Arthritis and other rheumatic conditions affect 53 million U.S. adults ages 18 and older, are the most common cause of disability, and are associated with considerable pain, activity limitation, and restriction of work and social participation. Projecting changes in the prevalence and impact of chronic diseases, such as arthritis, is crucial for planning future clinical and public health needs, informing health policy and establishing priorities for planning and resource allocation.
The aging of the population has driven previous projections of arthritis prevalence and the associated impact. A new report from the U.S. Census Bureau confirms that aging will remain an important factor in the future: by the time of the 2030 census, all baby boomers will have reached age 65 years, and one in five U.S. adults will be 65 years of age or older.
Previous projections of arthritis prevalence based on 2003 data have tracked well against subsequent arthritis prevalence estimates.
The authors of the study, “Updated Projected Prevalence of Self-Reported Doctor-Diagnosed Arthritis & Arthritis-Attributable Activity Limitation Among U.S. Adults, 2015–2040,” set out to update the projected prevalence of arthritis and arthritis-attributable activity limitations among U.S. adults, using a newer baseline for estimates.
They obtained baseline prevalence data from the 2010–2012 National Health Interview Survey. Arthritis was defined as an answer of “yes” to the question, “Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia?” Arthritis-attributable activity limitation was defined as an answer of “yes” to the question, “Are you limited in any way in any of your usual activities because of arthritis or joint symptoms?”
The baseline prevalence of arthritis and arthritis-attributable activity limitation was stratified according to age and sex, and was statistically weighted to account for the complex survey design. The projected prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation was calculated by multiplying the age- and sex-stratified population estimates projected for 2015–2040 (in five-year intervals; provided by the U.S. Census Bureau) by the baseline estimates. Age- and sex-specific prevalences were summed to provide the total prevalence estimates for each year.
Results
In 2010–2012, 52.5 million adults in the U.S. (22.7% of all adults) had doctor-diagnosed arthritis, and 22.7 million (9.8%) had arthritis-attributable activity limitation. By 2040, the number of U.S. adults with doctor-diagnosed arthritis is projected to increase 49% to 78.4 million (25.9% of all adults), and the number of adults with arthritis-attributable activity limitation will increase 52% to 34.6 million (11.4% of all adults).
Conclusion
Updated projections suggest that arthritis and arthritis-attributable activity limitation will remain large and growing problems for clinical and public health systems, which must plan and create policies and resources to address these future needs. Can the healthcare system accommodate these projected increases? By 2025, the expected demand for rheumatologists is expected to exceed supply by 2,576 adult and 33 pediatric rheumatologists. The shortage of rheumatologists in non-urban areas is especially critical; for some areas, the closest rheumatologist is located more than 200 miles away.
Strategies to address these shortages include using more physician assistants and nurse practitioners, implementing nurse-led clinics and intensifying efforts to recruit trainees to the rheumatology and orthopedic specialties. As an adjunct to clinical care, healthcare providers can also refer patients to effective self-management education and physical activity programs offered in their local communities.
Excerpted and adapted from:
Hootman JM, Helmick CG, Barbour KE, et al. Updated projected prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation among US adults, 2015–2040. Arthritis Rheumatol. 2016 Jul;68(7):1582–1587.
