A recent government report finding that arthritis and rheumatism account for much of the disability in Americans may be an underestimate.
The estimated percentage of Americans reporting a disability increased by 7.7% from 1999 to 2005, from 44.1 million to 47.5 million, with arthritis and rheumatism the most common causes of physical problems that interfere with daily life, according to a report issued by the Centers for Disease Control and Prevention.
Almost 22% of the adult population reported a physical disability in 2005, Dr. Chad Helmick and his coauthors wrote. Although the percentage hasn't changed since the last disability survey in 1999, the number represents an absolute increase of 7.7%—probably because of an increase in the number of older people as Baby Boomers age, wrote Dr. Helmick, an epidemiologist for the Centers for Disease Control and Prevention, and a coauthor of the study.
The most commonly reported causes of disability were arthritis and rheumatism (8.6 million people), followed by back or spine problems (7.6 million) and cardiac problems (3 million), the report said.
Dr. John Klippel, president and chief executive officer of the Arthritis Foundation, said the survey might underestimate the true impact of arthritis and rheumatic disease.
“I believe that many people who report disability due to back pain have arthritis as the underlying cause of that pain,” Dr. Klippel said in an interview. “If you add those two together, then the overwhelming reason for disability in American would be arthritis and musculoskeletal diseases.”
The data were extracted from the 2005 Survey of Income and Program Participation, conducted by the U.S. Census Bureau. The survey included interviews with 70,300 noninstitutionalized people aged 18 years or older from 37,400 households (representing 83% of eligible households).
Disability was defined as a “yes” answer to one of three categories: required use of an assistive device (cane, crutches, walker, or wheelchair); difficulty performing activities of daily living or specified functional activities; and a limitation in the ability to work around the house or at a job or business. Respondents then chose the cause of their disability from a list of 30 disorders. National estimates were extrapolated from the completed survey.
The survey concluded that most of those reporting a disability were 65 years or older (52%) and that disability was significantly higher in women than in men (24% vs. 19%, respectively). The most commonly reported functional disabilities were difficulty walking three or more blocks (10%; 22 million people) and climbing a flight of stairs (10%).
Of those with a disability, 19%—an estimated 9 million people—identified arthritis or a rheumatic disease as the cause. These disorders were also the most common cause of disability for women, affecting 24%.
Back and spine problems affected 17% of the population, and were the leading cause of disability for men (17%). Cardiac disorders affected 7% overall (8% of men and 5% of women).
The report suggests that disability numbers will continue to rise as the American population ages.
“To accommodate the expected increase in demand for disability-related medical and public health services, expanding the reach of effective strategies and interventions aimed at preventing progression to disability and improving disability management in the population is necessary,” according to the report (MMWR 2009;58:421–6).
Over the next 20 years as they age, the number of people reporting arthritis-related disability and the economic costs associated with it will skyrocket.” Arthritis and other rheumatic disease cost the U.S. $128 billion annually. “These will go up logarithmically,” Dr. Klippel said. “Given all the concerns for our economy, we have even more reasons to start focusing on health care reform, and arthritis and musculoskeletal diseases need to be at the top of the list.”
Only 12 states have CDC-funded arthritis health programs, Dr. Klippel said. “We at the Arthritis Foundation would like to see the CDC invest more in chronic disease prevention programs, including those for osteoarthritis. Without a greater investment in research, we will not have more effective therapies.”