Impact of arthritis

Arthritis can have a profound impact on a person’s quality of life and wellbeing 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 (Briggs et al. 2016).

Disease burden

Common forms of arthritis (osteoarthritis, rheumatoid arthritis and gout) are large contributors to illness, pain and disability in Australia. Based on data from the Australian Burden of Disease Study 2015, musculoskeletal conditions were responsible for 13% (approximately 611,300 disability-adjusted life years (DALY)) of the total burden of disease. Of this proportion, osteoarthritis contributed 19% of disease burden, rheumatoid arthritis contributed 15%, and gout contributed 0.9%. The remaining burden was attributed to ‘other musculoskeletal conditions’ (33%) and ‘back pain and problems’ (32%) (Figure 1).

Figure 1: Musculoskeletal conditions burden (DALY), by disease, 2015

This pie chart illustrates the contribution of disease burden of musculoskeletal conditions in DALYs. ‘Other musculoskeletal conditions’ contributed the most burden (33%25), followed by back pain and problems (32%25), osteoarthritis(19%25), rheumatoid arthritis(15%25) and gout (1%25).

Source: AIHW 2019a.

Perceived health status

Although arthritis affects people of all ages, its prevalence increases sharply from the age of 45 years.

According to the ABS 2017–18 National Health Survey (NHS), people aged 45 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 describe their health as poor (11%) compared with those without arthritis (4.0%) (Figure 2).

Figure 2: Self-assessed health of people aged 45 and over with and without arthritis, 2017–18

This vertical bar chart compares the self-assessed health of people aged 45 years and over, between those with arthritis and those without arthritis. Those with arthritis experienced higher rates of ‘poor’ (11%25), ‘fair’ (20%25) and ‘good’ (33%25) health compared with those without arthritis (4%25, 12%25 and 30%25 respectively). People with arthritis were less likely to experience ‘very good’ (28%25) and ‘excellent’ (8%25), compared with people without arthritis (35%25 and 19%25 respectively).

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2019 (Data table).

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 2017–18, half of people aged 45 and over with arthritis (56%) experienced ‘moderate’ to ‘very severe’ pain in the last 4 weeks; this was about 2.3 times as likely as people without arthritis (24%) (Figure 3). In addition, over 2 in 5 (45%) people aged 45 and over with arthritis described their pain as having a ‘moderate’ to ‘extreme’ interference with their normal work during the last 4 weeks (Table 2.3) (ABS 2019).

Figure 3: Pain(a) experienced by people aged 45 and over with and without arthritis, 2017–18

This vertical bar chart compares the pain experienced by people aged 45 years and older, between those with arthritis and those without arthritis. Those with arthritis experienced higher rates of ‘mild’ (19%25), ‘moderate’ (37%25), ‘severe’ (15%25) and ‘very severe’ (4%25) levels of pain compared with people without arthritis (16%25, 18%25, 5%25 and 1.4%25 respectively). Those with arthritis experienced lower rates of ‘very mild’ (15%25) and ‘none’ (no pain) (10%25) compared with those without arthritis (25%25 and 35%25 respectively).

(a) Bodily pain experienced in the 4 weeks prior to interview.

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2019 (Data table).

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 (Sharma et al. 2016).

According to the NHS 2017–18, 1 in 5 Australians (22%) with arthritis experienced high to very high levels of psychological distress. This was twice as likely as people without arthritis (10%) (Figure 4).

Figure 4: Psychological distress(a) experienced by people aged 45 and over with and without arthritis, 2017–18

This vertical bar chart compares self-reported distress levels experienced by people aged 45 and over, between those with arthritis and those without arthritis. Those with arthritis described higher rates of ‘moderate’ (24%25), ‘high’ (13%25) and ‘very high’ (8.6%25) distress levels, compared with people without arthritis (18%25, 6.8%25 and 3.0%25 respectively). Those with arthritis described lower rates of ‘low’ distress levels (54%25) compared with those without arthritis (72%25).

(a) Psychological distress is measured using the Kessler Psychological Distress Scale (K10), which involves 10 questions about negative emotional states experienced in the previous 4 weeks. The scores are grouped into Low: K10 score 10–15, Moderate: 16–21, High: 22–29, Very high: 30–50.

Note: Age-standardised to the 2001 Australian population.

Source: AIHW analysis of ABS 2019 (Data table).

Economic impact

Arthritis significantly impacts the Australian economy. Increased health care costs and higher use of health care services (for example, general practitioners, specialists, allied health and pharmaceuticals) required to treat and manage arthritis represent 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 (AIHW 2014; Arthritis Australia 2014).

Expenditure on health services for arthritis is substantial. In 2015–16, health expenditure for arthritis was estimated to cost:

  • $3.5 billion for osteoarthritis
  • $1.2 billion for rheumatoid arthritis (AIHW 2019b).

Musculoskeletal health is important for a productive and prolonged working life; as a result, the risk of arthritis will become increasingly important with an ageing 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 (Arthritis and Osteoporosis Victoria 2013).

Comorbidities of arthritis

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 2017–18, 3 out of 4 (75%) people aged 45 and over with arthritis had at least one other chronic condition (ABS 2019). Back problems was the most common comorbidity (36%), followed by mental and behavioural conditions (30%) and asthma (18%) (ABS 2019). These are also among the most common chronic conditions experienced by people without arthritis but those with arthritis experience them at higher rates.

Figure 5: Prevalence of chronic conditions in people aged 45 and over with and without arthritis, 2017–18
This vertical bar chart compares the prevalence of chronic conditions (back problems, mental and behavioural problems, asthma, osteoporosis, heart, stroke and vascular disease, diabetes, COPD, cancer, and kidney disease) among those with arthritis and those without. Back problems was the most common comorbidity (36%25), followed by mental and behavioural conditions (30%25) and asthma (18%25).

Notes:

  1. Age-standardised to the 2001 Australian population.
  2. Proportions do not total 100% as one person may have more than one additional diagnosis.

Source: AIHW analysis of ABS 2019 (Data table).

Data notes

The National Health Survey (NHS) uses three factors to determine whether or not a person is counted as having a particular condition: whether the condition is current, whether it is long term and whether it was medically diagnosed. The combination of these factors required for a person to count as having the condition varies according to the nature of the condition. For example, some conditions, such as diabetes and HSVD, once diagnosed, are seen to be lifelong. Even if a person no longer reports symptoms, they still count as having the condition. While other conditions, such as depression, asthma, cancer or back problems, can be lifelong, episodic or in complete remission.

Most conditions do not need the respondent to have been diagnosed by a doctor or nurse. The respondent is counted if they said they have the condition. However, in cases where the respondent said they had diabetes or HSVD and that the condition was not current, they need to have received a diagnosis to be counted.

Condition

Current

Long term

 

Has the condition been diagnosed by a doctor or nurse?

Table 1: Definitions used for chronic conditions

Arthritis

current

long term

no diagnosis required

Asthma

current

long term

no diagnosis required

Back problems

current

long term

no diagnosis required

Cancer

current

long term

no diagnosis required

COPD

current

long term

no diagnosis required

Diabetes

(2 combinations)

current

long term

no diagnosis required

ever had

not long term

diagnosis required

Heart, stroke and vascular disease (HSVD)

(2 combinations)

current

long term

no diagnosis required

ever had

not long term

diagnosis required

Kidney disease

current

long term

no diagnosis required

Mental and behavioural conditions

current

long term

no diagnosis required

Osteoporosis

current

long term

no diagnosis required

Note: Please see the 2017-18 NHS User Guide for more information on the definitions of the conditions.