomes important to patients and utilize patient-centered data resources.
Overall, the Arthritis Foundation wants to ensure that people with arthritis have access to the treatments and health care they
need to live full, meaningful and productive lives. However, physical well-being is only one dimension of arthritis. Another is
the economic burden. Arthritis is one of the top chronic conditions leading to death and disability in the U.S. (CDC 2016). As
of 2012, spending for the treatment of musculoskeletal conditions ranked third in the country (Peterson-Kaiser Health System
2016). The challenges faced by U.S. health care may well be conquerable, but will not be conquered without first addressing the costs of arthritis.
The following pages detail more than 200 observations about arthritis. Each has been carefully researched and published in
peer-reviewed journals by leaders in the field. This publication is designed to provide thought leaders (elected, academic,
industrial, professional and patient advocates) with a trustworthy set of facts. The data will be updated periodically to include the
most up-to-date information available. You can access this publication, and additional arthritis information, at arthritis.org.
Together, we can make the essential case for prioritizing science and policy that advance the needs of people with arthritis.
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Arthritis Foundation
TO D AY M O R E T H A N
50 M I L L I O N A M E R I C A N S
H AV E A R T H R I T I S
(Hootman 2016)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Section 1:
General Arthritis Facts
What Is Arthritis?
Arthritis is very common but not well understood. Actually,
“arthritis” is not a single disease; it is an informal way of referring
to joint pain or joint disease. There are more than 100 different
types of arthritis (see Appendix) and related conditions. People of
all ages, genders and races can and do have arthritis, and it is the
leading cause of disability in the United States. More than 50 million
adults and almost 300,000 children have arthritis or some other
type of rheumatic disease. It is most common among women and
occurs more frequently as people get older.
Common arthritis joint symptoms include swelling, pain, stiffness
and decreased range of motion. Symptoms may come and go, and
can be mild, moderate or severe. They may stay about the same for
years, but may progress or get worse over time. Severe arthritis
can result in chronic pain, inability to do daily activities and make it
difficult to walk or climb stairs. Arthritis can cause permanent joint
changes. These changes may be visible, such as knobby finger
joints, but often the damage can only be seen by X-ray. Some types
of arthritis also affect the heart, eyes, lungs, kidneys and skin as
well as the joints.
The following facts describe some of the features common to all
forms of arthritis.
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Arthritis Foundation
- There are more than 100 types of arthritis. (CDC 2016)
- Arthritis affects about 1 in 4 adults. (Barbour 2017)
- In 2010-2012, 52.5 million adults in the US (22.7percent of all
adults) had doctor-diagnosed arthritis, and 22.7 million (9.8
percent) had arthritis-attributable activity limitation. (Barbour 2013)
- Today more than 50 million Americans have arthritis.
Arthritis affects about
1 in 4 adults
(Hootman 2016)
- About 43 percent of people with arthritis have arthritisattributable activity limitations. (Hootman 2016)
(Barbour 2017)
- By 2015, 23.7 million adults reported activity limitation due to
their arthritis. (Barbour 2017)
- By 2040, the number of US adults with doctor-diagnosed
arthritis is projected to increase 49percent to 78.4 million (25.9
percent of all adults), and the number of adults with arthritis-attributable activity limitation will increase 52 percent to 34.6
million (11.4 percent of all adults). (Hootman 2016)
- In 2014, approximately one-fourth of adults with arthritis had
severe joint pain (27 percent).
- Among adults with arthritis, the prevalence of severe joint pain
was 27 percent, with the highest prevalence among persons 45
to 64 years old (31 percent). (Barbour 2016)
- Severe joint pain was higher among women (29 percent) and
those who had fair or poor health (49 percent), obesity (32
percent), heart disease (34 percent), diabetes (40.9 percent) or
serious psychological distress (56 percent). (CDC 2016)
- The prevalence of severe joint pain among adults with arthritis
was stable from 2002 to 2014, but the absolute number of adults
with severe joint pain was significantly higher in 2014 (14.6
million) than in 2002 (10.5 million) due, in part, to population
growth. (CDC 2016)
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- The prevalence of arthritis was 22.7 percent from 2010 to 2012. (CDC 2016)
- Almost 50 percent of adults 65 years or older reported
doctor-diagnosed arthritis from 2010-2012. (Barbour 2013)
- Between 2010 and 2012, arthritis was more common among
women (26 percent) than men (19 percent). (Barbour 2013)
- Arthritis is also more common among adults who are obese
than among those who are normal weight or underweight.
(Barbour 2013)
- About 4 million Hispanic adults have reported being doctordiagnosed with arthritis. (Barbour 2013)
- Almost 6 million non-Hispanic blacks have reported being
doctor-diagnosed with arthritis.
(Barbour 2013)
- By the year 2040, the number of people in the U.S. with arthritis
- older than the age of 65 is projected to grow from the
current 15 percent of the population to 21 percent.
- age 85 and older will double from the current less than 2
percent to 4 percent.
Arthritis by the Numbers | Book of Trusted Facts & Figures
- Health care services worldwide will face severe financial pressures in
the next 10 to 20 years due to the escalation in the number of people
affected by musculoskeletal diseases. (BMUS 2014)
- Obesity affects 36.5 percent of all adults in the US, occurs
frequently among those with arthritis. (Barbour 2016)
- Obesity and arthritis are more likely to have arthritis activity and
work limitation, be physically inactive, report depression and
anxiety, and have an increased risk of expensive knee replacement. (Barbour 2016)
- Between 2010 and 2012 in the U.S.:
- Almost half of the people with either heart disease or
diabetes also had doctor-diagnosed arthritis. Of
those, about one in four reported arthritis-attributable
activity limitations.
- Almost one in three people who were obese also had
doctor-diagnosed arthritis. Of those, about 15 percent
reported arthritis-attributable activity limitations.
- About one in five adults 18 and older (52.5 million) had
self-reported doctor-diagnosed arthritis. Of those, almost
half reported arthritis-attributable activity limitations.
(CDC 2013)
- Increase in obesity prevalence in older adults with doctor-diagnosed arthritis was not limited to those with poor health characteristics, but also occurred among those who reported meeting
physical activity recommendations, had very good/excellent
health and did not have a disease, diabetes, or serious psychological distress. (Barbour 2016)
- Researchers from the Centers for Disease Control and Prevention
found that one-third of U.S. adults with arthritis, 45 years and
older, report having anxiety or depression. (Murphy 2012)
Anxiety is nearly twice as common as depression among people
with arthritis, despite more clinical focus on the latter mental health
condition. (Murphy 2012)
- Annually 172 million work days are lost due to arthritis and other
rheumatic conditions. (BMUS 2014)
- In 2010 there were more than 100 million outpatient visits due to
arthritis. (BMUS 2014)
- In 2011 there were an estimated 6.7 million hospitalizations due
to arthritis. (BMUS 2014)
- In 2011 there were 757,000 knee replacements and 512,000
hip replacements. (BMUS 2014)
- Nearly one in four adults with arthritis also has heart disease.
(Murphy 2012)
Adults with Arthritis
- Among people with arthritis, 19 percent also have chronic
respiratory conditions and 16 percent also have diabetes. It’s
believed that arthritis likely comes first and results in these other
health problems. (Murphy 2012)
- Arthritis is the leading cause of disability among adults in the U.S.
(Barbour 2013)
64%
- In 2011, the cost directly attributed to treatment of arthritis
conditions in the U.S. is $116.1 billion. (Barbour 2013)
Under 65 years old
- Arthritis is strongly associated with major depression (attributable risk of 18.1 percent), probably through its role in creating
functional limitation. (Dunlop 2004)
(Barbour 2016)
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Arthritis Foundation
A N N U A L LY 172 M I L L I O N W O R K
D AYS A R E LO ST D U E TO
A R T H R I T I S A N D OT H E R
R H E U M AT I C C O N D I T I O N S
(BMUS 2014)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Section 2:
Osteoarthritis
What is Osteoarthritis?
Sometimes called degenerative joint disease or degenerative arthritis,
osteoarthritis (OA) is the most common chronic condition of the joints,
affecting more than 30 million Americans. OA can affect any joint, but
it occurs most often in knees, hips, lower back and neck, small joints of
the fingers and the bases of the thumb and big toe.
In normal joints, cartilage covers the end of each bone. Cartilage
provides a smooth, gliding surface for joint motion and acts as a
cushion between the bones. In OA, the cartilage breaks down,
causing pain, swelling and problems moving the joint. As OA
worsens over time, bones may break down and develop growths
called spurs. Bits of bone or cartilage may chip off and float around
in the joint. In the body, an inflammatory process occurs and
cytokines (proteins) and enzymes develop that further damage the
cartilage. In the final stages of OA, the cartilage wears away and
bone rubs against bone, leading to joint damage and more pain.
The following facts describe some of the features common to OA.
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Arthritis Foundation
Prevalence
- More than half of all individuals with diagnosed symptomatic
knee osteoarthritis (OA) have had sufficient progression of OA to
make them eligible for knee replacement. (Deshpande 2016)
- Today an estimated 30.8 million adults have osteoarthritis.
(Cisternas 2015)
- In U.S. adults, osteoarthritis is considered to be the most common
form of arthritis and the most common cause of disability.
(Lawrence 2008)
- Many people with symptomatic knee osteoarthritis (OA)
who are younger than 65 will live for three decades or more,
substantially increasing the chance for greater disability to occur.
(Deshpande 2016)
- Prevalence increases with age, ranging from about 2 percent
among persons younger than 45 to more than 80 percent among
those aged 75 and older. (Berger 2011)
- Among people younger than 45, osteoarthritis is more prevalent
among men; among those age 45 and older, it is more prevalent
among women. (Berger 2011)
- In 2010, the prevalence of symptomatic knee osteoarthritis (OA)
in patients 45 and older has been estimated between 5.9 and
13.5 percent in men and 7.2 and 18.7 percent in women. Approximately 10 million adults had symptomatic knee OA. (AAOS 2013)
- In people age 55 and younger, the prevalence of knee osteoarthritis (OA) in men is lower compared to women. (Heidari 2011)
- The prevalence of symptomatic knee osteoarthritis (OA) increases
with each decade of life, with the annual incidence of knee OA
being highest between 55 and 64 years old. (Deshpande 2016)
- About 13 percent of women and 10 percent of men age 60 and
older have symptomatic knee osteoarthritis (OA). (Zhang 2010)
- The prevalence of symptomatic knee osteoarthritis has been
increasing over the past several decades in the U.S., concurrent
with an aging population and the growing obesity epidemic.
US Military Prevalence
- One of every three military veterans in the United States lives with
arthritis. (CDC 2014)
(Deshpande 2016)
- The overall number of people in the U.S. with symptomatic knee
OA is nearly identical between those between the ages of 45 and
64 compared to those older than 65. (Deshpande 2016)
- There are 14 million individuals in the U.S. who have symptomatic
knee osteoarthritis. (Deshpande 2016)
- Nearly 2 million people under the age of 45 and 6 million
people between 45 and 64 have symptomatic knee osteoarthritis.
- A study of combat-injured soldiers found that osteoarthritis was
the most common unfitting condition, with 94.4 percent of osteoarthritis cases attributable to combat injury. (Rivera 2012)
- The rate of osteoarthritis in military service members ages 20 to
24 is 26 percent higher than the general population. (Cameron 2011)
- The rate of osteoarthritis in military personnel age 40 and older is
twice as high as the general population. (Cameron 2011)
(Deshpande 2016)
- Osteoarthritis is the most common cause of disability among
service members who are medically separated from active duty.
- More than 3 million people identifying as a racial/ethnic
minority have symptomatic knee OA, and that number is expected
to rise. (Deshpande 2016)
(Cross 2011)
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- Among service members 25 and older, the rate of osteoarthritis
(OA) overall was higher among black, non-Hispanics than other
racial/ ethnic group members. The rate of shoulder OA was higher
among males than females. (Williams 2016)
Arthritis by the Numbers | Book of Trusted Facts & Figures
- Among service members 35 and older, rates of OA of the knee
and pelvic region/thigh were higher among females than males.
(Williams 2016)
Global Prevalence
- Osteoarthritis (OA) is the most common articular disease of the
developed world and a leading cause of chronic disability, mostly
as a consequence of knee OA and/or hip OA. (Grazio 2009)
- The prevalence of osteoarthritis (OA) increases with age, up to
80 percent in people over 65 in high-income countries.
(Fernandes 2013)
1 in 3
Military Veterans
in the U.S
- As the world’s population continues to age, it is estimated that
degenerative joint disease disorders such as osteoarthritis will
impact at least 130 million individuals around the globe by the
year 2050. (Maiese 2016)
lives with arthritis
(CDC 2014)
- At least 15 percent of all adults over the age of 60 are believed
to suffer from this disorder with women having greater prevalence
of osteoarthritis than men. (Maiese 2016)
- Advanced age, obesity, genetics, gender, bone density, trauma
and a poor level of physical activity can lead to the onset and
progression of osteoarthritis. (Gabay 2016)
- It is estimated that worldwide, 9.6 percent of men and 18.0
percent of women over the age of 60 suffer with osteoarthritis (OA).
- Osteoarthritis is linked to increased rates of comorbidity (e.g.,
obesity, diabetes and heart disease). (Suri 2012)
(Maiese 2016)
- Osteoarthritis is thought to be the most prevalent of all musculoskeletal pathologies, affecting an estimated 10 percent of the
world’s population over the age of 60. (Pereira 2011)
- In the U.S., about 65 percent of patients with osteoarthritis are
prescribed NSAIDs, making them one of the most widely used
drugs in this patient population. (Gore 2012)
- Osteoarthritis ranks fifth among all forms of disability worldwide.
- Females, particularly those 55 and older, tend to have
more severe osteoarthritis in the knee but not in other sites.
(Murray 2012)
(Srikanth 2005)
- Hip and knee osteoarthritis represent a substantial cause of
disability worldwide and are responsible for approximately 17
million years lived with disability globally. (Cross 2014)
- Osteoarthritis accounts for more than 25 percent of all arthritis
related health care visits. (AAOS 2008)
Human and Economic Burdens
- A greater proportion of individuals with osteoarthritis are reported
to have depression (12.4 percent), as compared to individuals
without the disease. (Gore 2011)
- Current therapies, including pain management, improved nutrition
and regular programs for exercise, do not lead to the resolution of
osteoarthritis. (Maiese 2016)
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Arthritis Foundation
- Five common athletic injuries have been identified as placing
patients at greater risk of developing post-traumatic osteoarthritis.
These include three types of knee injuries (anterior cruciate ligament
ruptures, meniscus tears, and patellar dislocation), shoulder
dislocation, and ankle instability (the most commonly injured joint in
the body). (Whittaker 2015)
Economic Burden
- Earning losses due to osteoarthritis cost an estimated $80 billion
per year between 2008 and 2011. (OAA 2014)
Earning losses
due to OA
cost an estimated
$80 billion
per year between 2008 and 2011.
- Employed individuals with evidence of osteoarthritis (OA) have
much higher health care costs over a single year than those of
similar age and gender without evidence of OA. (Berger 2011)
(OAA 2014)
- Costs of short-term disability, workers’ compensation and
absenteeism are much higher among persons with osteoarthritis.
- More than 55,000 revision surgeries were performed in 2010
in the U.S., with 48 percent of them in patients under age 65.
(Berger 2011)
(Bhandari 2012)
- In the U.S. alone, osteoarthritis is the highest cause of work loss
and affects more than 20 million individuals, costing the U.S.
economy more than $100 billion annually. (Sandell 2012)
- By 2030, nearly two in three total knee arthroplasty revision
patients will be under 65 years. (Kurtz 2009)
- The indirect cost of absenteeism was estimated at approximately
$10.3 billion in the U.S in 2010. (Kotlarz 2010)
- It has been estimated that the costs due to absenteeism from osteoarthritis alone are at least $11.6 billion due to an estimated three
lost workdays per year. (Kotlarz 2010)
- Over 1 million total joint arthroplasties, at a cost of $18.8 billion,
were performed in the United States in 2012. (CDC-Table 105 2015)
- Coupled with increasing knee osteoarthritis prevalence, the rising
costs of health care may inflict a tremendous societal economic
burden in the future. There are currently no medical or surgical
treatments that will improve this alarming trajectory. (London 2011)
- Risks of revision surgery are especially pronounced in the younger
patient who may be more physically active and, consequently,
subject to multiple revision surgeries over a lifetime. (Bhandari 2012)
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- In 2010, each total knee arthroplasty revision surgery was
associated with total costs of $49,360. (Bozic 2010)
- During fiscal year 2011, the Medicare program reimbursed U.S.
hospitals:
- $3.5 billion for total knee arthroplasty (the program’s largest
expenditure for a single procedure)
- $3.4 billion for heart failure
- $2.0 billion for coronary intervention with drug-eluting stents
- $3.2 billion for spinal fusion. (Culler 2015)
- Opioids do not appear to be cost-effective in osteoarthritis
patients without comorbidities, principally because of their negative
impact on pain relief after total knee arthroplasty. (Rose 2016)
- Total knee arthroplasty procedures are costly, with an inpatient
procedure costing approximately $20,000, and a revision costing
approximately $25,000. (Losina 2015)
Arthritis by the Numbers | Book of Trusted Facts & Figures
- The total cost for all total knee arthroplasty procedures in the U.S.
in 2012 was over $11 billion. (Losina 2013)
- Compared with nonsurgical treatments, total hip arthroplasty
increased average annual productivity of patients by $9,503.
- It’s estimated that 54 percent of knee osteoarthritis (OA) patients
will receive total knee replacement over their lifetime under current
guidelines; the current trend suggests that there may be a 29
percent increase in lifetime direct medical costs attributable to this
procedure among knee OA patients. (Losina 2015)
(Koenig 2016)
- The total lifetime societal savings for total hip repair or replacement were estimated at almost $10 billion from more than 300,000
procedures performed in the U.S. each year. (Koenig 2016)
Knee, Hip and Shoulder OA Burden
- Knee osteoarthritis is frequently accompanied by comorbidities
that contribute to a decreased quality of life:
- obesity or being overweight (90 percent)
- hypertension (40 percent)
- depression (30 percent)
- diabetes (15 percent). (Hunter 2011)
- Knee injuries remain the most prevalent worldwide, with 700 000
cases annually in the U.S. and accounting for 12.5 percent of
post-traumatic osteoarthritis cases. (Gage 2012)
- Adolescents and young adults with anterior cruciate ligament
injuries are prone to develop osteoarthritis before they reach age
40. (Oiestad 2010)
- In anterior cruciate ligament ruptures, approximately 50 percent
of those affected develop post-traumatic osteoarthritis five to 15
years after injury (treated and with surgery). (Whittaker 2015)
- By the end stages of osteoarthritis, total knee arthroplasty is often
necessary to address the degradation of the joint and the associated symptoms that severely limit day-to-day function. (Hochberg 2012)
- Although many patients eventually require total knee arthroplasty,
they spend an average of 13 years exhausting pharmacologics
before undergoing surgery. (Losina 2015)
- Surgery for end-stage knee osteoarthritis is performed on
658,000 Americans annually. (Bhandari 2012)
- Hip and knee osteoarthritis causes the greatest burden in terms of
pain, stiffness and disability, leading to the need for prosthetic joint
replacement in the most severe cases. (Litwic 2013)
SURGERY for end-stage
KNEE OSTEOARTHRITIS
is performed on
- More than 719,000 total knee arthroplasties were performed in
2010 in the U.S. (HCUP 2010)
658,000
- Knee osteoarthritis contributes more than $27 billion in health care
expenditures annually. (Losina 2015)
Americans annually.
(Bhandari 2012)
- From 1999 to 2008, the utilization rate of total knee replacement
procedures in the U.S. more than doubled for the overall population, and tripled for individuals age 45 to 64. (Losina 2012)
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Arthritis Foundation
- Across all patients, primary total hip arthroplasty is projected to
grow by 75 percent between 2010 and 2020. (Kurtz 2014)
- One study projected that more than 50 percent of total hip
arthroplasties will be performed in patients younger than 65 by
2030. (Kurtz 2009)
Knee osteoarthritis
contributes more than
$27 billion
- The number of total hip arthroplasties performed on patients 18 to
64 years old has increased by 91 percent between 2003 and
2013. (HCUP 2015)
in health care expenditures
annually.
(Losina 2015)
- Most prosthetic infections are diagnosed after patients are
discharged (Poulsides 2012)
- Between July 1, 2007, and June 30, 2012, people without
significant comorbid conditions who underwent knee or hip
replacement procedure had a greater decrease in osteoarthritis-related health care resource utilization and costs after they recovered
from surgery. (Pasquale 2015)
- The most severe fracture that can result from osteoarthritis involves
the hip, which requires hospitalization. This type of fracture leads to
permanent disability in 50 percent of individuals and fatality in
another 20 percent. (Maiese 2016)
- Hip osteoarthritis profoundly affects quality of life in the U.S., with
estimated costs as high as $42.3 billion from 904,900 hip and
knee replacements in 2009. (Murphy 2012)
- With the lifetime risk of symptomatic hip osteoarthritis (OA)
estimated at 25.3 percent, conditions that can lead to OA must be
addressed to reduce the quality of life lost, caused by disability and
functional limitations, and their corresponding economic impact.
(Murphy 2010)
- Total hip arthroplasty is a highly successful medical intervention,
having favorable long-term outcomes in improvement of physical
functioning, survivorship and self-reported quality of life.
(Babovic 2013)
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- Infection is a devastating complication after shoulder arthroscopy
or arthroplasty that can lead to substantial morbidity. Recent studies
have reported a rate of infection of 0.27 percent after shoulder
arthroscopies and up to 15 percent of shoulder arthroplasties.
(Werner 2016)
- A recent study found infection was the most common surgical
cause of readmission after shoulder arthroplasty and that these
readmissions incurred an average hospital cost of $11,000.
(Schairer 2014)
- The 90-day readmission rate for shoulder arthroplasty has been
reported to be as high as 6 percent; these rates have been reported
to be increasing. (Matsen 2015)
- Factors associated with the risks of longer lengths of hospital stay,
readmission within 90 days and revision surgery for primary
shoulder arthroplasties:
- Advancing age was associated with longer lengths of stay
and more frequent readmission, but with fewer surgical
revisions.
- Women, African-Americans, and Medicaid patients had
longer lengths of stay.
- Patients who underwent arthroplasty for fracture-related
problems had longer lengths of stay.
Arthritis by the Numbers | Book of Trusted Facts & Figures
- Patients who underwent arthroplasty for post-traumatic
osteoarthritis had shorter lengths of stay but more revision
surgeries.
- Facilities with the highest case volumes had longer lengths of
stay and higher 90-day readmission rates. (Matsen 2015)
- The rate of revision for failed shoulder arthroplasty per 100,000
population has grown by 400 percent over the last two decades;
revisions now have been reported to account for up to 10 percent
of all shoulder arthroplasties. (Matsen 2015)
Global Burden
- In developed nations, osteoarthritis is considered to be one of the
10 most common disabilities in older individuals, especially those
who remain active in the workforce. (Palmer 2015)
- The total number of years lived with disability worldwide caused
by knee and hip osteoarthritis (OA) increased by 60.2 percent
between 1990 and 2010, and by 26.2 percent per 1,000 people.
This means OA has moved up from 15th to 11th in the list of the most
frequent causes of disability. (Vos 2013)
Australia
- More than half of the 1.8 million Australians with osteoarthritis
were between 25 and 64 years old in 2015. (Ackerman 2015)
- In Australia, 13 percent of primary total hip replacements and 7
percent of primary total knee replacements are undertaken in
people under age 55. (Ackerman 2015)
- While direct heath care costs are often reported, indirect health
care costs may be eight times greater than direct costs, indicating
that the true burden of osteoarthritis is underestimated. (Finch 2015)
- The cost of arthritic disease in Australia is estimated to be $24
billion per annum, affecting one in eight adults. (Finch 2015)
- Osteoarthritis (OA) is an independent predictor of increased risk
of cardiovascular disease. (Finch 2015)
- People undergoing total joint replacement are 26 percent more
likely to have cardiovascular disease than people without OA.
(Finch 2015)
United Kingdom
- Knee pain and disability are very strongly related to obesity,
which is rising fast. Knee replacements are being performed much
more frequently. There were more than 80 000 primary procedures
in 2011and increasing by around 3 percent annually. The majority
of patients were obese (body mass index of 35 or greater) and this
proportion is growing.
- In 2006, 15 percent of patients were obese.
- In 2013, 21 percent of patients were obese. (Willis 2015)
- Younger, more active patients are at greater risk of implant failure,
as are obese patients.
- There are around 5,000 (6 percent) revisions out of 88 000
total procedures in England each year.
- The need for revisions is bound to increase considerably with
the increase in primary procedures and the tendency to
operate on younger and more obese patients. (Willis 2015)
- The costs of retiring early in Australia due to arthritis include over
$9 billion in lost gross domestic product, and additional societal
costs are associated with reduced work productivity. (Ackerman 2015)
- An increasing incidence of sports injuries could result in an
increasingly larger future burden of osteoarthritis in the population,
with a corresponding increase in health service delivery and
musculoskeletal ill-health burdens in future years. (Finch 2015)
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Arthritis Foundation
I N 2015, E ST I M AT E D N AT I O N A L
I N D I R E C T C O STS O F R A - R E L AT E D
ABSENTEEISM FROM WORK
W E R E $252 M I L L I O N A N N U A L LY.
(Gunnarsson 2015)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Section 3:
Autoimmune and
Inflammatory Arthritis
A Related Group of Rheumatoid Diseases
A healthy immune system is protective. It generates internal
inflammation to get rid of infection and prevent disease. But the
immune system can go awry, mistakenly attacking the joints with
uncontrolled inflammation, causing joint erosion and damage to
internal organs, eyes and other parts of the body.
There are many types of arthritis that fall into the category of
autoimmune and inflammatory arthritis. This section presents the facts
for some of the most common diseases in this group: rheumatoid
arthritis (RA), spondyloarthritis (SpA), psoriatic arthritis (PsA) and
systemic lupus erythematosus (SLE or lupus). The goal of treatment is
to reduce pain, improve function and prevent further joint damage.
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Arthritis Foundation
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disease in which the
body’s immune system mistakenly attacks the joints. This creates
inflammation that causes the tissue that lines the inside of joints to
thicken, resulting in swelling and pain in and around the joints.
Irreversible joint deformity can occur, so doctors recommend early
diagnosis and aggressive treatment to control RA.
RA most commonly affects the joints of the hands, feet, wrists,
elbows, knees and ankles, and is usually symmetrical. Because RA
can also affect body systems, such as the cardiovascular or
respiratory system, it is called a systemic disease, meaning “entire
body.”
The following facts describe some of the features common to RA.
Prevalence
Human and Economic Burdens
- Rheumatoid arthritis (RA) is an inflammatory systemic disease,
with the hallmark of symmetric peripheral polyarthritis. The
etiology of RA is not completely known and assumed to be
affected by environmental causes, genetic predisposition, and
female sex; women develop RA in a 2:3 ratio compared to men.
- Only 7 percent of all rheumatologists practice in rural areas,
where 20 percent of the population lives. (ACR 2013)
(Houri 2016)
- In 2005, rheumatoid arthritis was estimated to affect 1.3 million
adults in the U.S., representing 0.6 percent of the population.
(Helmick 2008)
- By 2007, an estimated 1.5 million adults had rheumatoid
arthritis. (Myasoedova 2010)
- The prevalence of rheumatoid arthritis is approximately 0.5
percent to 1 percent in developed countries and 0.6 percent in
the U.S. population. (Gabriel 2009)
- Women are two to three times as likely to be affected as men.
- The lost productivity associated with rheumatoid arthritis is
substantial. Because of its progressive nature, many individuals
report missing work or choose not to work because of disease-related disabilities. (Burton 2006)
- Approximately 20 percent to 70 percent of individuals who
were working at the inception of their rheumatoid arthritis were
disabled after seven to 10 years. (Burton 2006)
- One study that followed employees with early-stage rheumatoid
arthritis, and found a 39 percent prevalence of work disability
after 10 years. (Eberhardt 2007)
- The indirect cost of rheumatoid arthritis due to lost productivity
has been estimated to be nearly three times greater than the costs
associated with treating the disease. (Agarwal 2011)
(Vollenhoven 2009)
- One in 12 women and 1 in 20 men will develop an inflammatory
autoimmune rheumatic disease during their lifetime. (Crowson 2011)
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- Approximately one-fourth to one-half of all patients with
rheumatoid arthritis become unable to work within 10 to 20 years
of follow-up. (Mikuls 2010)
Arthritis by the Numbers | Book of Trusted Facts & Figures
- Among those who did miss work, employees with rheumatoid
arthritis (RA) missed more days than employees without the
disease. (Gunnarsson 2015)
- From a stakeholder perspective, 33% of the total cost was
allocated to employers, 28% to patients, 20% to the government, and 19% to caregivers. (Birnbaum 2010)
- In 2015, estimated national indirect costs of RA-related
absenteeism from work were $252 million annually.
- A 2009 study found that approximately 43.6 percent of
rheumatoid arthritis patients had problems paying medical and
drug bills after insurance payments and 9.0 percent reported a
severe or great burden -- being unable to purchase all the
medications or care they needed because of out-of-pocket
medical expenses. This burden was substantially greater for
patients <65 years of age (11.8 percent) compared with those
≥65 years (5.3 percent). (Wolfe 2009)
(Gunnarsson 2015)
- Mortality hazards are 60-70 percent higher in patients with
rheumatoid arthritis (RA) compared with those in the general
population, and the survival gap between patients with RA and
those without RA appears to be only widening. (Mikuls 2010)
- There were 323,649 hospitalizations for rheumatoid arthritis
(RA; mean age 61.0 years; men, 21.5 percent) between 1993
and 2011. During this time, the annual hospitalization rate for
patients with a principle discharge diagnosis of RA declined
from 13.9 to 4.6 per 100,000 US adults. (Lim 2016)
Comorbidities
- In addition to imposing enormous indirect costs, rheumatoid
arthritis (RA) extracts an increasing amount of health care
resources. Based on 2005 U.S. Medicare/Medicaid data, total
annual societal costs of RA (direct, indirect, and intangible)
increased to $39.2 billion. (Birnbaum 2010)
- Psychiatric disorders in rheumatoid arthritis are common,
particularly depression, with an estimated point prevalence of
16.8 percent (10 percent to 23 percent) that is significantly
greater compared with that of the general population. (Matcham
- A 2007 study found that excess mortality in rheumatoid
arthritis has been seen in cardiovascular disease (31 percent),
pulmonary fibrosis (4 percent), and lymphoma (2.3 percent).
(Young 2007)
2013)
- The direct and indirect costs included annual excess health care
costs to RA patients of $8.4 billion, and costs of other RA
consequences of $10.9 billion. These costs translate to a total
annual cost of $19.3 billion. The intangible costs included of
quality-of-life deterioration ($10.3 billion) and premature
mortality ($9.6 billion). (Birnbaum 2010)
WOMEN ARE
T W O TO T H R E E
T I M E S AS L I K E LY
TO B E A F F E C T E D
BY R A AS M E N .
(Vollenhoven 2009)
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Arthritis Foundation
Spondyloarthritis (SpA)
Spondyloarthritis (SpA) is an umbrella term for inflammatory diseases
that involve both the joints and the entheses (the sites where the
ligaments and tendons attach to the bones). The most common of these
diseases is ankylosing spondylitis. Others include reactive arthritis,
psoriatic arthritis and enteropathic arthritis, which is associated with
inflammatory bowel disease.
In most cases, spondyloarthritis primarily affects the spine. Some
forms can affect the peripheral joints – those in the hands, feet, arms
and legs.
The following facts describe some of the features common to SpA.
Prevalence
- The spondyloarthritis (SpA) prevalence estimates are in the range
of SpA prevalence estimates reported elsewhere in population-based surveys and it is likely that SpA may affect up to 1
percent of US adults, a prevalence similar to that reported for
rheumatoid arthritis. (Reveille 2012)
- The overall age-adjusted prevalence of definite and probably SpA by
the Amor criteria was 0.9 percent, corresponding to an estimated 1.7
million persons. (Reveille 2012)
- Current estimates of the prevalence of spondyloarthritis (SpA) in the
U.S. range between: 0.2 percent and 0.5 percent ankylosing spondylitis, 0.1 percent for psoriatic arthritis, 0.065 percent for enteropathic
peripheral arthritis, 0.05 percent and 0.25 percent for enteropathic
axial arthritis, and an overall prevalence of SpA as high as >1 percent.
Only 7% of all
RHEUMATOLOGISTS
practice in rural areas,
where 20 % of the
population lives.
RURAL
(Reveille 2011)
Human and Economic Burdens
URBAN
- Prevalent patients with ankylosing spondylitis are at a 30 percent to 50
percent increased risk of incident cardiovascular events. (Eriksson 2016)
- Work disability affects 10 percent to 20 percent of patients with
ankylosing spondylitis, most often in those with physically demanding
jobs. Lost income and lost productivity due to work disability represent
major burdens to both families and society. (Reveille 2012)
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URBAN
URBAN
RURAL
RURAL
Percentage of
Rhumatologists
U.S. Population
(ACR 2013)
Arthritis by the Numbers | Book of Trusted Facts & Figures
Psoriatic Arthritis (PsA)
Some people might hear “psoriasis” and think of the skin disease
that causes itchy, scaly rashes and crumbling nails. It’s true, psoriasis
is a skin disease. But about 30 percent of people with psoriasis also
develop a form of autoimmune, inflammatory arthritis called
psoriatic arthritis (PsA), which can lead to joint pain, stiffness and
swelling. It can affect the entire body and may result in permanent
joint and tissue damage if not treated early and aggressively.
The disease may lay dormant in the body until triggered by some
outside influence, such as a common throat infection.
The following facts describe some of the features common to PsA.
Prevalence
- Psoriatic arthritis is a heterogeneous disease characterized by
involvement of skin, nails, peripheral and axial joints, and
enthuses. (Sukhov 2016)
- The presence of Pso (psoriasis), inflammatory arthritis and
absence of positive serological tests for rheumatoid arthritis are
the hallmarks of psoriatic arthritis (PsA). In 60 to 70 percent of
patients Pso precedes PsA, while in 15 to 20 percent arthritis
precedes the onset of Pso. (Kerschbaumer 2016)
- Up to 30 percent of individuals with psoriasis may also develop
psoriatic arthritis, an inflammatory form of arthritis that can lead to
- In seven European and North American countries, almost a third
of patients with psoriasis seen in dermatology centers had
psoriatic arthritis (PsA) as determined by rheumatologists. Of the
patients given the diagnosis of PsA in this study, 41 percent had
not received a previous PsA diagnosis, suggesting under-diagnosis of patients in dermatologic practices of this potentially debilitating disorder. (Mease 2013)
- In the U.S., psoriasis remains a common, immune-mediated
disease, affecting 7.4 million adults. Its prevalence has remained
stable since the mid-2000s. (Rachakonda 2014)
Human and Economic Burdens
- Psoriasis frequency ranges from 1 percent to 3 percent in white
population, and arthritis occurs in 10 percent to 40 percent of
psoriasis patients. (Ogdie 2015)
- Depression and anxiety are estimated to affect more than 30
percent of psoriasis patients. Low self-esteem, social anxiety,
embarrassment due to disease stigmata, or absence from work
due to painful arthritis may partly explain the psychosocial impact
of psoriasis. (Dowlatshahi 2014)
- Psoriatic arthritis (PsA) has a prevalence of 0.05 percent to 0.25
percent of the population and 6 percent to 41 percent of patients
with psoriasis. (Ogdie 2015)
- Depression or insomnia is commonly seen in patients with psoriasis or psoriatic arthritis, ranging from 20 percent to 50 percent in
the literature. (Fleming 2015)
- PsA has a higher prevalence in patients with more extensive skin
disease and a prevalence as high as 30 percent in dermatology
clinics (where patients tend to have more extensive/severe
psoriasis). (Ogdie 2015)
- In National Psoriasis Foundation surveys, roughly two-thirds of
people with psoriasis and/or psoriatic arthritis said their disease
made them feel angry, frustrated, and/or helpless. More than half
said psoriasis interfered with their ability to enjoy life, nearly 30
irreversible joint damage if left untreated. (Gladman 2005)
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Arthritis Foundation
percent suffer from depression, and 88 percent of family
members report the same levels of depression and anxiety
as those with psoriasis. (Martinez-Garcia 2014)
- Patients with psoriatic arthritis and psoriasis tend to be
heavier than unaffected individuals and patients with
rheumatoid arthritis. (Bhole 2012)
- According to a 2014 study, 55 percent of patients with
moderate-to-severe psoriasis, and 41 percent of patients
with psoriatic arthritis, are not being treated to the established standards of care. (Lebwohl 2014)
- Patients with psoriatic arthritis experience pain, swelling,
and joint tenderness, which produce reduced functioning in
daily activities and impaired quality of life. (Strand 2012)
- Severe psoriasis is more common among psoriasis patients
with psoriatic arthritis (PsA) than patients without PsA.
- A 2013 study of data collected from National Psoriasis
Foundation surveys found that although roughly 91 percent
of patients with psoriasis or psoriatic arthritis were covered
by insurance, the majority spent more than $2500 per year
in out-of-pocket costs for their disease. (Bhutani 2013)
(Haroon 2013)
- Both psoriasis and psoriatic arthritis, similar to other
systemic inflammatory conditions, were linked to an
increased risk of developing cardiovascular diseases.
- Obesity has also been found to predict worse outcome
and poor response to treatment in patients with psoriasis
and psoriatic arthritis. (Eder 2 014)
- Psoriatic disease is an expensive condition: the economic
burden of psoriatic disease is up to $135 billion a year.
(Brezinski 2015)
(Husted 2011)
IN THE U.S., PSORIASIS
REMAINS A COMMON,
IMMUNE-MEDIATED
DISEASE, AFFECTING
7.4 MILLION ADULTS.
(Rachakonda 2014)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Systemic Lupus Erythematosus (SLE or Lupus)
Lupus is a chronic, autoimmune disease. People with lupus have an
overactive and misdirected immune system. Lupus is systemic,
meaning that it affects a wide part of the body, including the joints,
kidneys, skin, blood, brain and other organs.
Systemic lupus erythematosus (SLE) accounts for about 70 percent of
all lupus cases. While SLE generally is considered the most serious form
of lupus, cases range from very mild to severe. SLE affects various
parts of the body and can cause joint pain, fatigue, hair loss,
sensitivity to light, fever, rash and kidney problems.
The following facts describe some of the features common to SLE.
Prevalence
- In Georgia, striking gender, age, and racial disparities in
systemic lupus erythematosus (SLE) have been confirmed. Women
have an age-adjusted incidence rate >5 times higher and
prevalence rate >8 times higher than men using the American
College of Rheumatology Criteria. The relatively higher female to
male ratio that we found in prevalent (8:1) compared to incidence
cases (5:1) may be related to a greater awareness among
physicians of SLE in general and as a result in men. (Lim 2014)
- The prevalence of SLE is 3 to 4 times higher in African Americans
than whites, and disease onset occurs at a younger age among
African Americans. (Lim 2014)
- In Michigan, systemic lupus erythematosus prevalence was 2.3
times higher in black persons than in white persons, and 10 times
higher in females than in males. (Somers 2014)
- In the United States, studies suggest strong associations between
ethnicity, socioeconomic status, and outcomes of lupus, with
African-Americans, Hispanics and individuals of low socioeconomic status being most susceptible. (Crosslin 2009)
- Geographic and racial distribution — both geography and race
affect the prevalence of systemic lupus erythematosus and of
frequency and severity of clinical and laboratory manifestations.
- The disease appears to be more common in urban than rural
areas. (Chakravarty 2007)
- There is an increased prevalence of systemic lupus erythematosus (SLE) in women. Nearly nine times greater than in men. In
addition, there is a large incidence of SLE in people of non-Caucasian origin. (Danchenko 2006)
- The prevalence of systemic lupus erythematosus is higher among
Asians, Afro-Americans, Afro-Caribbeans, and Hispanic Americans compared with Americans of European decent in the U.S,
and among Asian Indians compared with Caucasians in Great
Britain. (Rus 2002)
- In the US population, the all race incidence was 5.1 per
100,000 per year and the prevalence was 52.2 per 100,000,
with comparative figures of 3.8 and 26.2 in the U.K., and 2.9 and
28.4 in Japan, respectively. (D’Cruz 2007)
Human and Economic Burdens
- Serious infections are recognized as major causes of morbidity
and mortality in patients with lupus, accounting for 13 to 37
percent of hospitalizations, 65 percent of avoidable hospitalizations and one-third of deaths. (Tektonidou 2015)
(Chakravarty 2007)
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Arthritis Foundation
- Hospitalization rates for serious infections in systemic lupus
erythematosus (SLE) increased substantially between 1996 and
2011, reaching over 12 times higher than in patients without SLE in
2011. In-hospital mortality was higher among patients with SLE
and opportunistic infections and those with pneumonia or sepsis
who required mechanical ventilation. (Tektonidou 2015)
- Fatigue in systemic lupus erythematosus is known to be related to
physical inactivity, poor sleep quality, depression, anxiety, negative
mood, cognitive dysfunction, obesity, vitamin D deficiency/
insufficiency, and comorbidities such as fibromyalgia. (Ahn 2012)
- In systemic lupus erythematosus patients, the occurrence of
neuropsychiatric events is associated with a lower quality of life
and poor prognosis. (Hanly 2010)
- Cognitive dysfunction is present in up to 80 percent of patients
with systemic lupus erythematosus. (Meszaros 2012)
- Based on a study using data from Medicaid billing claims from
47 U.S. states and Washington, D.C., mortality rates for patients
who were coded for systemic lupus erythematosus found that
mortality rates were highest among Native American, white and
black patients. (Gomez-Puerta 2015)
- While we have certainly improved over the past 10 to 20 years,
increased mortality remains part of the natural history of lupus.
Systemic lupus erythematosus patients still have two to five times the
risk of death compared with the general population. (Fors Nieves 2016)
- The analysis of the Truven Health MarketScan database
(2006-2012) revealed that pregnancies in women with lupus
were associated with a higher risk of complications, higher
healthcare costs, and fewer prescribed medications, including
immunosuppressants, than the control groups. (Petri 2015)
- Due to the chronic, unpredictable, and systemic nature of
complete systemic lupus erythematosus, patients often have
reduced ability to perform work, care for their dependents and
engage in other unpaid work. Hence, the resulting indirect costs
can exceed direct costs by two-to-four-fold. (Choi 2016)
- Studies from the U.S. reveal that 15 percent to 40 percent of
systemic lupus erythematosus patients are unemployed within 5
years of diagnosis. (Drenkard 2014)
- About 44 percent of the hip and knee joints of systemic lupus
erythematosus patients undergoing corticosteroid treatment
display osteonecrosis lesions. (Nakamura 2010)
- A systematic review from 2000 to 2009 demonstrated that most
systemic lupus erythematosus direct costs were related to inpatient
(16-20 percent) and outpatient (24 56 percent) services,
followed by medications (19-30 percent). (Slawsky 2011)
The medical costs of
LUPUS total
- Based on health insurance claims, the annual per patient direct
costs for complete systemic lupus erythematosus were estimated to
range as high as $71,334 in 2015 for those with lupus nephritis.
$51,295
(Carls 2009)
- In a retrospective study of U.S. Medicaid enrollees between
2000 and 2009, systemic lupus erythematosus (SLE) patients had
significantly higher healthcare utilization and higher overall
expenditures than patients with no SLE. Compared with a matched
cohort of patients without SLE, SLE patients incurred $10,984
more total cost per year with 55 percent of that being attributed to
inpatient care. (Kan 2013)
(mean total over a
4 year period)
(Kan 2016)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
2004 national average hourly wage of $18.09, the mean income
of working-age participants decreased from $24,931 in the year
of diagnosis to $16,272 at the time of the study, representing a
productivity cost of $8,659. (Panopalis 2008)
15-20%
of patients with
LUPUS will be
diagnosed before age 18
(Weiss 2012)
- SLE flares were experienced by 97 percent of SLE patients, with
an average of 2.6 flares per patient per year. Cost per flare was
highest for severe flares at $11,716. Patients with at least one
severe flare during the follow-up period had an annual cost of
$49,754, more than twice the costs of patients with moderate or
mild flares as their highest flare severity. (Kan 2013)
- Between 2000-2010 in the U.S., mean annual direct costs of
systemic lupus erythematosus (SLE) patients ranged from $13,735
to $20,926; the costs of those with and without nephritis ranged
from $29,034 to $62,651 and $12,273 to $16,575, respectively.
Across studies of a general SLE population, pharmaceutical costs
composed 19 to 30 percent of total expenditures, with inpatient
costs accounting for 16 to 50 percent and outpatient costs accounting for 24 to 56 percent of overall costs. (Slawsky 2011)
- The medical costs of systemic lupus erythematosus are substantial, with a mean total medical care cost of $51,295 over 4 years.
- Glomerulonephritis is seen in 30 to 50 percent of unselected
patients with systemic lupus erythematosus at the onset of the
disease, and renal involvement is observed in at least 60 percent
in the course of this disease. (Rajashekar 2008)
- Renal damage is one of the principal causes of morbidity and
mortality in patients with systemic lupus erythematosus. (Rahman 2008)
- Childhood-onset systemic lupus erythematosus (SLE) comprises
about 15 to 20 percent of all patients with SLE. (Silva 2012)
- Neuropsychiatric manifestations usually occur early in the
course of systemic lupus erythematosus. (Hanly 2007)
- Acute articular involvement is an important feature of childhood-onset systemic lupus erythematosus and adult-onset
patients. It has been described in up to 70 percent of children
and 90 percent of adults. (Tarr 2015)
- The prevalence of renal and cardiovascular damage in systemic
lupus erythematosus (SLE) is higher among African Americans
than Whites, and African Americans with SLE suffer these complications at earlier ages. (Ward 2007)
- It is estimated that 10 to 30 percent of patients with systemic
lupus erythematosus progress to end-stage renal disease within
10 years, even with aggressive therapies. (Hanly 2016)
(Kan 2016)
- According to a longitudinal survey of persons with systemic
lupus erythematosus (SLE), in the year of diagnosis, 76.8 percent
of participants had been employed, whereas only 48.7 percent
were employed at the end of the study. As expected, annual hours
of employment also decreased since the year of diagnosis, from
1,378.2 hours per year to 899.5 hours per year. Applying the
- Systemic lupus erythematosus is one of the leading causes of
work disability in the U.S., accounting for about 20 percent of the
more than estimated 1.5 million Americans with a work disability.
(Agarwal 2016)
- The symptoms of lupus can have a profound impact on the
person’s employment. Impacts of lupus are more pronounced
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Arthritis Foundation
among young and middle-adulthood. Studies have shown
that loss in work hours cost the nation nearly $13 billion
annually. The loss also impacts the individual’s work, quality
of life, self-management, and self-efficacy. (Agarwal 2016)
- Among the pre-SLE women, pre-eclampsia was found in
26 percent of those with SLE within two years postpartum
and 13 percent in those with SLE within two to five years
postpartum. (Arkema 2016)
- Depression in lupus is multifactorial. Higher-dose prednisone (20 mg or more daily) is one important risk factor.
Global disease activity is not a risk factor, but cutaneous
activity and certain types of neurologic activity (myelitis) are
predictive of depression. The independent effect of prednisone provides clinicians with an additional incentive to avoid
and reduce high-dose prednisone exposure in lupus.
- Infant outcomes, such as preterm birth, infection and
mortality, were worse among those born to mothers with
prevalent SLE and pre-SLE during pregnancy. (Arkema 2016)
(Huang 2014)
- A longitudinal study among predominantly middle-class
white women with systemic lupus erythematosus indicated
that more than 60 percent were out of the workforce 20
years after the diagnosis. (Yelin 2007)
- Adverse pregnancy outcomes (APO) occurred in 19
percent (almost one in five) of pregnancies: fetal death
occurred in 4 percent, neonatal death occurred in 1 percent,
preterm delivery occurred in 9 percent, and 10 percent of
neonates were small for their gestational age (birthweight
was below the fifth percentile). Maternal flares and higher
disease activity also predicted the APOs. (Buyon 2015)
- About 15 to 20 percent of all systemic lupus erythematosus
cases develops before the age of 18 years and constitutes
pediatric systemic lupus erythematosus. (Weiss 2012)
- Lupus nephritis is a severe manifestation of the disease,
affecting up to 60 percent of patients at some point.
(Singh 2009)
- The overall reported prevalence of end-stage renal disease
caused by lupus nephritis has increased 56 percent over the
10-year period of 2000 to 2010. (NIH 2010)
- Cross-sectional studies report the prevalence of obesity
among adults with systemic lupus erythematosus (SLE) at
around 28 percent. (Chaiamnuay 2007)
- Maternal outcomes (such as pre-eclampsia, hypothyroidism, stroke and infection) were more common among women
with systemic lupus erythematosus (SLE): 16 percent of
prevalent-SLE pregnancies were diagnosed with pre-eclampsia, compared with 5 percent of those from the general
population. (Arkema 2016)
LUPUS APPEARS
TO BE MORE
COMMON IN
URBAN THAN
RURAL AREAS.
(Chakravarty 2007)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Section 4:
Juvenile Idiopathic
Arthritis
The Most Common Type of Arthritis in Children
There are many forms of childhood arthritis. An estimated 294,000
U.S. children under age 18 (or one in 250 children) are diagnosed with
arthritis or another rheumatologic condition (Sacks 2007). Of all the
forms of arthritis, juvenile idiopathic arthritis (JIA) is the most common
type of arthritis in children. It occurs when the immune system
mistakenly attacks the body’s tissues, causing inflammation in joints
and potentially other areas of the body. Idiopathic means “of
unknown origin.”
The following facts describe some of the features common to all forms
of JIA
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Arthritis Foundation
There are six JIA subtypes.
Systemic JIA causes inflammation in one or more joints and is often accompanied by a high spiking fever that lasts at least two weeks
and a skin rash. About 10 percent of children with JIA will have this form.
Oligoarticular JIA causes arthritis in four or fewer joints, typically the large ones (knees, ankles and elbows). Children with this type
of JIA are more likely to get uveitis (chronic eye inflammation) than those with the other subtypes.
Polyarticular JIA causes inflammation in five or more joints, often the small joints of the fingers and hands, but weight-bearing joints
and the jaw can also be affected. About 25 percent of children with JIA will have this form.
Juvenile psoriatic arthritis involves arthritis that usually occurs in combination with a skin disorder called psoriasis. The psoriasis
may begin many years before any joint symptoms become apparent.
Enthesitis-related JIA is characterized by tenderness where the bone meets a tendon, ligament or other connective tissue. This
tenderness accompanies joint inflammation of arthritis and most often affects the hips, knees and feet.
Undifferentiated arthritis describes juvenile arthritis that does not fit into any of the other types, or involves symptoms spanning two
or more subtypes.
Prevalence
- The cause of juvenile idiopathic arthritis is unknown, and more
girls than boys are affected. (Sacks 2007)
- The disorder has been identified all over the world in nearly all
races and ethnicities with an average prevalence rate of one to
two per 1,000 children. (Gabriel 2009)
percent of respondents agreed that there are patients who
continue to experience moderate to severe pain despite appropriately dosed disease-modifying anti-rheumatic drugs (DMARDs)
and non-steroidal anti-inflammatory drugs (NSAIDs). (Kimura 2006)
- There is higher inpatient healthcare utilization in children with
juvenile idiopathic arthritis (JIA) compared to those without JIA
including joint surgery, non-joint surgery, and hospitalizations.
Human and Economic Burdens
(Krause 2016)
- The term juvenile idiopathic arthritis describes an inflammatory
syndrome in children which predominantly affects the joints. The
definition includes an onset before the 16th birthday and symptoms persisting for longer than 6 weeks. (Thierry 2014)
- It has been found that there are higher rates of depression in
children with juvenile idiopathic arthritis as compared to those
without but no difference when adults. (Krause 2016)
- Juvenile idiopathic arthritis is an incurable, relapsing and
remitting and potentially progressive condition. (Stoll 2014)
- Fatigue is common in patients with juvenile idiopathic arthritis
(JIA), even when they reach adulthood. The prevalence of fatigue
in patients with JIA is great compared to the general population.
In many children, juvenile idiopathic arthritis is a life-long illness
with a high risk of disease- and treatment-related morbidity.
(Armbrust 2016)
(Guzman 2014)
- Parents of a child with juvenile idiopathic arthritis are likely to
incur high medical costs due to their offspring’s frequent visits to
physicians and therapists to manage the disease. (Bernatsky 2007)
- In a survey of North American pediatric rheumatologists, 77
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Arthritis by the Numbers | Book of Trusted Facts & Figures
JIA-ASSOCIATED
UVEITIS
can lead to
- The consequences of JIA-induced fatigue can be major, as they
hamper children’s performance at school, social life, sports, and
hobbies. (Eyckmans 2011)
- American studies demonstrated obesity in 18 percent of patients
with juvenile idiopathic arthritis. (Pelajo 2012)
Ocular Complications and
Permanent Vision Loss.
- In many children, juvenile idiopathic arthritis is a life-long illness
with a high risk of disease- and treatment-related morbidity.
(Saurenmann 2007)
(Guzman 2014)
- In addition to pain and physical limitations, children with juvenile
idiopathic arthritis may also experience high levels of stress during
the course of their disease. (Seid 2014)
- Fifty-three percent of the parents of juvenile idiopathic arthritis
(JIA) cases reported an increase in the number of missed work
hours for the period covering the year before and the year after
their child’s index diagnosis, while only 32 percent of the parents
of children without JIA reported a work-time loss. (Rasu 2015)
- Patients with juvenile idiopathic arthritis (JIA) have a poorer
HRQOL (Health Related Quality of Life) as compared with healthy
peers in both physical and psychosocial domains, with physical
health being more affected. The areas of HRQOL most affected by
JIA were global health, physical functioning, role social limitation
(physical), and bodily pain/discomfort. (Oliveira 2007)
- Parents of a child with juvenile idiopathic arthritis (JIA) were 2.78
times more likely to report work-time loss than parents having no
children with JIA. (Rasu 2015)
- Juvenile idiopathic arthritis-associated uveitis (JIA-U) can lead to
ocular complications and permanent vision loss. (Saurenmann 2007)
- Male parents of children with juvenile idiopathic arthritis are
2.81 times more likely to report a work-time loss than female
parents. (Rasu 2015)
- Parents of children without juvenile idiopathic arthritis were 64
percent less likely to experience work-time loss than parents with a
child with JIA. (Rasu 2015)
- Approximately 10 to 25 percent of the children in the U.S. with
juvenile idiopathic arthritis develop uveitis within the first 4 years
of their arthritis diagnosis. (Saurenmann 2007)
- Approximately one-third of children with systemic juvenile
idiopathic arthritis present with occult macrophage activation
syndrome, a potentially life-threatening condition necessitating
rapid recognition and treatment. (Shenoi 2016)
- Compared with parents who had no children with juvenile
idiopathic arthritis (JIA), who lost an estimated average of U.S.
$2986.08 due to aggregate missed work hours between 2000
and 2009, those who had a child with JIA lost an average of U.S.
$4,589.37 due to missed work during the same period. (Rasu 2015)
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Arthritis Foundation
IN MANY CHILDREN,
JUVENILE IDIOPATHIC
ARTHRITIS IS A LIFE-LONG
ILLNESS WITH A HIGH RISK OF
DISEASE- AND TREATMENTRELATED MORBIDIT Y.
(Guzman 2014)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Section 5:
Gout
What is Gout?
Gout is a form of inflammatory arthritis that develops in some people
who have high levels of uric acid in the blood. The acid can form
needle-like crystals in a joint and cause sudden, severe episodes of
pain, tenderness, redness, warmth and swelling. The pain may last
hours or weeks and make it difficult to perform daily activities.
The first gout attack usually occurs in the large joint of the big toe, but
other joints can be affected too. Gout attacks usually occur at night
and may last three to 10 days.
The following facts describe some of the features common to gout.
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Arthritis Foundation
Prevalence
- Gout is a treatable condition in which monosodium urate crystals
deposit in the joints and periarticular tissues, causing inflammation and
painful flares of arthritis. In more severe cases, tophaceous gout may
also occur. Although treatable, the prevalence of gout is increasing,
and patients often struggle to successfully manage the condition.
(Dalbeth 2016)
- In western developed countries, contemporary prevalence of gout is
3 to 6 percent in men and 1 to 2 percent in women. Prevalence steadily increases with age, but plateaus after age 70. (Kuo 2015)
- Gout is one of the most common rheumatology diseases and is the
most common cause of inflammatory arthritis among adults in the
U.S. (Khanna 2012)
- Gout is the most common inflammatory arthritis in the U.S., with a
prevalence of about 3.9 percent of adults, or 8.3 million individuals.
(Zhu 2011)
- An analysis of the National Health and Nutrition Examination Survey
estimates that approximately 8 million Americans are affected by gout.
(Zhu 2011)
- Men are nearly three times more likely to develop gout, compared
with women, and black males are most commonly affected. (Wilson
2016)
- Approximately 60 percent of patients experience a recurrent gout
flare within one year of an initial event, and 78 percent experience a
recurrent flare within two years. (Brixner 2005)
Human and Economic Burdens
- Gout incidence increases with age in both men and women, with the
most significant age-related increase noticed in postmenopausal
women. (Wilson 2016)
- Yearly incremental total health care cost of patients with treatment
failure for gout was $10,222, where 40 percent of the annual medical
cost was for gout-related care. (Wu 2012)
- In one qualitative study, pain associated with acute gout was
described as intolerable, resulting in a feeling of desperation for the
attack to end and a sense of helplessness. (Lindsay 2011)
- Gout flares frequently result in patients being unable to bear weight
and being bedbound for the duration of the acute attack. Severe foot
pain, impairment and disability were observed in a study among
patients with acute gout. (Rome 2012)
- Patients with gout have higher than average medical costs and health
care utilization than patients without gout. (Jackson 2015)
- Based on recent prevalence estimates for gout, and taking into
account the higher costs associated with managing frequent gout, it
was estimated that for all gout cases, the annual cost directly attributable to gout was at least $4 billion ($666 per patient per year), and
that the overall aggregate annual costs for the medical care of patients
with gout may have exceeded $20 billion in 2006 ($2,500 per
patient per year). (Bardin 2015)
- It is estimated that direct and gout-specific costs range from $199 for
patients with fewer than three yearly attacks, to $6,179 per year for
patients with three or more yearly attacks, and were of similar
magnitude as costs associated with rheumatoid arthritis. (Rai 2015)
- Costs associated with emergency department (ED) visits in the U.S.
from 2006 to 2008 due to gouty arthritis accounted for 0.2 percent of
the total annual ED visit costs, and that the median ED visit cost for
gouty arthritis was $667 per visit; total costs associated with ED visits
for gouty arthritis in 2008 equaled $166 million. (Garg 2013)
- Using data from two national ambulatory care surveys, there were a
total of 50.1 million gout-related ambulatory visits in the U.S. from
2002 to 2008 (an average of 7.2 million visits per year), corresponding to a cost of approximately $1 billion annually. (Li 2013)
- Gout has a substantial comorbidity burden, and is particularly
interconnected with other diseases associated with hyperuricemia,
such as diabetes, hypertension and obesity. (Karis 2014)
- The U.S. labor force consisted of 155 million persons in July 2012. If
gout is present in 2 percent of workers (3.1 million persons), and each
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Arthritis by the Numbers | Book of Trusted Facts & Figures
misses five days annually as a result of the disease, the yearly loss of
wages/productivity amounts to $833 per worker (based on 2010
data), or an aggregate loss of $2.6 billion. Thus, a combined
provisional estimate of annual direct and indirect costs of gout patient
care totals more than $6 billion. In fact, the actual disease burden is
even greater when the cost and health risks of over-the-counter
analgesic and anti-inflammatory drugs, missed wages of spouses and
the need for caregivers or transport providers are added. (Wertheimer
- Nearly 8 percent of all emergency department visits for gout result in
hospitalization, with a median inpatient stay approaching three days.
2013)
- Every year, medical expenses in the U.S. attributed to gout account
for a staggering $4 billion in direct costs and $2.6 billion in indirect
costs. These costs take a considerable toll on our economy.
- Compared to controls without gouty arthritis, employees with this
condition had significantly more sick leave, short-term disability, and
worker’s compensation benefits. (Brook 2006)
- The number of work days missed increases as the number of yearly
gout flares increases. (Lynch 2013)
(Singh 2016)
- For those with a primary gout diagnosis leading to hospitalization,
total combined charges resulting from the emergency department and
subsequent inpatient stay approached $350 million. (Coburn 2016)
(Wertheimer 2013)
- Using an emergency department database spanning the U.S., visits
pertaining to gout generated more than $166 million in emergency
department charges (with a median charge of $667 per visit) in 2008.
(Garg 2013)
- Advanced gout is associated with impaired mobility and reduced
health-related quality of life, as well as an increased risk of all-cause
mortality. (Dalbeth 2016)
- The National Health and Nutrition Examination Survey data from
2007-2008 reported that among gout patients: 74 percent had
hypertension, 71 percent had stage two or greater chronic kidney
disease, 53 percent were obese, 26 percent had diabetes, 14 percent
have had myocardial infarction and 10 percent have had a stroke.
- There were 254,982 hospitalizations for gout (mean age: 66.7
years; men: 66.4 percent). From 1993 to 2011, the annual hospitalization rate for patients with a principle discharge diagnosis of gout
increased from 4.4 to 8.8 per 100,000 U.S. adults. From 2001 to
2011, the inflation-adjusted hospital costs per 100,000 adults with a
principle discharge diagnosis of gout increased from $34,457 to
$58,003. (Lim 2016)
(Dalbeth 2016)
- The frequency of outpatient visits for gout increased three-fold from
1993 to 2009, with the most significant increase after 2003.
- Large prospective studies have shown that gout is associated with
increased risk of death, primarily due to cardiovascular disease. (Choi
(Krishnan 2013)
2007)
- The number and cost of emergency department (ED) visits with gout
as the primary diagnosis rose from 2009 to 2012.
• In 2009, there were 180,789 ED visits, costing a total of
$195 million.
• In 2010, there were 201,044 ED visits, costing $239 million.
• In 2012, there were 205,152 ED visits, costing $287 million.
These accounted for 0.14 to 0.16 percent of all ED visits.
- Poorly controlled gout leads to absences from work, health care use
and reduced social participation. (Khanna 2012)
- The rate of emergency department visits for gout in adults overall
increased from 75.0 to 85.4 per 100,000 (a 14 percent increase),
and increased 29 percent for those aged 45 to 54. Nationwide,
emergency department charges increased from $156 million to $281
million (an 80 percent increase). (Jinno 2012)
(Singh 2016)
- While comorbid conditions may account for some of the elevated
resource use among gout patients, gout-related health care utilization
increases with the severity of gout. (Singh 2011)
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Arthritis Foundation
GOUT IS ONE OF THE MOST COMMON
RHEUMATOLOGY DISEASES AND IS
THE MOST COMMON CAUSE OF
INFLAMMATORY ARTHRITIS AMONG
ADULTS IN THE UNITED STATES.
(Khanna 2012)
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Section 6:
Fibromyalgia
What is Fibromyalgia?
Fibromyalgia is a condition associated with widespread chronic
pain, fatigue, memory problems and mood changes. It is not a
single disease, but a constellation of symptoms that can be
managed. Although fibromyalgia is not a form of arthritis
because it does not inflame or damage joints, it is considered
an arthritis-related condition. It is often found as a comorbid
condition in people who have different forms of arthritis.
Fibromyalgia affects more than 3.7 million Americans. The
majority are women between 40 and 75, but it also affects
men, young women and children, especially adolescent
females. It sometimes occurs in more than one member of the
same family, suggesting that a predisposing gene may exist.
The following facts describe some of the features common
to fibromyalgia.
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Arthritis Foundation
Prevalence
- With as many as three in four patients with fibromyalgia undiagnosed, estimates of its prevalence have ranged from 2 percent to 5
percent. (Arnold 2011)
Human and Economic Burdens
- Fibromyalgia is a condition characterized by chronic, widespread pain. In addition to pain, patients frequently report a
number of other symptoms, including sleep disturbances, headaches, fatigue, reduced function, anxiety and depression. (Bennett
2009)
- Fibromyalgia represents a substantial economic burden for both
the patient and the health care system, with increased costs for
prescription medications, lost productivity, and short-term disability, compared to patients with chronic widespread pain. (Schaefer
2016)
- Fibromyalgia symptoms directly affect a patient’s ability to work,
frequently resulting in missed workdays, reduction in hours and
having to change jobs. (Schaefer 2016)
- Living with fibromyalgia also has a significant emotional impact,
with depression and anxiety being common comorbidities. (Vincent
2015)
- Fibromyalgia symptoms result in significant functional impairment
and a negative impact on patients’ quality of life, which manifests
in a number of ways: Patients report difficulties in establishing and
maintaining physical and emotional relationships with others;
adjusting their personal expectations of what activities they can
complete and goals they can achieve; dealing with mood
disturbances, such as anxiety and depression; and starting or
continuing education or a career. (Arnold 2008)
- Patients often have difficulty adjusting to living with fibromyalgia,
with one study of patients and their spouses/partners identifying a
sense of loss of identity. (Rodham 2010)
- 36 -
- Patients also felt isolated from health care providers whom they
felt they had to convince they had a “real” condition to be taken
seriously. (Rodham 2010)
- Patients have characterized living with fibromyalgia as having to
manage two major burdens: pain, which can be ever-present and
overwhelming, and being doubted by others because the symptoms of fibromyalgia are subjective and not seen by others.
(Juuso 2011)
Juvenile-Onset Fibromyalgia
- The lifetime prevalence of major depression is estimated to be 26
percent in children with juvenile-onset fibromyalgia and 61.5
percent in adults with fibromyalgia. (Schaefer 2015)
- Objective physical activity monitoring has documented that
adolescents with juvenile-onset fibromyalgia become very
sedentary and therefore are at greater risk of deconditioning and
further risk of inactivity. (Kashikar-Zuck 2010)
- School absenteeism is common, with adolescents missing
an average of three school days per month, and several of
them are unable to attend regular school at all (that is, they are
homeschooled) because of the symptoms of juvenile-onset
fibromyalgia. (Kashikar-Zuck 2010)
- Perhaps not surprising, adolescents with juvenile-onset fibromyalgia are seen by their classmates (and themselves) as being
isolated, more emotionally sensitive than their healthy peers, and
have fewer friendships. (Kashikar-Zuck 2007)
Arthritis by the Numbers | Book of Trusted Facts & Figures
CONCLUSION
Every day we feel the toll of arthritis. Describing the research that has led to our understanding of the personal
and community costs of arthritis can be daunting. More so, by restricting the work to original peer-reviewed
sources, Arthritis by the Numbers is a single vetted repository of key findings. This publication is designed to
be an expedient resource to professional and lay audiences, such as the tireless advocates who, each day,
make the case for prioritizing the science and policy that advance the needs of people with arthritis.
For nearly a decade, our health care system has been in transition. With a time of unprecedented change to
health care and research, there are many opportunities to advance the cause of people with arthritis. We need
to shift the dialogue from cutting costs to investing in science and innovation in order to find a cure.
Many issues prevent people with arthritis from accessing even the treatments and health care currently
available: cost of treatments, lack of the number of physicians needed for specialty care, and distance to
providers and other care services. As the number of people affected by arthritis increases, the costs and
burdens to individuals and society will continue to increase unless we advocate for the changes needed to
help people with arthritis live fuller, more productive lives. We must seize the opportunities to advance our
understanding of arthritis through innovative research to find a cure.
By investing in finding a cure, and prioritizing science and policy that advance the needs of people with
arthritis, we will ultimately be able to reduce the community and personal costs of arthritis.
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Arthritis Foundation
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RA
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Birnbaum H, et al. Societal Cost of Rheumatoid Arthritis Patients in the U.S. Curr
Med Res Opin. 2010.
Burton W, Morrison A, Maclean R, Ruderman E. Systematic Review of Studies of
Productivity Loss Due to Rheumatoid Arthritis. Occup Med (Lond). 2006;56:18–
27.
Crowson CS, et al. The Lifetime Risk of Adult-onset Rheumatoid Arthritis and Other
Inflammatory Autoimmune Rheumatic Diseases. Arthritis Rheum. 2011.
Eberhardt K, et al. Work Disability in Rheumatoid Arthritis--Development Over 15
Years and Evaluation of Predictive Factors Over Time. J Rheumatology.
2007;34(3):481–487.
Gabriel SE, Michaud K. Epidemiological Studies in Incidence, Prevalence,
Mortality, and Comorbidity of the rheumatic disease. Arthritis Res Ther.
2009;11:229.
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Gunnarsson C, et al. The Employee Absenteeism Costs of Rheumatoid Arthritis:
Evidence From US National Survey Data. Journal of Occupational and
Environmental Medicine. 2015.
Helmick CG, et al. Estimates of the Prevalence of Arthritis and Other Rheumatic
Conditions in the United States. Part I. Arthritis Rheumatism. 2008;58(1):15–25.
Houri LE, et al. Coexistence of Ischemic Heart Disease and Rheumatoid Arthritis
Patients—a Case Control Study. Autoimmun Rev. 2016;15(4):393–396
Lim SY, et al.Trends in Gout and Rheumatoid Arthritis Hospitalizations in the United
States, 1993-2011. JAMA. 2016.
Matcham F, et al. The prevalence of depression in rheumatoid arthritis: a
systematic review and meta-analysis. Rheumatology (Oxford). 2013;52 , pp.
2136–2148
Mikuls TR. Rheumatoid Arthritis Incidence: What Goes Down Must Go Up?
Arthritis Rheumatology. 2010.
Myasoedova E, Crowson CS, Kremers HM, Therneau TM, Gabriel SE. Is the
Incidence of Rheumatoid Arthritis Rising? Results From Olmsted County,
Minnesota, 1955-2007. Arthritis Rheum. 2010; 62(6):1576-1582.
Vollenhoven RFV. Sex Differences in Rheumatoid Arthritis: More Than Meets the
Eye. BMC Med. 2009;7:12.
Wolfe F, Michaud K. Out-of-pocket Expenses and Their Burden in Patients With
Rheumatoid Arthritis. Arthritis Rheum. 2009;61: 1563–70.
Young A, et al. Mortality in Rheumatoid Arthritis. Increased in the Early Course of
Disease, in Ischaemic Heart Disease and in Pulmonary Fibrosis. Rheumatology
(Oxford). 2007.
SpA + PsA
Bhole V, et al. Differences in Body Mass Index Among Individuals With PsA,
Psoriasis, RA and the General Population. Rheumatology (Oxford). 2012;51:
552–556.
Bhutani T, Wong JW, Bebo BF, Armstrong AW. Access to Health Care in Patients
With Psoriasis and Psoriatic Arthritis: Data From National Psoriasis Foundation
Survey Panels. JAMA Dermatol. 2013;149(6):717-721.
Brezinski EA, et al. Economic Burden of Psoriasis in the United States: A Systematic
Review. JAMA Dermatology. 2015.
Dowlatshahi EA, et al. The Prevalence and Odds of Depressive Symptoms and
Clinical Depression in Psoriasis Patients: A Systematic Review and Meta-Analysis. J
Invest Dermatol. 2014; 134:1542–1551.
Eder L, Thavaneswaran A, Chandran V, Cook R, Gladman D. Increased Burden of
Inflammation Over Time is Associated With the Extent of Atherosclerotic Plaques in
Patients With Psoriatic Arthritis. Ann Rheum Dis. 2014(b).
Eriksson JK, et al. Is Ankylosing Spondylitis a Risk Factor for Cardiovascular
Disease, and How do These Risks Compare With Those in Rheumatoid Arthritis?
Annals of the Rheumatic Diseases. 2016.
Fleming P, et al. Effect of biologics on depressive symptoms in patients with
psoriasis: a systematic review. J Eur Acad Dermatol Venereol. 2015; 29:1063–
1070.
Arthritis by the Numbers | Book of Trusted Facts & Figures
Gladman DD, et al. Psoriatic Arthritis: Epidemiology, Clinical Features, Course,
and Outcome. Ann Rheum Dis. 2005.
Carls G, et al. Direct and indirect costs to employers of patients with systemic lupus
erythematosus with and without nephritis. J Occup Environ Med 2009; 51: 66–79.
Haroon M, et al. High Prevalence of Psoriatic Arthritis in Patients With Severe
Psoriasis With Suboptimal Performance of Screening Questionnaires. Ann Rheum
Dis. 2013;72(5):736–40.
Chaiamnuay S, Bertoli AM, Fernandez M, et al. The Impact of Increased Body
Mass Index on Systemic Lupus Erythematosus: Data From LUMINA, a Multiethnic
Cohort (LUMINA XLVI) [corrected] J Clin Rheumatol. 2007;(3):128–133.
Husted J, et al. Cardiovascular and Other Comorbidities in Patients With Psoriatic
Arthritis: a Comparison With Patients With Psoriasis. Arthritis Care Res (Hoboken).
2011;63: 1729–1735.
Chakravarty EF, Bush TM, Manzi S, Clarke AE and Ward MM. Prevalence of
Adult Systemic Lupus Erythematosus in California and Pennsylvania in 2000:
Estimates Obtained Using Hospitalization Data. Arthritis Rheum. 2007;56 (6).
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Features, Pathophysiology and Novel Treatment Targets. Wien Klin Wochenschr.
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Lebwohl MG, et al. Patient Perspectives in the Management of Psoriasis: Results
From the Population-based Multinational Assessment of Psoriasis and Psoriatic
Arthritis Survey. J Am Acad Dermatol. 2014;70(5):871-881.
Martinez-Garcia E, et al. Quality of Life in Persons Living With Psoriasis Patients. J
Am Acad Dermatol. 2014;71(2):302-307.
Mease PJ, et al. The Prevalence of Rheumatologist-Diagnosed Psoriatic Arthritis in
Patients With Psoriasis in European/North American Dermatology Clinics. J Am
Acad Dermatol. 2013;69:729-35.
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Systemic Lupus Erythematosus. Ethn Dis. 2009;19:301–307.
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2007; 369: 587–96.
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Ogdie A. The Epidemiology of Psoriatic Arthritis. Rheumatic Disease Clinics of
North America. 2015; 41:545–68.
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Updated Review. Current Rheumatology Reports. 2016.
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Am Acad Dermatol. 2014;70:512-6.
Gomez-Puerta JA. et al. Racial/Ethnic Variation in All-cause Mortality Among
United States Medicaid Recipients With Systemic Lupus Erythematosus: a Hispanic
and Asian Paradox. Arthritis Rheum. 2015.
Reveille JD, et al. Economic Considerations of the Treatment of Ankylosing
Spondylitis. Arthritis Care Research. 2012.
Reveille JD, et al. Prevalence of Axial Spondylarthritis in the United States:
Estimates From a Cross-sectional Survey. Arthritis Care Res (Hoboken). 2012.
Hanly JG, et al. Neuropsychiatric Events at the Time of Diagnosis of Systemic
Lupus Erythematosus: an International Inception Cohort Study. Arthritis Rheum.
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Journal of the Medical Sciences. 2011.
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Analysis of Neuropsychiatric Events in an International Disease Inception Cohort
of Patients With Systemic Lupus Erythematosus. Ann Rheum Dis. 2010;69.
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Arthritis, Psoriatic Arthritis and Psoriasis and Effects of Etanercept Treatment. Ann
Rheum Dis. 2012; 71 (7).
Hanly JG, et al. The Frequency and Outcome of Lupus Nephritis: Results From an
International Inception Cohort study. Rheumatology (Oxford). 2016;55(2):25262.
Sukhov A, et al. Interactions of the Immune System With Skin and Bone Tissue in
Psoriatic Arthritis: a Comprehensive Review. Clin Rev Allergy Immunol. 2016;51
(1) ; 87–99.
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Erythematosus. J Rheumoatology. 2014. 41(9);1823-333.
SLE
Agarwal N and Kumar V. Burden of Lupus on Work: Issues in the Employment of
Individual with Lupus. Work. 2016 Oct;55(2):429-439.
Ahn GE, Ramsey-Goldman R. Fatigue in Systemic Lupus Erythematosus. Int J Clin
Rheumtol. 2012;7:217–227.
Arkema EV, et al. What to Expect When Expecting With Systemic Lupus
Erythematosus (SLE): A Population-Based Study of Maternal and Fetal Outcomes
in SLE and Pre-SLE. Arthritis Care Res (Hoboken). 2016.
Buyon JP, et al. Predictors of Pregnancy Outcomes in Patients With Lupus: A Cohort
Study. Ann Intern Med. 2015;163(3):153-63.
Kan H, et al. Longitudinal Treatment Patterns and Associated Outcomes in Patients
With Newly Diagnosed Systemic Lupus Erythematosus. Clinical Therapeutics.
2016.
Kan HJ, et al. Healthcare Utilization and Costs of Systemic Lupus Erythematosus in
Medicaid. BioMed Research International. 2013.
Lim SS, et al. The Incidence and Prevalence of Systemic Lupus Erythematosus,
2002–2004: The Georgia Lupus Registry. Arthritis Rheumatol. 2014.
Meszaros ZS, Perl A, Faraone SV. Psychiatric Symptoms in Systemic Lupus
Erythematosus: a Systematic Review. J Clin Psychiatry. 2012;73:993 1001.
Nakamura J, et al. Spontaneous Repair of Asymptomatic Osteonecrosis
Associated With Corticosteroid Therapy in Systemic Lupus Erythematosus: 10-year
Minimum Follow-up With MRI. Lupus. 2010;19, pp. 1307–1314.
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Arthritis Foundation
National Institutes of Health (NIH). National Institute of Diabetes and Digestive
and Kidney Diseases U.S. Renal Data System 2010 Annual Data Report: Atlas of
Chronic Kidney Disease and End-Stage Renal Disease in the United States, URL
www.usrds.org
Panopalis P, et al. Health Care Costs and Costs Associated With Changes in Work
Productivity Among Persons With Systemic Lupus Erythematosus. Arthritis Rheum.
2008.
Petri M, et al. Healthcare Costs of Pregnancy in Systemic Lupus Erythematosus:
Retrospective Observational Analysis From a U.S. Health Claims Database. J Med
Econ. 2015.
Rahman A. Management of Cardiovascular Risk Factors in Patients With Systemic
Lupus Erythematosus. Acta Reumatol Port. 2008;33:13–15.
Rajashekar A, Perazella MA, Crowley S. Systemic Diseases with Renal
Manifestations. Prim Care. 2008;35:297 328, vi–vii.
Rus V, Maury EE, and Hochberg MC. “The Epidemiology of Systemic Lupus
Erythematosus.” Dubois’ Lupus Erythematosus. Wallace DJ, Hahn BH (Eds),
Lippincott Williams and Wilkins, Philadelphia. 2002.
Silva CA, Avcin T, Brunner HI. Taxonomy for systemic lupus erythematosus with
onset before adulthood. Arthritis Care Res (Hoboken). 2012;64 (12), 1787–93.
Singh S, Saxena R. Lupus nephritis. Am J Med Sci. 2009; 337(6):451-60.
Slawsky KA, et al. A Structured Literature Review of the Direct Costs of Adult
Systemic Lupus Erythematosus in the U.S. Arthritis Care & Research. 2011.
Somers EC, et al. Population-Based Incidence and Prevalence of Systemic Lupus
Erythematosis: The Michigan Lupus Epidemiology and Surveillance Program.
Arthritis Rheumatol. 2014;66: 369-378.
Tarr T, et al. Similarities and Differences Between Pediatric and Adult Patients With
Systemic Lupus Erythematosus. Lupus. 2015;24:796–803.
Brixner DI, Ho MJ. Clinical, Humanistic and Economic Outcomes of Gout. Am J
Manag Care. 2005;11(15 Suppl):S459–64.
Brook RA, Kleinman NL, Patel PA, et al. The Economic Burden of Gout on an
Employed Population. Curr Med Res Opin. 2006;22:1381–9.
Choi HK and Curhan G. Independent Impact of Gout on Mortality and Risk for
Coronary Heart Disease. Circulation. 2007.
Coburn BW and Mikuls TR. The Problem With Gout is That It’s Still Such a Problem.
Journal of Rheumatology. 2016.
Dalbeth N, Merriman TR, Stamp LK. Gout. The Lancet. 2016.
Eyckmans L, et al. What Does it Mean to Grow Up with Juvenile Idiopathic
Arthritis? A qualitative study on the perspectives of patients. Clin Rheumatology.
2011.
Gabriel S. E., Michaud K. Epidemiological Studies in Incidence, Prevalence,
Mortality and Comorbidity of the Rheumatic Diseases. Arthritis Research &
Therapy. 2009.
Garg R, et al. Gout-Related Health Care Utilization in U.S. Emergency
Departments, 2006 Through 2008. Arthritis Care Res. 2013; 65, 571–577.
Guzman J, et al. The Outcomes of Juvenile Idiopathic Arthritis in Children
Managed With Contemporary Treatments: Results From the ReACCh-Out Cohort.
Ann Rheum Dis. 2014.
Jackson R, et al. Flare Frequency, Health Care Resource Utilization and Costs
Among Patients With Gout in a Managed Care Setting: A Retrospective Medical
Claims-Based Analysis. BMJ Open. 2015.
Jinno S, et al. Trends in Emergency Department Visits and Charges for Gout in the
United States Between 2006 and 2012. J Rheumatol. 2016.
Tektonidou MG, et al. Arthritis Care & Research. 2015.
Karis E, Crittenden DB, Pillinger MH. Hyperuricemia, Gout and Related
Comorbidities: Cause and Effect on a Two-Way Street. South Med .J
2014;107:235−41.
Ward MM. Medical Insurance, Socioeconomic Status, and Age of Onset of
Endstage Renal Disease in Patients with Lupus Nephritis. J Rheumatol.
2007;34(10):2024–2027.
Khanna D, et al. 2012 American College of Rheumatology Guidelines for
Management of Gout. Part 2: Therapy and Anti-inflammatory Prophylaxis of Acute
Gouty Arthritis. Arthritis Care Res. 2012.
Weiss JE. Pediatric Systemic Lupus Erythematosus: More than a Positive
Antinuclear Antibody. Pediatr Rev. 2012 Feb;33(2):62-73.
Khanna PP, et al. Tophi and Frequent Gout Flares Are Associated With Impairments
to Quality of Life, Productivity and Increased Health Care Resource Use: Results
From a Cross-Sectional Survey. Health Qual Life Outcomes. 2012.
Yelin E, et al. Work Dynamics Among Persons With Systemic Lupus Erythematosus.
Arthritis Rheum. 2007;57:56–63.
Section 4: Juvenile Idiopathic Arthritis (JIA)
Armbrust W, et al. Fatigue in Patients with Juvenile Idiopathic Arthritis: A Systematic
Review of the Literature. Seminars in Arthritis and Rheumatism. 2016.
Bardin T, et al. The Human and Economic Burden of Difficult-to-Treat Gouty
Arthritis. Joint Bone Spine. 2015.
Bernatsky S, Duffy C, Malleson P et al. Economic impact of juvenile idiopathic
arthritis. Arthritis Rheum. 2007;57: 4448.
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Kimura Y, et al. Treatment of pain in juvenile Idiopathic Arthritis: A Survey of
Pediatric Rheumatologists. Arthritis Rheum. 2006;55(1):81–5.
Krause ML, et al. Population-based Study of Outcomes of Patients with Juvenile
Idiopathic Arthritis (JIA) Compared to Non-JIA Subjects. Seminars in Arthritis and
Rheumatism. 2016.
Krishnan E, Chen L. Trends in Physician-Diagnosed Gout and Gout Therapies in the
U.S.: Results From the National Ambulatory Health Care Surveys 1993 to 2009.
Arthritis Res Ther. 2013;15(6):R181.
Kuo C-F, et al. Global Epidemiology of Gout: Prevalence, Incidence and Risk
Factors. Nat Rev Rheumatol. 2015.
Arthritis by the Numbers | Book of Trusted Facts & Figures
Li C, et al. Ambulatory Resource Utilization and Cost for Gout in the United States.
Am J Pharm Benefits. 2013; 5, e46–e54.
Lim SY, et al. Trends in Gout and Rheumatoid Arthritis Hospitalizations in the United
States, 1993-2011. JAMA. 2016.
Lindsay K, et al. The Experience and Impact of Living With Gout: A Study of Men
With Chronic Gout Using a Qualitative-Grounded Theory Approach. J Clin
Rheumatol. 2011;17:1–6.
Lynch W, et al. Economic Burden of Gouty Arthritis Attacks for Employees With
Frequent and Infrequent Attacks. Popul Health Manag. 2013;16:138–45.
Oliveira S, et al, for the Pediatric Rheumatology International Trials Organization
(PRINTO). Proxy-reported Health-related Quality of Life of Patients with Juvenile
Idiopathic Arthritis: The Pediatric Rheumatology International Trials Organization
Multinational Quality of Life Cohort Study. Arthritis Rheum. 2007.
Pelajo CF, Lopez-Benitez JM, and Miller LC. Obesity and Disease Activity in
Juvenile Idiopathic Arthritis. Pediatric Rheumatology. 2012.
Rai SK, et al. The Economic Burden of Gout: A Systematic Review. Semin Arthritis
Rheum. 2015.
Rasu RS, et al. Impact of JIA on Parents’ Work Absences. Rheumatology. 2015.
Rome K, Frecklington M, McNair P, et al. Foot Pain, Impairment and Disability in
Patients With Acute Gout Flares: A Prospective Observational Study. Arthritis Care
Res (Hoboken) 2012;64:384–8.
Sacks J, et al. Prevalence of and Annual Ambulatory Health Care Visits for
Pediatric Arthritis and Other Rheumatologic Conditions in the U.S. in 2001-2004.
Arthritis Rheumatol. 2007.
Saurenmann RK, et al. Prevalence, Risk Factors, and Outcome of Uveitis in Juvenile
Idiopathic Arthritis: A long-term follow-up study. Arthritis Rheum. 2007.
Section 5: Gout
Seid M, et al. Determinants of Health-related Quality of Life in Children Newly
Diagnosed with Juvenile Idiopathic Arthritis. Arthritis Care and Research. 2014.
Shenoi S and Wallace CA. Diagnosis and Treatment of Systemic Juvenile
Idiopathic Arthritis. 2016. J Pediatr. 177: 19-26.
Singh JA and Yu S. Time Trends, Predictors and Outcome of Emergency
Department Use for Gout: A Nationwide U.S. Study. J Rheumatol. 2016.
Singh JA, et al. Health Care Utilization in Patients With Gout. Semin Arthritis
Rheum. 2011;40:501–511.
Stoll ML, Cron RQ. Treatment of juvenile idiopathic arthritis: a revolution in care.
Pediatr Rheumatol. 2014;12(1):13.
Thierry S, Fautrel B, Lemelle I, Guillemin F. Prevalence and incidence of juvenile
idiopathic arthritis: a systematic review. Joint Bone Spine. 2014;81(2):112–7.
Wu EQ, et al. Comorbidity Burden, Health Care Resource Utilization and Costs in
Chronic Gout Patients Refractory to Conventional Urate-Lowering Therapy. Am J of
Therapeutics. 2012;19(6):e157-e166.
Zhu Y, et al. Prevalence of Gout and Hyperuricemia in the U.S. General
Population: The National Health and Nutrition Examination Survey 2007-2008.
Arthritis Rheum. 2011;63:3136–41.
Section 6: Fibromyalgia
Arnold LM, Clauw DJ, and McCarberg BH. Improving the Recognition and
Diagnosis of Fibromyalgia. Mayo Clin Proc. 2011;86(5):457–464.
Arnold LM, et al. Patient Perspectives on the Impact of Fibromyalgia. Patient Educ
Couns. 2008;73(1):114–120.
Bennett R. Clinical Manifestations and Diagnosis of Fibromyalgia. Rheum Dis Clin
North Am. 2009;35:215–232.
Juuso P, Skär L, Olsson M, and Söderberg S. Living With a Double Burden:
Meanings of Pain for Women With Fibromyalgia. Int J Qual Stud Health
Well-being. 2011;6(3).
Kashikar-Zuck S, et al. Actigraphy-Based Physical Activity Monitoring in Adolescents
With Juvenile Primary Fibromyalgia Syndrome. J Pain. 2010;11:885–893.
Kashikar-Zuck S, et al. Social Functioning and Peer Relationships of Adolescents
With Juvenile Fibromyalgia Syndrome. Arthritis Rheum. 2007;57:474–480.
Rodham K, Rance N, and Blake D. A Qualitative Exploration of carers’ and
Patients’ Experiences of Fibromyalgia: One Illness, Different Perspectives.
Musculoskeletal Care. 2010;8(2):68–77.
Schaefer C, et al. The Comparative Burden of Chronic Widespread Pain and
Fibromyalgia in the United States. Pain Pract. 2016;16(5):565–579.
Vincent A, et al. A Cross-Sectional Assessment of the Prevalence of Multiple Chronic
Conditions and Medication Use in a Sample of Community-Dwelling Adults With
Fibromyalgia in Olmsted County, Minnesota. BMJ Open. 2015;5(3):e006681.
Appendix 2
The state arthritis facts in Appendix 2 come from the CDC web pages. The
references for each fact are noted by the numbers listed below.
1. Centers for Disease Control and Prevention (CDC). Murphy LB, et al. Arthritis
Among Veterans – United States, 2011-2013. MMWR. Nov 7 2014;
63(44);999-1003. Table 2 available at: https://www.cdc.gov/mmwr/
preview/mmwrhtml/mm6344a4.htm?s_cid=mm6344a4_e#tab2
2. CDC. State Data Tables (from Behavioral Risk Factor Surveillance System).
Available at: https://www.cdc.gov/arthritis/data_statistics/state-data-listcurrent.htm. Updated Sept 27, 2016.
Wertheimer A, Morlock R, and Becker MA. A Revised Estimate of the Burden of
Illness of Gout. Curr Ther Res Clin Exp. 2013;75:1–4.
3. CDC. State Data Tables. Prevalence of Arthritis-Attributable Work Limitation
Among All Adults (Age-Adjusted). Available at: https://www.cdc.gov/
arthritis/data_statistics/state-text.htm#figure4. Updated December 8, 2016.
Wilson L and Saseen JJ. Gouty Arthritis: A Review of Acute Management and
Prevention. Pharmacotherapy. 2016.
4. CDC. Disease Cost Calculator Version 2. Available at: https://www.cdc.gov/
chronicdisease/calculator/. Updated February 10, 2015.
Wilson L and Saseen JJ. Gouty Arthritis: A Review of Acute Management and
Prevention. Pharmacotherapy. 2016.
5. Barbour KE, et al. Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and
Arthritis-Attributable Activity Limitation -- United States 2013-2015. MMWR
2017;66(9);246-253.
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Arthritis Foundation
APPENDIX 1
Types of Arthritis
The following is a list of arthritis and related conditions considered to be types of arthritis.
For more information about each type of arthritis, visit arthritis.org.
- Adult-onset Still’s Disease
- Ankylosing Spondylitis
- Myositis
- Osteoarthritis (OA)
- Back Pain
- Behçet’s Disease
- Bursitis
- Calcium Pyrophosphate Deposition Disease (CPPD)
- Carpal Tunnel Syndrome
- Chondromalacia Patella
- Chronic Fatigue Syndrome
- Complex Regional Pain Syndrome
- Cryopyrin-Associated Periodic Syndromes
- Degenerative Disc Disease
- Developmental-Dysplasia of Hip
- Ehlers-Danlos
- Familial Mediterranean Fever
- Fibromyalgia
- Fifth Disease
- Giant Cell Arteritis
- Gout
- Hemochromatosis
- Infectious Arthritis
- Inflammatory Arthritis
- Inflammatory Bowel Disease
- Juvenile Dermatomyositis (JD)
- Juvenile Idiopathic Arthritis (JIA)
- Juvenile Scleroderma
- Kawasaki Disease
- Lupus
- Lupus in Children & Teens
- Lyme Disease
- Mixed Connective Tissue Disease
- Osteoporosis
- Pagets
- Palindromic Rheumatism
- Patellofemoral Pain Syndrome
- Pediatric Rheumatic Diseases
- Pediatric SLE
- Polymyalgia Rheumatica
- Pseudogout
- Psoriatic Arthritis (PsA)
- Raynaud’s Phenomenon
- Reactive Arthritis
- Reflex Sympathetic Dystrophy
- Reiter’s Sydrome
- Rheumatic Fever
- Rheumatism
- Rheumatoid Arthritis (RA)
- Scleroderma
- Sjögren’s Disease
- Spinal Stenosis
- Spondyloarthritis (SpA)
- Systemic Juvenile Idiopathic Arthritis (JIA)
- Systemic Lupus Erythematosus (SLE)
- Systemic Lupus Erythematosus (SLE) in Children & Teens
- Systemic Sclerosis
- Temporal Arteritis
- Tendinitis
- Vasculitis
- Wegener’s Granulomatosis
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Arthritis by the Numbers | Book of Trusted Facts & Figures
APPENDIX 2
State Facts
All of the state data presented in this appendix is from the Center for Disease Control and Prevention (CDC).
The CDC presents state-specific data from the Behavioral Risk Factor Surveillance System (BRFSS), which the
CDC considers the best source for state-specific arthritis prevalence estimates.
BRFSS collects information in odd-numbered years (i.e., 2003, 2005, etc.) from a randomly dialed telephone
survey of non-institutionalized, US civilians aged 18 years or older. The survey is completed in all 50 states,
the District of Columbia, Puerto Rico, Guam, and the Virgin Islands. For additional information on the BRFSS
and how it is used to collect specific information on arthritis, see https://www.cdc.gov/arthritis/data_statistics/state-data-current.htm.
Because the state arthritis facts in Appendix 2 are from the CDC, the references for each fact are noted by
numbers (see References for Appendix 2).
Each state’s “yearly costs for days lost from work because of arthritis” has been calculated by the Arthritis
Foundation’s Advocacy staff using the CDC’s Disease Cost Calculator (Version 2; Reference 4).
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Arthritis Foundation
APPENDIX 2
CDC Map
Arthritis Prevalence in the U.S.
Percentage of people by state who have doctor-diagnosed arthritis
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Alabama: Why Arthritis Matters
Arthritis affects 33% of the population in Alabama. That’s 1,248,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,248,000 people in AL living with doctor-diagnosed arthritis.2
• That means that 33% of AL adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 15% of the people
in AL with arthritis.1
In AL, adults with one or more chronic conditions often have arthritis.
•Diabetes: 56% of AL adults with diabetes also have arthritis.2
•Hypertension: 51% of AL adults with hypertension also have arthritis.2
•Obesity: 41% of AL adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis. 5
• 640,000 (51%) adults in AL with arthritis have activity limitations.2
•About 16% of these adults have arthritis-attributable work limitations.3
•About 44% of adults in AL with arthritis are inactive.2
• In AL, the yearly cost for days lost from work because of arthritis is $235 million.4
You can help people in AL by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Alaska: Why Arthritis Matters
Arthritis affects 21% of the population in Alaska. That’s 117,000 adults living
with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 117,000 people in AK living with doctor-diagnosed arthritis.2
• That means that 21% of AK adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 22% of the people
in AK with arthritis.1
In AK, adults with one or more chronic conditions often have arthritis.
•Diabetes: 44% of AK adults with diabetes also have arthritis.2
•Hypertension: 39% of AK adults with hypertension also have arthritis.2
•Obesity: 30% of AK adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis. 5
• 55,000 (47%) adults in AK with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 32% of adults in AK with arthritis are inactive.2
• In AK, the yearly cost for days lost from work because of arthritis is $35 million.4
You can help people in AK by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Arizona: Why Arthritis Matters
Arthritis affects 24% of the population in Arizona. That’s 1,222,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,222,000 people in AZ living with doctor-diagnosed arthritis. 2
• That means that 24% of AZ adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 19% of the people
in AZ with arthritis.1
In AZ, adults with one or more chronic conditions often have arthritis.
•Diabetes: 46% of AZ adults with diabetes also have arthritis.2
•Hypertension: 40% of AZ adults with hypertension also have arthritis.2
•Obesity: 30% of AZ adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis. 5
• 558,000 (56%) adults in AZ with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 34% of adults in AZ with arthritis are inactive.2
• In AZ, the yearly cost for days lost from work because of arthritis is $314 million.4
You can help people in AZ by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Arkansas: Why Arthritis Matters
Arthritis affects 30% of the population in Arkansas. That’s 672,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 672,000 people in AR living with doctor-diagnosed arthritis. 2
• That means that 30% of AR adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 15% of the people
in AR with arthritis.1
In AR, adults with one or more chronic conditions often have arthritis.
•Diabetes: 59% of AR adults with diabetes also have arthritis.2
•Hypertension: 46% of AR adults with hypertension also have arthritis.2
•Obesity: 38% of AR adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 345,000 (51%) adults in AR with arthritis have activity limitations.2
•About 15% of these adults have arthritis-attributable work limitations.3
•About 48% of adults in AR with arthritis are inactive.2
• In AR, the yearly cost for days lost from work because of arthritis is $142 million.4
You can help people in AR by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
California: Why Arthritis Matters
Arthritis affects 19% of the population in California. That’s 5,719,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 5,719,000 people in CA living with doctor-diagnosed arthritis. 2
• That means that 19% of CA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in CA with arthritis.1
In CA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 36% of CA adults with diabetes also have arthritis.2
•Hypertension: 36% of CA adults with hypertension also have arthritis.2
•Obesity: 26% of CA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 2,446,000 (43%) adults in CA with arthritis have activity limitations.2
•About 8% of these adults have arthritis-attributable work limitations.3
•About 25% of adults in CA with arthritis are inactive.2
• In CA, the yearly cost for days lost from work because of arthritis is $1.791 billion.4
You can help people in CA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Colorado: Why Arthritis Matters
Arthritis affects 23% of the population in Colorado. That’s 949,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 949,000 people in CO living with doctor-diagnosed arthritis. 2
• That means that 23% of CO adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in CO with arthritis.1
In CO, adults with one or more chronic conditions often have arthritis.
•Diabetes: 47% of CO adults with diabetes also have arthritis.2
•Hypertension: 42% of CO adults with hypertension also have arthritis.2
•Obesity: 33% of CO adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 398,000 (42%) adults in CO with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 27% of adults in CO with arthritis are inactive.2
• In CO, the yearly cost for days lost from work because of arthritis is $253 million.4
You can help people in CO by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Connecticut: Why Arthritis Matters
Arthritis affects 25% of the population in Connecticut. That’s 690,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 690,000 people in CT living with doctor-diagnosed arthritis. 2
• That means that 25% of CT adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in CT with arthritis.1
In CT, adults with one or more chronic conditions often have arthritis.
•Diabetes: 45% of CT adults with diabetes also have arthritis.2
•Hypertension: 43% of CT adults with hypertension also have arthritis.2
•Obesity: 35% of CT adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 290,000 (42%) adults in CT with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 33% of adults in CT with arthritis are inactive.2
• In CT, the yearly cost for days lost from work because of arthritis is $191 million.4
You can help people in CT by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Deleware: Why Arthritis Matters
Arthritis affects 28% of the population in Deleware. That’s 207,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 207,000 people in DE living with doctor-diagnosed arthritis. 2
• That means that 28% of DE adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in DE with arthritis.1
In DE, adults with one or more chronic conditions often have arthritis.
•Diabetes: 50% of DE adults with diabetes also have arthritis.2
•Hypertension: 45% of DE adults with hypertension also have arthritis.2
•Obesity: 36% of DE adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 90,000 (44%) adults in DE with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 42% of adults in DE with arthritis are inactive.2
• In DE, the yearly cost for days lost from work because of arthritis is $44 million.4
You can help people in DE by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Washington, DC: Why Arthritis Matters
Arthritis affects 18% of the population in Washington, DC. That’s 207,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 101,000 people in DC living with doctor-diagnosed arthritis. 2
• That means that 18% of DC adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 10% of the people
in DC with arthritis.1
In DC, adults with one or more chronic conditions often have arthritis.
•Diabetes: 47% of DC adults with diabetes also have arthritis.2
•Hypertension: 42% of DC adults with hypertension also have arthritis.2
•Obesity: 37% of DC adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 48,000 (48%) adults in DC with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 31% of adults in DC with arthritis are inactive.2
• In DC, the yearly cost for days lost from work because of arthritis is $29 million.4
You can help people in DC by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Florida: Why Arthritis Matters
Arthritis affects 26% of the population in Florida. That’s 4,154,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 4,154,000 people in FL living with doctor-diagnosed arthritis. 2
• That means that 26% of FL adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in FL with arthritis.1
In FL, adults with one or more chronic conditions often have arthritis.
•Diabetes: 53% of FL adults with diabetes also have arthritis.2
•Hypertension: 44% of FL adults with hypertension also have arthritis.2
•Obesity: 35% of FL adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 1,941,000 (47%) adults in FL with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 39% of adults in FL with arthritis are inactive.2
• In FL, the yearly cost for days lost from work because of arthritis is $934 million.4
You can help people in FL by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Georgia: Why Arthritis Matters
Arthritis affects 25% of the population in Georgia. That’s 1,890,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,890,000 people in GA living with doctor-diagnosed arthritis. 2
• That means that 25% of GA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 17% of the people
in GA with arthritis.1
In GA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 52% of GA adults with diabetes also have arthritis.2
•Hypertension: 43% of GA adults with hypertension also have arthritis.2
•Obesity: 35% of GA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 882,000 (47%) adults in GA with arthritis have activity limitations.2
•About 12% of these adults have arthritis-attributable work limitations.3
•About 39% of adults in GA with arthritis are inactive.2
• In GA, the yearly cost for days lost from work because of arthritis is $465 million.4
You can help people in GA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Hawaii: Why Arthritis Matters
Arthritis affects 19% of the population in Hawaii. That’s 211,000 adults living
with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 211,000 people in HI living with doctor-diagnosed arthritis. 2
• That means that 19% of HI adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 17% of the people
in HI with arthritis.1
In HI, adults with one or more chronic conditions often have arthritis.
•Diabetes: 39% of HI adults with diabetes also have arthritis.2
•Hypertension: 31% of HI adults with hypertension also have arthritis.2
•Obesity: 28% of HI adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 81,000 (38%) adults in HI with arthritis have activity limitations.2
•About 7% of these adults have arthritis-attributable work limitations.3
•About 26% of adults in HI with arthritis are inactive.2
• In HI, the yearly cost for days lost from work because of arthritis is $67 million.4
You can help people in HI by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Idaho: Why Arthritis Matters
Arthritis affects 25% of the population in Idaho. That’s 309,000 adults living
with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 309,000 people in ID living with doctor-diagnosed arthritis. 2
• That means that 25% of ID adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 19% of the people
in ID with arthritis.1
In ID, adults with one or more chronic conditions often have arthritis.
•Diabetes: 47% of ID adults with diabetes also have arthritis.2
•Hypertension: 42% of ID adults with hypertension also have arthritis.2
•Obesity: 32% of ID adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 137,000 (44%) adults in ID with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 31% of adults in ID with arthritis are inactive.2
• In ID, the yearly cost for days lost from work because of arthritis is $75 million.4
You can help people in ID by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Illinois: Why Arthritis Matters
Arthritis affects 23% of the population in Illinois. That’s 2,308,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 2,308,000 people in IL living with doctor-diagnosed arthritis. 2
• That means that 23% of IL adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 13% of the people
in IL with arthritis.1
In IL, adults with one or more chronic conditions often have arthritis.
•Diabetes: 46% of IL adults with diabetes also have arthritis.2
•Hypertension: 43% of IL adults with hypertension also have arthritis.2
•Obesity: 32% of IL adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 982,000 (43%) adults in IL with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 36% of adults in IL with arthritis are inactive.2
• In IL, the yearly cost for days lost from work because of arthritis is $721 million.4
You can help people in IL by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Indiana: Why Arthritis Matters
Arthritis affects 28% of the population in Indiana. That’s 1,390,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,390,000 people in IN living with doctor-diagnosed arthritis. 2
• That means that 28% of IN adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 13% of the people
in IN with arthritis.1
In IN, adults with one or more chronic conditions often have arthritis.
•Diabetes: 51% of IN adults with diabetes also have arthritis.2
•Hypertension: 48% of IN adults with hypertension also have arthritis.2
•Obesity: 36% of IN adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 599,000 (43%) adults in IN with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 41% of adults in IN with arthritis are inactive.2
• In IN, the yearly cost for days lost from work because of arthritis is $362 million.4
You can help people in IN by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Iowa: Why Arthritis Matters
Arthritis affects 26% of the population in Iowa. That’s 619,000 adults living
with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 619,000 people in IA living with doctor-diagnosed arthritis. 2
• That means that 26% of IA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 15% of the people
in IA with arthritis.1
In IA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 52% of IA adults with diabetes also have arthritis.2
•Hypertension: 45% of IA adults with hypertension also have arthritis.2
•Obesity: 34% of IA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 228,000 (37%) adults in IA with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 37% of adults in IA with arthritis are inactive.2
• In IA, the yearly cost for days lost from work because of arthritis is $173 million.4
You can help people in IA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Kansas: Why Arthritis Matters
Arthritis affects 25% of the population in Kansas. That’s 536,000 adults living
with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 536,000 people in KS living with doctor-diagnosed arthritis. 2
• That means that 25% of KS adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 17% of the people
in KS with arthritis.1
In KS, adults with one or more chronic conditions often have arthritis.
•Diabetes: 50% of KS adults with diabetes also have arthritis.2
•Hypertension: 43% of KS adults with hypertension also have arthritis.2
•Obesity: 34% of KS adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 228,000 (43%) adults in KS with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 37% of adults in KS with arthritis are inactive.2
• In KS, the yearly cost for days lost from work because of arthritis is $157 million.4
You can help people in KS by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Kentucky: Why Arthritis Matters
Arthritis affects 32% of the population in Kentucky. That’s 1,087,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,087,000 people in KY living with doctor-diagnosed arthritis. 2
• That means that 32% of KY adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 13% of the people
in KY with arthritis.1
In KY, adults with one or more chronic conditions often have arthritis.
•Diabetes: 56% of KY adults with diabetes also have arthritis.2
•Hypertension: 49% of KY adults with hypertension also have arthritis.2
•Obesity: 44% of KY adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 562,000 (52%) adults in KY with arthritis have activity limitations.2
•About 16% of these adults have arthritis-attributable work limitations.3
•About 42% of adults in KY with arthritis are inactive.2
• In KY, the yearly cost for days lost from work because of arthritis is $217 million.4
You can help people in KY by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Louisiana: Why Arthritis Matters
Arthritis affects 28% of the population in Louisiana. That’s 989,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 989,000 people in LA living with doctor-diagnosed arthritis. 2
• That means that 28% of LA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in LA with arthritis.1
In LA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 54% of LA adults with diabetes also have arthritis.2
•Hypertension: 45% of LA adults with hypertension also have arthritis.2
•Obesity: 36% of LA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 472,000 (48%) adults in LA with arthritis have activity limitations.2
•About 16% of these adults have arthritis-attributable work limitations.3
•About 45% of adults in LA with arthritis are inactive.2
• In LA, the yearly cost for days lost from work because of arthritis is $218 million.4
You can help people in LA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Maine: Why Arthritis Matters
Arthritis affects 31% of the population in Maine. That’s 332,000 adults living
with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 332,000 people in ME living with doctor-diagnosed arthritis. 2
• That means that 31% of ME adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in ME with arthritis.1
In ME, adults with one or more chronic conditions often have arthritis.
•Diabetes: 58% of ME adults with diabetes also have arthritis.2
•Hypertension: 49% of ME adults with hypertension also have arthritis.2
•Obesity: 40% of ME adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 149,000 (45%) adults in ME with arthritis have activity limitations.2
•About 12% of these adults have arthritis-attributable work limitations.3
•About 37% of adults in ME with arthritis are inactive.2
• In ME, the yearly cost for days lost from work because of arthritis is $77 million.4
You can help people in ME by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Maryland: Why Arthritis Matters
Arthritis affects 24% of the population in Maryland. That’s 1,096,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,096,000 people in MD living with doctor-diagnosed arthritis. 2
• That means that 24% of MD adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in MD with arthritis.1
In MD, adults with one or more chronic conditions often have arthritis.
•Diabetes: 44% of MD adults with diabetes also have arthritis.2
•Hypertension: 41% of MD adults with hypertension also have arthritis.2
•Obesity: 37% of MD adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 405,000 (37%) adults in MD with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 38% of adults in MD with arthritis are inactive.2
• In MD, the yearly cost for days lost from work because of arthritis is $287 million.4
You can help people in MD by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
- 67 -
Arthritis Foundation
Massachusetts: Why Arthritis Matters
Arthritis affects 24% of the population in Massachusetts. That’s 1,300,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,300,000 people in MA living with doctor-diagnosed arthritis. 2
• That means that 24% of MA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in MA with arthritis.1
In MA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 48% of MA adults with diabetes also have arthritis.2
•Hypertension: 41% of MA adults with hypertension also have arthritis.2
•Obesity: 37% of MA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 555,000 (43%) adults in MA with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 38% of adults in MA with arthritis are inactive.2
• In MA, the yearly cost for days lost from work because of arthritis is $353 million.4
You can help people in MA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
- 68 -
Arthritis by the Numbers | Book of Trusted Facts & Figures
Michigan: Why Arthritis Matters
Arthritis affects 30% of the population in Michigan. That’s 2,305,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 2,305,000 people in MI living with doctor-diagnosed arthritis. 2
• That means that 30% of MI adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 13% of the people
in MI with arthritis.1
In MI, adults with one or more chronic conditions often have arthritis.
•Diabetes: 53% of MI adults with diabetes also have arthritis.2
•Hypertension: 48% of MI adults with hypertension also have arthritis.2
•Obesity: 39% of MI adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 1,038,000 (45%) adults in MI with arthritis have activity limitations.2
•About 13% of these adults have arthritis-attributable work limitations.3
•About 36% of adults in MI with arthritis are inactive.2
• In MI, the yearly cost for days lost from work because of arthritis is $585 million.4
You can help people in MI by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
- 69 -
Arthritis Foundation
Minnesota: Why Arthritis Matters
Arthritis affects 22% of the population in Minnesota. That’s 907,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 907,000 people in MN living with doctor-diagnosed arthritis. 2
• That means that 22% of MN adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in MN with arthritis.1
In MN, adults with one or more chronic conditions often have arthritis.
•Diabetes: 48% of MN adults with diabetes also have arthritis.2
•Hypertension: 40% of MN adults with hypertension also have arthritis.2
•Obesity: 32% of MN adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 393,000 (43%) adults in MN with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 33% of adults in MN with arthritis are inactive.2
• In MN, the yearly cost for days lost from work because of arthritis is $302 million.4
You can help people in MN by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Mississippi: Why Arthritis Matters
Arthritis affects 29% of the population in Mississippi. That’s 647,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 647,000 people in MS living with doctor-diagnosed arthritis. 2
• That means that 29% of MS adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in MS with arthritis.1
In MS, adults with one or more chronic conditions often have arthritis.
•Diabetes: 52% of MS adults with diabetes also have arthritis.2
•Hypertension: 45% of MS adults with hypertension also have arthritis.2
•Obesity: 34% of MS adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 346,000 (54%) adults in MS with arthritis have activity limitations.2
•About 15% of these adults have arthritis-attributable work limitations.3
•About 50% of adults in MS with arthritis are inactive.2
• In MS, the yearly cost for days lost from work because of arthritis is $142 million.4
You can help people in MS by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Missouri: Why Arthritis Matters
Arthritis affects 29% of the population in Missouri. That’s 1,372,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,372,000 people in MO living with doctor-diagnosed arthritis. 2
• That means that 29% of MO adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 15% of the people
in MO with arthritis.1
In MO, adults with one or more chronic conditions often have arthritis.
•Diabetes: 56% of MO adults with diabetes also have arthritis.2
•Hypertension: 48% of MO adults with hypertension also have arthritis.2
•Obesity: 37% of MO adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 649,000 (51%) adults in MO with arthritis have activity limitations.2
•About 14% of these adults have arthritis-attributable work limitations.3
•About 37% of adults in MO with arthritis are inactive.2
• In MO, the yearly cost for days lost from work because of arthritis is $341 million.4
You can help people in MO by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Montana: Why Arthritis Matters
Arthritis affects 27% of the population in Montana. That’s 216,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 216,000 people in MT living with doctor-diagnosed arthritis. 2
• That means that 27% of MT adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 19% of the people
in MT with arthritis.1
In MT, adults with one or more chronic conditions often have arthritis.
•Diabetes: 54% of MT adults with diabetes also have arthritis.2
•Hypertension: 45% of MT adults with hypertension also have arthritis.2
•Obesity: 36% of MT adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 103,000 (48%) adults in MT with arthritis have activity limitations.2
•About 12% of these adults have arthritis-attributable work limitations.3
•About 30% of adults in MT with arthritis are inactive.2
• In MT, the yearly cost for days lost from work because of arthritis is $53 million.4
You can help people in MT by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Nebraska: Why Arthritis Matters
Arthritis affects 23% of the population in Nebraska. That’s 334,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 334,000 people in NE living with doctor-diagnosed arthritis. 2
• That means that 23% of NE adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 17% of the people
in NE with arthritis.1
In NE, adults with one or more chronic conditions often have arthritis.
•Diabetes: 48% of NE adults with diabetes also have arthritis.2
•Hypertension: 42% of NE adults with hypertension also have arthritis.2
•Obesity: 32% of NE adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 137,000 (41%) adults in NE with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 34% of adults in NE with arthritis are inactive.2
• In NE, the yearly cost for days lost from work because of arthritis is $100 million.4
You can help people in NE by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Nevada: Why Arthritis Matters
Arthritis affects 22% of the population in Nevada. That’s 477,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 477,000 people in NV living with doctor-diagnosed arthritis. 2
• That means that 22% of NV adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in NV with arthritis.1
In NV, adults with one or more chronic conditions often have arthritis.
•Diabetes: 42% of NV adults with diabetes also have arthritis.2
•Hypertension: 42% of NV adults with hypertension also have arthritis.2
•Obesity: 29% of NV adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 212,000 (44%) adults in NVwith arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 33% of adults in NV with arthritis are inactive.2
• In NV, the yearly cost for days lost from work because of arthritis is $131 million.4
You can help people in NV by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
New Hampshire: Why Arthritis Matters
Arthritis affects 27% of the population in New Hampshire. That’s 282,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 282,000 people in NH living with doctor-diagnosed arthritis. 2
• That means that 27% of NH adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 17% of the people
in NH with arthritis.1
In NH, adults with one or more chronic conditions often have arthritis.
•Diabetes: 53% of NH adults with diabetes also have arthritis.2
•Hypertension: 45% of NH adults with hypertension also have arthritis.2
•Obesity: 37% of NH adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 115,000 (41%) adults in NH with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 35% of adults in NH with arthritis are inactive.2
• In NH, the yearly cost for days lost from work because of arthritis is $75 million.4
You can help people in NH by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
New Jersey: Why Arthritis Matters
Arthritis affects 23% of the population in New Jersey. That’s 1,590,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,590,000 people in NJ living with doctor-diagnosed arthritis. 2
• That means that 23% of NJ adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 13% of the people
in NJ with arthritis.1
In NJ, adults with one or more chronic conditions often have arthritis.
•Diabetes: 48% of NJ adults with diabetes also have arthritis.2
•Hypertension: 40% of NJ adults with hypertension also have arthritis.2
•Obesity: 34% of NJ adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 675,000 adults in NJ with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 37% of adults in NJ with arthritis are inactive.2
• In NJ, the yearly cost for days lost from work because of arthritis is $467 million.4
You can help people in NJ by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
New Mexico: Why Arthritis Matters
Arthritis affects 25% of the population in New Mexico. That’s 386,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 386,000 people in NM living with doctor-diagnosed arthritis. 2
• That means that 25% of NM adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in NM with arthritis.1
In NM, adults with one or more chronic conditions often have arthritis.
•Diabetes: 46% of NM adults with diabetes also have arthritis.2
•Hypertension: 43% of NM adults with hypertension also have arthritis.2
•Obesity: 30% of NM adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 176,000 (46%) adults in NM with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 30% of adults in NM with arthritis are inactive.2
• In NM, the yearly cost for days lost from work because of arthritis is $100d million.4
You can help people in NM by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
New York: Why Arthritis Matters
Arthritis affects 23% of the population in New York. That’s 3,629,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 3,629,000 people in NY living with doctor-diagnosed arthritis. 2
• That means that 23% of NY adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 10% of the people
in NY with arthritis.1
In NY, adults with one or more chronic conditions often have arthritis.
•Diabetes: 48% of NY adults with diabetes also have arthritis.2
•Hypertension: 44% of NY adults with hypertension also have arthritis.2
•Obesity: 35% of NY adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 1,503,000 (46%) adults in NY with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 41% of adults in NY with arthritis are inactive.2
• In NY, the yearly cost for days lost from work because of arthritis is $1.042 billion.4
You can help people in NY by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
North Carolina: Why Arthritis Matters
Arthritis affects 27% of the population in North Carolina. That’s 2,089,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 2,089,000 people in NC living with doctor-diagnosed arthritis. 2
• That means that 27% of NC adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in NC with arthritis.1
In NC, adults with one or more chronic conditions often have arthritis.
•Diabetes: 53% of NC adults with diabetes also have arthritis.2
•Hypertension: 46% of NC adults with hypertension also have arthritis.2
•Obesity: 37% of NC adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 1,080,000 (52%) adults in NC with arthritis have activity limitations.2
•About 13% of these adults have arthritis-attributable work limitations.3
•About 40% of adults in NC with arthritis are inactive.2
• In NC, the yearly cost for days lost from work because of arthritis is $460 million.4
You can help people in NC by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
North Dakota: Why Arthritis Matters
Arthritis affects 23% of the population in North Dakota. That’s 134,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 134,000 people in ND living with doctor-diagnosed arthritis. 2
• That means that 23% of ND adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in ND with arthritis.1
In ND, adults with one or more chronic conditions often have arthritis.
•Diabetes: 44% of ND adults with diabetes also have arthritis.2
•Hypertension: 41% of ND adults with hypertension also have arthritis.2
•Obesity: 31% of ND adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 57,000 (43%) adults in ND with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 37% of adults in ND with arthritis are inactive.2
• In ND, the yearly cost for days lost from work because of arthritis is $37 million.4
You can help people in ND by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Ohio: Why Arthritis Matters
Arthritis affects 28% of the population in Ohio. That’s 2,547,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 2,547,000 people in OH living with doctor-diagnosed arthritis. 2
• That means that 28% of OH adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in OH with arthritis.1
In OH, adults with one or more chronic conditions often have arthritis.
•Diabetes: 54% of OH adults with diabetes also have arthritis.2
•Hypertension: 46% of OH adults with hypertension also have arthritis.2
•Obesity: 38% of OH adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 1,136,000 (45%) adults in OH with arthritis have activity limitations.2
•About 12% of these adults have arthritis-attributable work limitations.3
•About 39% of adults in OH with arthritis are inactive.2
• In OH, the yearly cost for days lost from work because of arthritis is $671 million.4
You can help people in OH by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Oklahoma: Why Arthritis Matters
Arthritis affects 28% of the population in Oklahoma. That’s 813,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 813,000 people in OK living with doctor-diagnosed arthritis. 2
• That means that 28% of OK adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in OK with arthritis.1
In OK, adults with one or more chronic conditions often have arthritis.
•Diabetes: 55% of OK adults with diabetes also have arthritis.2
•Hypertension: 48% of OK adults with hypertension also have arthritis.2
•Obesity: 36% of OK adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 419,000 (52%) adults in OK with arthritis have activity limitations.2
•About 14% of these adults have arthritis-attributable work limitations.3
•About 46% of adults in OK with arthritis are inactive.2
• In OK, the yearly cost for days lost from work because of arthritis is $179 million.4
You can help people in OK by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Oregon: Why Arthritis Matters
Arthritis affects 27% of the population in Oregon. That’s 838,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 838,000 people in OR living with doctor-diagnosed arthritis. 2
• That means that 27% of OR adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in OR with arthritis.1
In OR, adults with one or more chronic conditions often have arthritis.
•Diabetes: 48% of OR adults with diabetes also have arthritis.2
•Hypertension: 45% of OR adults with hypertension also have arthritis.2
•Obesity: 35% of OR adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 425,000 (51%) adults in OR with arthritis have activity limitations.2
•About 13% of these adults have arthritis-attributable work limitations.3
•About 27% of adults in OR with arthritis are inactive.2
• In OR, the yearly cost for days lost from work because of arthritis is $202 million.4
You can help people in OR by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Pennsylvania: Why Arthritis Matters
Arthritis affects 29% of the population in Pennsylvania. That’s 2,937,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 2,937,000 people in PA living with doctor-diagnosed arthritis. 2
• That means that 29% of PA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in PA with arthritis.1
In PA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 55% of PA adults with diabetes also have arthritis.2
•Hypertension: 48% of PA adults with hypertension also have arthritis.2
•Obesity: 40% of PA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 1,118,000 (38%) adults in PA with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 39% of adults in PA with arthritis are inactive.2
• In PA, the yearly cost for days lost from work because of arthritis is $684 million.4
You can help people in PA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Rhode Island: Why Arthritis Matters
Arthritis affects 27% of the population in Rhode Island. That’s 226,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 226,000 people in RI living with doctor-diagnosed arthritis. 2
• That means that 27% of RI adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in RI with arthritis.1
In RI, adults with one or more chronic conditions often have arthritis.
•Diabetes: 52% of RI adults with diabetes also have arthritis.2
•Hypertension: 46% of RI adults with hypertension also have arthritis.2
•Obesity: 37% of RI adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 89,000 (39%) adults in RI with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 39% of adults in RI with arthritis are inactive.2
• In RI, the yearly cost for days lost from work because of arthritis is $57 million.4
You can help people in RI by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
South Carolina: Why Arthritis Matters
Arthritis affects 29% of the population in South Carolina. That’s 1,105,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,105,000 people in SC living with doctor-diagnosed arthritis. 2
• That means that 29% of SC adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in SC with arthritis.1
In SC, adults with one or more chronic conditions often have arthritis.
•Diabetes: 57% of SC adults with diabetes also have arthritis.2
•Hypertension: 48% of SC adults with hypertension also have arthritis.2
•Obesity: 38% of SC adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 555,000 (50%) adults in SC with arthritis have activity limitations.2
•About 14% of these adults have arthritis-attributable work limitations.3
•About 38% of adults in SC with arthritis are inactive.2
• In SC, the yearly cost for days lost from work because of arthritis is $228 million.4
You can help people in SC by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
South Carolina: Why Arthritis Matters
Arthritis affects 29% of the population in South Carolina. That’s 1,105,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,105,000 people in SC living with doctor-diagnosed arthritis. 2
• That means that 29% of SC adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in SC with arthritis.1
In SC, adults with one or more chronic conditions often have arthritis.
•Diabetes: 57% of SC adults with diabetes also have arthritis.2
•Hypertension: 48% of SC adults with hypertension also have arthritis.2
•Obesity: 38% of SC adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 555,000 (50%) adults in SC with arthritis have activity limitations.2
•About 14% of these adults have arthritis-attributable work limitations.3
•About 38% of adults in SC with arthritis are inactive.2
• In SC, the yearly cost for days lost from work because of arthritis is $228 million.4
You can help people in SC by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
South Dakota: Why Arthritis Matters
Arthritis affects 24% of the population in South Dakota. That’s 158,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 158,000 people in SD living with doctor-diagnosed arthritis. 2
• That means that 24% of SD adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in SD with arthritis.1
In SD, adults with one or more chronic conditions often have arthritis.
•Diabetes: 47% of SD adults with diabetes also have arthritis.2
•Hypertension: 43% of SD adults with hypertension also have arthritis.2
•Obesity: 32% of SD adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 73,000 (46%) adults in SD with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 30% of adults in SD with arthritis are inactive.2
• In SD, the yearly cost for days lost from work because of arthritis is $46 million.4
You can help people in SD by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Tennessee: Why Arthritis Matters
Arthritis affects 32% of the population in Tennessee. That’s 1,630,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,630,000 people in TN living with doctor-diagnosed arthritis. 2
• That means that 32% of TN adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 17% of the people
in TN with arthritis.1
In TN, adults with one or more chronic conditions often have arthritis.
•Diabetes: 54% of TN adults with diabetes also have arthritis.2
•Hypertension: 50% of TN adults with hypertension also have arthritis.2
•Obesity: 41% of TN adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 772,000 (47%) adults in TN with arthritis have activity limitations.2
•About 15% of these adults have arthritis-attributable work limitations.3
•About 41% of adults in TN with arthritis are inactive.2
• In TN, the yearly cost for days lost from work because of arthritis is $316 million.4
You can help people in TN by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Texas: Why Arthritis Matters
Arthritis affects 20% of the population in Texas. That’s 4,055,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 4,055,000 people in TX living with doctor-diagnosed arthritis. 2
• That means that 20% of TX adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 16% of the people
in TX with arthritis.1
In TX, adults with one or more chronic conditions often have arthritis.
•Diabetes: 42% of TX adults with diabetes also have arthritis.2
•Hypertension: 38% of TX adults with hypertension also have arthritis.2
•Obesity: 26% of TX adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 1,773,000 (44%) adults in TN with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 43% of adults in TX with arthritis are inactive.2
• In TX, the yearly cost for days lost from work because of arthritis is $1.122 billion.4
You can help people in TX by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Utah: Why Arthritis Matters
Arthritis affects 20% of the population in Utah. That’s 407,000 adults living
with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 407,000 people in UT living with doctor-diagnosed arthritis. 2
• That means that 20% of UT adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 14% of the people
in UT with arthritis.1
In UT, adults with one or more chronic conditions often have arthritis.
•Diabetes: 47% of UT adults with diabetes also have arthritis.2
•Hypertension: 40% of UT adults with hypertension also have arthritis.2
•Obesity: 29% of UT adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 168,000 (41%) adults in UT with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 29% of adults in UT with arthritis are inactive.2
• In UT, the yearly cost for days lost from work because of arthritis is $116 million.4
You can help people in UT by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Vermont: Why Arthritis Matters
Arthritis affects 27% of the population in Vermont. That’s 136,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 136,000 people in VT living with doctor-diagnosed arthritis. 2
• That means that 27% of VT adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 15% of the people
in VT with arthritis.1
In VT, adults with one or more chronic conditions often have arthritis.
•Diabetes: 49% of VT adults with diabetes also have arthritis.2
•Hypertension: 45% of VT adults with hypertension also have arthritis.2
•Obesity: 37% of VT adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 61,000 (45%) adults in VT with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 32% of adults in VT with arthritis are inactive.2
• In VT, the yearly cost for days lost from work because of arthritis is $36 million.4
You can help people in VT by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Virginia: Why Arthritis Matters
Arthritis affects 23% of the population in Virginia. That’s 1,513,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,513,000 people in VA living with doctor-diagnosed arthritis. 2
• That means that 23% of VA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 17% of the people
in VA with arthritis.1
In VA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 49% of VA adults with diabetes also have arthritis.2
•Hypertension: 40% of VA adults with hypertension also have arthritis.2
•Obesity: 33% of VA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 631,000 (42%) adults in VA with arthritis have activity limitations.2
•About 9% of these adults have arthritis-attributable work limitations.3
•About 38% of adults in VA with arthritis are inactive.2
• In VA, the yearly cost for days lost from work because of arthritis is $392 million.4
You can help people in VA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Washington: Why Arthritis Matters
Arthritis affects 24% of the population in Washington. That’s 1,346,000
adults living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,346,000 people in WA living with doctor-diagnosed arthritis. 2
• That means that 24% of WA adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in WA with arthritis.1
In WA, adults with one or more chronic conditions often have arthritis.
•Diabetes: 48% of WA adults with diabetes also have arthritis.2
•Hypertension: 42% of WA adults with hypertension also have arthritis.2
•Obesity: 35% of WA adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 657,000 (49%) adults in WA with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 26% of adults in WA with arthritis are inactive.2
• In WA, the yearly cost for days lost from work because of arthritis is $343 million.4
You can help people in WA by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
West Virginia: Why Arthritis Matters
Arthritis affects 38% of the population in West Virginia. That’s 557,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 557,000 people in WV living with doctor-diagnosed arthritis. 2
• That means that 38% of WV adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 15% of the people
in WV with arthritis.1
In WV, adults with one or more chronic conditions often have arthritis.
•Diabetes: 62% of WV adults with diabetes also have arthritis.2
•Hypertension: 55% of WV adults with hypertension also have arthritis.2
•Obesity: 47% of WV adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 303,000 (54%) adults in WV with arthritis have activity limitations.2
•About 19% of these adults have arthritis-attributable work limitations.3
•About 41% of adults in WV with arthritis are inactive.2
• In WV, the yearly cost for days lost from work because of arthritis is $97 million.4
You can help people in WV by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis by the Numbers | Book of Trusted Facts & Figures
Wisconsin: Why Arthritis Matters
Arthritis affects 25% of the population in Wisconsin. That’s 1,104,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 1,104,000 people in WI living with doctor-diagnosed arthritis. 2
• That means that 25% of WI adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 15% of the people
in WI with arthritis.1
In WI, adults with one or more chronic conditions often have arthritis.
•Diabetes: 43% of WI adults with diabetes also have arthritis.2
•Hypertension: 42% of WI adults with hypertension also have arthritis.2
•Obesity: 33% of WI adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 479,000 adults in WI with arthritis have activity limitations.2
•About 10% of these adults have arthritis-attributable work limitations.3
•About 29% of adults in WI with arthritis are inactive.2
• In WI, the yearly cost for days lost from work because of arthritis is $330 million.4
You can help people in WI by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
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Arthritis Foundation
Wyoming: Why Arthritis Matters
Arthritis affects 26% of the population in Wyoming. That’s 116,000 adults
living with doctor-diagnosed arthritis in the state.
There are more than 50 million American adults with arthritis.5
• There are 116,000 people in WY living with doctor-diagnosed arthritis. 2
• That means that 26% of WY adults live with arthritis.2
• In the U.S., 1 in 3 veterans has arthritis—veterans represent 18% of the people
in WY with arthritis.1
In WY, adults with one or more chronic conditions often have arthritis.
•Diabetes: 52% of WY adults with diabetes also have arthritis.2
•Hypertension: 43% of WY adults with hypertension also have arthritis.2
•Obesity: 34% of WY adults who are obese also have arthritis.2
23.7 million Americans experience activity limitation due to their arthritis.5
• 49,000 adults in WY with arthritis have activity limitations.2
•About 11% of these adults have arthritis-attributable work limitations.3
•About 35% of adults in WY with arthritis are inactive.2
• In WY, the yearly cost for days lost from work because of arthritis is $28 million.4
You can help people in WY by ensuring that all legislation protects:
• Timely Access to Care and Treatments.
• Continuous Coverage without pre-existing exclusions.
• Affordability of premiums, co-pays, deductibles and other patient cost-sharing.
- 98 -
We wish to thank the following individuals for their time in helping create this publication:
The arthritis facts reviewers:
Timothy Beukelman, MD, juvenile idiopathic arthritis (JIA) facts; Dr. Beukelman is an associate professor of Pediatrics in the
Division of Rheumatology at the University of Alabama at Birmingham.
Leigh Callahan, PhD, osteoarthritis (OA) facts; Dr. Callahan is a professor in the University of North Carolina at Chapel Hill
School of Medicine.
Hyon Choi, MD, gout facts; Dr. Choi is a professor of medicine at Harvard Medical School.
Daniel Clauw, MD, fibromyalgia facts; is a professor at the University of Michigan in Ann Arbor.
Jennifer Hootman, PhD, general arthritis facts; Dr. Hootman is an epidemiologist with the Centers for Disease Control and
Prevention.
Eric Matteson, MD, rheumatoid arthritis (RA) facts; Dr. Matteson is a professor of medicine at the Mayo Clinic College of Medicine.
Philip Mease, MD, spondyloarthritis (SpA) and psoriatic arthritis (PsA) facts; Dr. Mease is a professor at the University of
Washington School Medicine in Seattle.
Louise Murphy, PhD, military OA facts; Dr. Murphy is a senior service fellow with the Centers for Disease Control and
Prevention.
Michelle Petri, MD, systemic lupus erythematosus (SLE) facts; Dr. Petri is the director of the Hopkins Lupus Center and
professor of medicine at Johns Hopkins University in Baltimore, MD.
Rosalind Ramsey-Goldman, MD, systemic lupus erythematosus (SLE) facts. Dr. Ramsey-Goldman is a professor of
medicine at Northwestern University Feinberg School of Medicine in Chicago, IL.
Arthritis Foundation staff:
Deborah Scotton, arthritis facts project manager/editor; Sonia Thompson, intern/researcher; Jennifer Oddo, project liaison
and copy editor; Tony Williams, writer and copy editor; Debbie Malone, art director and design; and Marcy O’Koon project
consultant.
Thanks also to the Advocacy staff’s Appendix 2 State Facts contributors: Kayla Amodeo, PhD, lead researcher/editor; Julie
Eller, researcher/editor; and Caynen Hansen. Intern/cost calculations contributor.
We would also like to thank Guy Eakin, PhD, senior vice president of scientific strategy, whose vision drove the creation of this
document. Additionally, our thanks go to the other senior leadership team members who made this document a reality: Sandie
Preiss, vice president of advocacy and access; Cindy McDaniel, senior vice president of consumer health; and Ann
McNamara, senior vice president of revenue strategy.
arthritis.org
Arthritis Foundation. Arthritis By the Numbers / Book of Trusted Facts & Figures. 2017; v1.2.