Impact of arthritis

Arthritis can have a profound impact on a person’s quality of life and well-being due to acute and chronic pain, physical limitations, management of the condition and mental health issues. This can often result in withdrawal from social, community and occupational activities [1].

Disease burden

Arthritis is a large contributor to illness, pain and disability in Australia. Based on data from the Australian Burden of Disease Study 2011, musculoskeletal conditions were responsible for 12% (around 521,000 disability-adjusted life years (DALY)) of the total burden of disease. Of this proportion, osteoarthritis contributed 17% of disease burden, rheumatoid arthritis contributed 16%, and gout contributed 0.8%. The remaining burden was attributed to ‘other musculoskeletal conditions’ (35%) and ‘back pain and problems’ (31%) (Figure 1).

Figure 1: Musculoskeletal conditions burden (DALY), by disease, 2011

This pie chart illustrates the contribution of disease burden of musculoskeletal conditions in DALYs. Osteoarthritis contributed 17%25 of disease burden, rheumatoid arthritis contributed 16%25, and gout contributed 0.8%25. The remaining burden was attributed to ‘other musculoskeletal conditions’ (35%25) and ‘back pain and problems’ (31%25).

Source: AIHW 2016 [3].

Perceived health status

According to the ABS 2014–15 National Health Survey, people aged 25 and over with arthritis are less likely to perceive their health as excellent or very good than people without the condition. Conversely, people with arthritis were twice as likely to report their health as poor (9.3%) compared to the general population (4.6%) [2].

1 in 10 people with arthritis reported their health as poor

Figure 2: Self-assessed health of people aged 25 and over with arthritis compared to the general population, 2014–15

This vertical bar chart compares the self-assessed health of people aged 25 years and over, between those with arthritis and the general population. Those with arthritis reported higher rates of ‘poor’ (9.3%25), ‘fair’ (17%25) and ‘good’ (32%25) health compared to the general population (4.6%25, 11%25 and 29%25 respectively). People with arthritis were less likely to report ‘very good’ (28%25) and ‘excellent’ (11.3%25), compared to the general population (37%25 and 19%25 respectively).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2016 [2] (Data table).

Physical impact

1 in 2 Australians with arthritis reported moderate to very severe pain

Arthritis can have a significant impact on a person’s physical health, due to the pain and physical limitations associated with the disease.

In 2014–15, half of people aged 25 and over with arthritis (51%) experienced ‘moderate’ to ‘very severe’ pain in the last 4 weeks; this was about 1.9 times as high as the general population (27%) (Figure 3). In addition, over one-third (38%) of people aged 18 and over with arthritis reported their pain had a ‘moderate’ to ‘extreme’ interference with their normal work during the last 4 weeks [2].

Figure 3: Pain(a) experienced by people aged 25 and over with arthritis compared to the general population, 2014–15

This vertical bar chart compares the pain experienced by people aged 25 years and older, between those with arthritis and the general population. Those with arthritis reported higher rates of ‘mild’ (19%25), ‘moderate’ (32%25), ‘severe’ (14%25) and ‘very severe’ (4.2%25) levels of pain compared to the general population (18%25, 18%25, 7.2%25 and 1.6%25 respectively). Those with arthritis reported lower rates of ‘very mild’ (20%25) and ‘none’ (no pain) (12%25) compared to the general population (23%25 and 31%25 respectively).

  1. Bodily pain experienced in the 4 weeks prior to interview.

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2016 [2] (Data table).

Mental impact

1 in 6 Australians with arthritis reported high levels of psychological distress

Arthritis can affect both physical health and mental wellbeing. The chronic and progressive symptoms and the management of the condition can cause distress, which may lead to mental health issues such as anxiety or depression [4].

According to the NHS 2014–15, one in six Australians (15%) with arthritis reported high levels of psychological distress. This was twice as high compared to the general population (7.5%) (Figure 4).

Figure 4: Psychological distress(a) experienced by people aged 25 and over with arthritis compared to the general population, 2014–15

This vertical bar chart compares self-reported distress levels experienced by people aged 25 and over, between those with arthritis and the general population. Those with arthritis reported higher rates of ‘moderate’ (23%25), ‘high’ (15%25) and ‘very high’ (8.3%25) distress levels, compared to the general population (19%25, 7.5%25 and 3.7%25 respectively). Those with arthritis reported lower rates of ‘low’ distress levels (53%25) compared to the general population (69%25).

  1. Psychological distress is measured using the Kessler Psychological Distress Scale, which involves ten questions about negative emotional states experienced in the previous 4 weeks. The scores are grouped into low (including little or no psychological distress), high and very high (including very high levels of psychological distress).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2016 [2] (Data table).

Economic impact

Arthritis significantly impacts the Australian economy. Increased health care costs and higher use of health care services (e.g. general practitioners, specialists, allied health and pharmaceuticals) required to treat and manage arthritis, provide direct financial costs to the health care system. There are also indirect costs associated with arthritis and/or musculoskeletal conditions and comorbidities, such as productivity losses, disability support pensions and other welfare payments, early retirement and carer costs [5,6].

Expenditure on health services for arthritis is substantial. According to a report by Arthritis Australia [7], in 2015 health expenditure for arthritis was estimated to cost:

  • over $2.1 billion for osteoarthritis
  • over $550 million for rheumatoid arthritis.

Musculoskeletal health is important for a productive and prolonged working life; as a result, the risk of arthritis will become increasingly important with an aging population participating in the workforce for longer. People with arthritis are more likely to have reduced productivity and retire early, resulting in an economic loss that far outweighs direct health care costs [8].

Comorbidities of arthritis

Over 3 in 4 Australians who reported arthritis also reported at least one other chronic condition

People with arthritis often have other chronic diseases and long-term conditions. This is referred to as ‘comorbidity’, where two or more health problems occur at the same time.

In 2014–15, more than 3 out of 4 (79%) people of all ages who reported having arthritis had at least one other chronic condition. Cardiovascular disease was the most common comorbidity (48%), followed by back pain and problems (33%) and mental health problems (27%) [9].

Overall, there was no difference in the prevalence rates of comorbidities with arthritis between males and females (79%). Females with arthritis had higher rates of comorbid asthma and mental health problems, whereas males with arthritis had higher rates of CVD, comorbid back pain and problems, diabetes, COPD and cancer (Figure 5).

Figure 5: Prevalence of chronic conditions in people with arthritis, by sex, 2014–15

This vertical bar chart compares the prevalence of chronic conditions (including CVD, back problems, mental health problems, asthma, diabetes, COPD and cancer) among those with arthritis, by sex. Females with arthritis had higher rates of comorbid asthma (17%25) and mental health problems (28%25) compared to males (13%25 and 26%25 respectively). Males with arthritis had higher rates of CVD (51%25), comorbid back pain and problems (35%25), diabetes (15%25), COPD (10%25) and cancer (4.8%25) compared to females (47%25, 32%25, 13%25, 7.8%25 and 3.8%25 respectively).

Source: ABS 2015. National Health Survey: First Results, 2014–15. ABS cat. No. 4364.0.55.001. Canberra: Australian Bureau of Statistics (Data table).

References

  1. Briggs AM, Cross MJ, Hoy DG, Sànchez-Riera L, Blyth FM, Woolf AD et al. 2016. Musculoskeletal Health Conditions Represent a Global Threat to Healthy Aging: A Report for the 2015 World Health Organization World Report on Ageing and Health. Gerontologist 56: S243-S255.
  2. ABS 2016. Microdata: National Health Survey, 2014-15, TableBuilder. ABS cat. no. 4324.0.55.001. Canberra: ABS. Findings based on AIHW analysis of ABS TableBuilder data.
  3. AIHW 2016. Australian Burden of Disease Study: impacts and causes of illness and death in Australia 2011. Australian Burden of Disease Study series no. 3. Cat. no. BOD 4. Canberra: AIHW.
  4. Sharma A, Kudesia P, Shi Q & Gandhi R. 2016. Anxiety and depression in patients with osteoarthritis: impact and management challenges. Open Access Rheumatology: Research and Reviews, 8: 103–113.
  5. AIHW 2014. Health-care expenditure on arthritis and other musculoskeletal conditions: 2008–09. Canberra: AIHW.
  6. Arthritis Australia 2014. Time to move: rheumatoid arthritis, a national strategy to reduce a costly burden. Sydney: Arthritis Australia.
  7. Arthritis Australia 2016. Counting the cost, part 1: healthcare costs (PDF). Sydney: Arthritis Australia. Viewed 13 June 2018.
  8. Arthritis and Osteoporosis Victoria 2013. A problem worth solving. The rising cost of musculoskeletal conditions in Australia. Melbourne: Arthritis and Osteoporosis Victoria.
  9. ABS 2015. National Health Survey: First Results, 2014–15. ABS cat. no. 4364.0.55.001. Canberra: ABS.