Australian Institute of Health and Welfare 2019. Rheumatoid arthritis. Cat. no. PHE 252. Canberra: AIHW. Viewed 17 November 2019, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/rheumatoid-arthritis
Australian Institute of Health and Welfare. (2019). Rheumatoid arthritis. Retrieved from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/rheumatoid-arthritis
Rheumatoid arthritis. Australian Institute of Health and Welfare, 30 August 2019, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/rheumatoid-arthritis
Australian Institute of Health and Welfare. Rheumatoid arthritis [Internet]. Canberra: Australian Institute of Health and Welfare, 2019 [cited 2019 Nov. 17]. Available from: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/rheumatoid-arthritis
Australian Institute of Health and Welfare (AIHW) 2019, Rheumatoid arthritis, viewed 17 November 2019, https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/rheumatoid-arthritis
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Rheumatoid arthritis is an autoimmune disease where the body’s immune system attacks its own tissues. Rheumatoid arthritis can affect anyone at any age, and may cause significant pain and disability.
In 2016–17, there were 13,213 hospitalisations for rheumatoid arthritis, a rate of 54 per 100,000 population
Rates of rheumatoid arthritis are slightly higher for women (2.3%) than men (1.5%)
About 458,000 Australians (1.9% of the total population) have rheumatoid arthritis
Rheumatoid arthritis is most common in people aged 75 years or over
Rheumatoid arthritis can severely affect a person’s quality of life and cause significant disability. Physical limitations, pain, fatigue and mental health issues are symptoms of rheumatoid arthritis that can impact a person’s ability to engage in daily activities . In Australia, rheumatoid arthritis accounted for 15% of the total burden of disease due to musculoskeletal conditions in 2015 . Additionally, there is an economic impact of rheumatoid arthritis. In 2015–16, Rheumatoid arthritis cost the Australian health system an estimated $1.2 billion, representing 9.6% of disease expenditure on Musculoskeletal conditions and 1% of total disease expenditure .
as likely to describe poor health among those with rheumatoid arthritis, compared with those without the condition
People aged 45 and over with rheumatoid arthritis had lower self-assessed health status compared with people without the condition—based on self-reported data from the ABS 2017–18 National Health Survey. People with rheumatoid arthritis were 3.2 times as likely to describe their health as poor (18%) compared with those without the condition (5.6%) (Figure 1).
Note: Rates are age-standardised to the Australian population as at 30 June 2001.
Source: AIHW analysis of ABS 2019  (Data table).
as likely to have severe pain in those with rheumatoid arthritis, compared with those without the condition
Rheumatoid arthritis is a significant cause of physical disability. Functional limitations arrive soon after the onset of the disease and worsen with time. Joint damage in the wrist is reported as the cause of most severe limitation even in the early stages of rheumatoid arthritis .
In 2017–18, more than 2 in 3 people with rheumatoid arthritis aged 45 and over (68%) experienced ‘moderate’ to ‘very severe’ pain in the last 4 weeks. People with rheumatoid arthritis were 3.1 times as likely to have severe or very severe bodily pain in the last 4 weeks (30%) compared with those without the condition (10%) (Figure 2).
a. Bodily pain experienced in the 4 weeks prior to interview.
as likely to describe very high psychological distress in those with rheumatoid arthritis compared with those without the condition
People with rheumatoid arthritis are more likely to suffer from anxiety, depression and low self-esteem . Rheumatoid arthritis can affect a person’s ability to participate in work, hobbies and social and daily activities. Combined with the chronic pain associated with rheumatoid arthritis, this can lead to mental health issues including depression, anxiety, feelings of helplessness and poor self-esteem .
People aged 45 and over with rheumatoid arthritis were 2.5 times as likely to describe very high levels of psychological distress (11%) compared with those without the condition (4.3%)—according to the 2017–18 NHS (Figure 3).
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.
People with rheumatoid arthritis often have other chronic conditions, or ‘comorbidities’ (2 or more health conditions occurring at the same time). According to self-reported data from the ABS NHS 2017–18, among people aged 45 and over with rheumatoid arthritis:
For this analysis, the selected comorbidities are heart, stroke and vascular disease, back problems, mental and behavioural conditions, asthma, diabetes, chronic obstructive pulmonary disease (COPD), kidney disease, osteoporosis and cancer.
Most chronic diseases are more common in older age groups. The average age of people with rheumatoid arthritis is older than the average age of the general population, therefore people with rheumatoid arthritis are more likely to have age-related comorbidities. The rates of back problems, mental and behavioural conditions, heart, stroke, and vascular disease, asthma, osteoporosis, and COPD as comorbidities remained significantly higher for people with rheumatoid arthritis compared with those without after adjusting for age. There was no significant difference for diabetes, cancer or kidney disease. It is important to note that regardless of the differences in age structures, having multiple chronic health problems is often associated with worse health outcomes , in addition to a poorer quality of life  and more complex clinical management and increased health costs. Rheumatoid arthritis is also associated with increased mortality due to comorbidities and related complications .
Note: these components do not total 100% as one person may have more than one comorbidity.
The comorbidity data presented here are based on self-reported data from the Australian Bureau of Statistics National Health Survey (NHS). When interpreting self-reported data, it is important to recognise that because we rely on respondents providing accurate information, the outputs may not always be a true reflection of the situation.
In the 2017–18 NHS, the number and proportion of persons with long-term health conditions is presented as those who have "a current medical condition which has lasted, or is expected to last, for 6 months or more, unless otherwise stated" . For the conditions rheumatoid arthritis, asthma, cancer, heart, stroke and vascular disease (HSVD), diabetes, kidney disease and mental and behavioural conditions, the estimates are based on: persons who reported having been told by a doctor or nurse that they had the condition/s and whether they reported that their condition was current and long-term; that is, their condition was current at the time of interview and had lasted, or was expected to last, 6 months or more.
For HSVD and diabetes, estimates also included persons who reported they had had the conditions, but that these conditions were not current and long-term at the time of interview.
The conditions data collected for back problems and COPD are 'as reported' by respondents and do not necessarily represent conditions as medically diagnosed. However, as the data relate to conditions which had lasted, or were expected to last, for six months or more, there is considered to be a reasonable likelihood that medical diagnoses would have been made in most cases. The degree to which conditions have been medically diagnosed is likely to differ across condition types. See the National Health Survey: Users’ Guide, 2017─18  for more information.
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