How Much Does Arthritis Limit A Person's Ability To Work?

Arthritis:

The term arthritis?encompasses more than 100 different conditions. Arthritis affects between 50 and 70 million adults depending on the source of information used. Arthritis is the disease most commonly associated with disability. To date, accurate determinations of the extent of disability related to arthritis have been incomplete.

However, a recent Centers for Disease Control and Prevention (CDC) study has been able to provide the first ever state-by-state data on adults experiencing work limitations caused by arthritis.

The numbers presented were staggering. Conclusions from the report?the proportion of working-age adults with arthritis who reported that the disease was severe enough to limit their ability to work ranged from 25.1 percent in Nevada to 51.3 percent in Kentucky.

The study, "State-specific Prevalence of Arthritis-Attributable Work Limitation-United States, 2003," was released in CDC′s Morbidity and Mortality Weekly Report. The data on work limitation due to arthritis covered adults aged 18-64 in all 50 states, the District of Columbia, and U.S. territories.

The CDC study examined the percent of all working age adults in each state who experience work limitations due to arthritis and was conducted using self-reported data from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) survey. The variations across states could be related to the varying prevalence of arthritis across states or to the predominance of certain occupations, which can worsen arthritic symptoms, such as mining, manufacturing, and agricultural jobs, in different states.

Janet Collins, Ph.D., director of the CDC′s National Center for Chronic Disease Prevention and Health Promotion , stated, "These findings show that large numbers of workers in every state are affected by arthritis. With the increasing number of older Americans in the nation′s workforce, it is important that employers, health departments and others take steps that help people with arthritis stay employed or become employed."

Kristina Theis, M.P.H., the study′s lead author in CDC′s Division of Adult and Community Health echoed Dr. Collins statements, "There′s no question that people with arthritis face a number of challenges." She added, "Fortunately, simple workplace accommodations like flexible work schedules, ergonomic work stations and efforts to promote exercise and physical activity can help many workers who have arthritis."

The CDC is already targeting arthritis as a public health issue and supports activities in 36 states and works to implement evidence-based community interventions to reduce pain and disability and improve the quality of life for people with arthritis.

At issue here is the economic burden coming from two fronts. The first is the loss from work?cost. Against this factor is the other issue: the high cost of medical care and treatment required for arthritis.

Some forms of arthritis such as rheumatoid arthritis (RA) are especially associated with high rates of disability and even death if not treated aggressively. At the same time, newer biologic drugs that are capable of driving this disease into remission are quite expensive and insurance companies have balked at paying for many treatments, despite evidence showing the cost-effectiveness of these drugs. Even one country, the United Kingdom, with its National Health Service, has declined to pay for some RA biologic medicines.

To date, studies which have used various economic models have concluded that the cost of arthritis care more than pays for itself by keeping workers functional. If the CDC statistics are accurate and the economic models showing the cost effectiveness of therapy are accurate, then it makes sense that every attempt be made to diagnose early and treat aggressively in order to prevent and lessen workplace disability due to arthritis. This approach will be more critical than ever to adopt as population demographics support the notion of an older working population.

Nathan Wei, MD FACP FACR is a rheumatologist and Director of the Arthritis and Osteoporosis Center of Maryland. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine. For more info: Arthritis Treatment



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