Disease burden can be measured in many ways. This is particularly important for AORC, which has a modest effect on conveniently measured outcomes like mortality, but a much larger impact on less conveniently measured outcomes important to the ability to function for most people. Such outcomes include effects on work, sports activities, health-related quality of life, independence, and ability to keep doing valued life activities. Three of these burdens, along with lifestyle factors that impact on arthritis, are addressed in the data.
Bed days are defined as spending one-half or more days in bed because of injury or illness, excluding hospitalization. Among adults with doctor-diagnosed arthritis in 2012, 22.4 million, or 9.5% of the entire adult population experienced bed days. These individuals reported an average of 24.0 bed days in the past 12 months. This is far higher than the 14.5 bed days reported by adults with any medical condition. This resulted in 537.6 million bed days overall, or 53% of the 1 trillion bed days among adults reporting any medical condition. Females and those 75 years and older had higher than average bed days. (Reference Table 4.7 PDF [1] CSV [2])
Lost work days for persons in the workforce are defined as absence from work because of illness or injury in the past 12 months, excluding maternity or family leave. Among adults with doctor-diagnosed arthritis in 2012, 12.0 million experienced lost work days. These individuals reported an average of 14.3 workdays lost in the past 12 months, far higher than the 9.9 work days reported by adults with any medical condition. This resulted in 172.1 million total work days lost due to AORC, or 33% of the 526.4 million work days lost among adults reporting any medical condition. There was little difference reported by sex in work days lost, but age was a factor, with more wor kdays lost by those aged 65 years and older. (Reference Table 4.7 PDF [1] CSV [2])
Arthritis-attributable activity limitations (AAAL) are defined by the self-reported question: “Are you now limited in any way in any of your usual activities because of arthritis or joint symptoms?” in the National Health Interview Survey [3]. Estimated doctor-diagnosed arthritis prevalence was also used to estimate that AAAL affected an average of 22.7 million adults between 2010 and 2012,1 higher than the 22 million projected to be affected by 2020 in a 2006 project.2 Estimates showed the typical distribution of higher rates among females and older adults, and lower rates among Hispanics and Asians. Absolute estimates show that most of the adults with arthritis-attributable activity limitation (13.8 million, or 61%) were under age 65 years. However, these ages comprise 83% of the US population. Thus, the rate of AAAL is higher in persons age 65 years and older. (Reference Table 4.1 PDF [4] CSV [5])
Arthritis-attributable work limitations (AAWL) are defined in reference to work for pay as: “Do arthritis or joint symptoms now affect whether you work, the type of work you do, or the amount of work you do?” In 2002, AAWL affected an estimated 30% adults (6.9 million) aged 18 to 64 years with doctor-diagnosed arthritis. Higher rates were found among those aged 45 to 64 years, women, non-Hispanic blacks, and those with low education or low income.3 Between 2010 and 2012, 3.8 million people age 18 years and older with doctor-diagnosed arthritis reported they are “unable to work now due to a health,” while 2.1 million reported they are “limited in the kind or amount of work they can do.” Arthritis conditions represented about one in five people with a work limitation from any medical condition. (Reference Table 4.6.1 PDF [6] CSV [7]; Table 4.6.2 PDF [8] CSV [9])
Limitations in daily living and activity (ACL) National Adult Survey data from 2010 to 2012 examined those with “any limitation” and with three specific ACL limitations—routine needs, personal care, and walking. Participants were asked to attribute their limitations to up to three medical conditions.
Among all adults with limitations, those with doctor-diagnosed arthritis naming arthritis as the cause comprised 19% of the estimated 40.8 million with “any limitation.” One-third of people with difficulty walking (32%) attributed their limitation to arthritis, while about one in four attributed limitations with personal care and routine needs to arthritis. This demonstrates the large impact of arthritis on adults with daily chronic limitations. This effect was much stronger among females than males and among older adults. Little difference was found between persons by race. (Reference Table 4.6.1 PDF [6] CSV [7]; Table 4.6.2 PDF [8] CSV [9]; and Table 4.6.3 PDF [10] CSV [11])
Among people with doctor-diagnosed arthritis (DDA) compared with those without doctor-diagnosed arthritis, Health-Related Quality of Life (HRQoL) is worse on several scales. When assessed by self-reported health status, 27% of those with DDA reported fair/poor health compared to 12% of those without DDA. The DDA group also reported a higher mean number of days in the past month with poor physical health (6.6 vs. 2.5 days), poor mental health (5.4 vs. 2.8 days), or days with limitations in usual activities (4.3 vs. 1.4 days).1
Switching to the perspective of the general population and using a different survey, the prevalence of doctor-diagnosed arthritis and of arthritis-attributable activity limitations is much higher among those with the lifestyle factors of obesity, insufficient or no physical activity, and fair/poor self-rated health. In this same survey, those with doctor-diagnosed arthritis had very high proportions of all three lifestyle factors. (Reference Table 4.8 PDF [12] CSV [13])
Links:
[1] https://www.boneandjointburden.org/docs/T4.7.pdf
[2] https://www.boneandjointburden.org/docs/T4.7.csv
[3] http://www.cdc.gov/nchs/nhis.htm
[4] https://www.boneandjointburden.org/docs/T4.1.pdf
[5] https://www.boneandjointburden.org/docs/T4.1.csv
[6] https://www.boneandjointburden.org/docs/T4.6.1.pdf
[7] https://www.boneandjointburden.org/docs/T4.6.1.csv
[8] https://www.boneandjointburden.org/docs/T4.6.2.pdf
[9] https://www.boneandjointburden.org/docs/T4.6.2.csv
[10] https://www.boneandjointburden.org/docs/T4.6.3.pdf
[11] https://www.boneandjointburden.org/docs/T4.6.3.csv
[12] https://www.boneandjointburden.org/docs/T4.8.pdf
[13] https://www.boneandjointburden.org/docs/T4.8.csv