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).
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).
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).
(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).
(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.
Notes:
- Age-standardised to the 2001 Australian population.
- 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.
Table 1: Definitions used for chronic conditions
|
Condition
|
Current
|
Long term
|
Has the condition been diagnosed by a doctor or nurse?
|
|
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.