Arthritis Action Plan
I. Executive Summary
Arthritis: The Disease and its Implications
Arthritis is one of the oldest diseases known to humankind. It has been found in the mummies of Egypt and in the excavated remains of other ancient civilizations. While there are as many as 100 different types of arthritis, the most common include rheumatoid arthritis, osteoarthritis, fibromyalgia, juvenile rheumatoid arthritis and gout.
In the United States, arthritis affects nearly 70 million persons. Arthritis occurs at all ages but it is more prevalent in old age. Of persons age 65 and older, nearly half are diagnosed with the disease. Three out of five persons diagnosed with arthritis are below age 65 and 285,000 of them are children. Women age 15 years and older account for 60% of arthritis cases.
Arthritis limits activity for more than 7 million citizens with that number predicted to rise to 12% of the population by 2020. In 1999, 17.5% of all adults with a disability reported that the main health condition associated with their disability was arthritis and rheumatism. Persons with arthritis are known to have a degraded quality of life, which impacts them, their families, employers, and the healthcare system. Estimates put the total direct and indirect costs to treat persons diagnosed with arthritis and related diseases at $125 billion annually.
In New York State, arthritis affects approximately 4.7 million adult New Yorkers. Of those, 1.5 million are age 65 and older. More New York women are living with arthritis than men, with 36% of female respondents stating that they have some form of arthritis or chronic joint symptoms (2001 BRFSS). We also know that New York adults who are overweight or obese experience more arthritis than those who are not.
The Challenge
The prevalence of arthritis will increase in the US as the population ages. In 2000, a person 65 years of age had a further life expectancy of 17.9 years. This phenomenon will be complicated if the lifestyle habits of many Americans remain. As a nation, many are inactive, overweight or obese, unaware of the arthritis-injury connection, and inattentive to the risks unhealthy lifestyles create as we age.
In 1999, the Centers for Disease Control and Prevention (CDC) published The National Arthritis Action Plan (NAAP). The Plan describes a framework for state intervention that encourages and promotes evidence-based approaches to arthritis management. The framework describes three levels of intervention: primary, which considers weight control and injury prevention; secondary, which emphasizes early diagnosis and sound medical management; and tertiary, which focuses on self-management to reduce pain and the complications from the disease. Together with other organizations, the CDC is encouraging state public health programs to make arthritis control and prevention a priority.
The overall aims of the National Arthritis Action Plan are to stimulate and strengthen a nationally coordinated effort for reducing the occurrence of arthritis and to mitigate its accompanying disabilities. The Plan delineates certain goals and includes efforts to:
- Establish a solid scientific base of knowledge concerning the prevention of arthritis and related disabilities;
- Increase awareness of arthritis, its impact, the importance of early diagnosis as well as early intervention management, and effective prevention strategies.
- Implement effective programs to prevent the onset of arthritis and its related disabilities.
- Achieve the arthritis-related objectives included in Healthy People 2010. These objectives reflect benchmarks of success for measuring improvements in health and quality of life.
The New York State Arthritis Plan
In 1999, the New York State Department of Health received a three-year grant from the CDC to create an Arthritis Program. This Arthritis Plan was prepared by the New York State (NYS) Arthritis Program in cooperation with stakeholders statewide. Consistent with the guidance provided by the CDC, goals and objectives are identified in three strategic areas:
- Epidemiology, Surveillance and Disease Prevention -document an accurate estimate of the number of people in NYS with arthritis and related diseases; publish a county specific analysis of the costs of arthritis;
- Communication and Education -identify underserved groups who lack accurate knowledge of the nature of arthritis; increase the use of proven interventions among persons with arthritis and related diseases, their families, and health providers; develop and disseminate a broad array of material designed to reach a variety of targeted populations; and
- Program, Policy and Systems -articulate ongoing policies that promote "best practice" methods.
The Plan incorporates a long-term time frame of five years or more with a priority sequencing of objectives based on current capacity, known or anticipated resources, successful prototype models, current needs and other environmental factors. It also acknowledges and supports the Healthy People 2010 goals that for the first time prioritize arthritis and related diseases as important areas of policy and program focus for public health over the next decade.
The Plan is a useful guide for state and local providers, persons with arthritis and related diseases and their caregivers, health professionals and insurers, policy makers, and the general public to better understand the burden of arthritis in New York State. Importantly, the Plan describes strategies for reducing the disabling effects of the disease.
