Arthritis: The Disease, Arthritis: The Disease, The Program & The Program & Interventions Interventions Debbie Campbell MBA, CHES Debbie Campbell MBA, CHES Arthritis Health Section Chief Arthritis Health Section Chief Department of Health & Human Services - Division of Health Department of Health & Human Services - Division of Health and and Appathurai Balamurugan MD, MPH Appathurai Balamurugan MD, MPH Senior Epidemiologist, Senior Epidemiologist, Department of Health & Human Services - Division of Health Department of Health & Human Services - Division of Health Assistant Professor, Dept. of Epidemiology, UAMS College of Assistant Professor, Dept. of Epidemiology, UAMS College of Public Health Public Health
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Arthritis: The Disease, The Program & Interventions Debbie Campbell MBA, CHES Arthritis Health Section Chief Department of Health & Human Services - Division.
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Arthritis: The Disease, Arthritis: The Disease, The Program & The Program & InterventionsInterventions
Debbie Campbell MBA, CHESDebbie Campbell MBA, CHESArthritis Health Section ChiefArthritis Health Section Chief
Department of Health & Human Services - Division of HealthDepartment of Health & Human Services - Division of Health
Department of Health & Human Services - Division of Health Department of Health & Human Services - Division of Health Assistant Professor, Dept. of Epidemiology, UAMS College of Public Assistant Professor, Dept. of Epidemiology, UAMS College of Public
Health Health
Debbie Campbell MBA, CHESDebbie Campbell MBA, CHESArthritis Health Section ChiefArthritis Health Section Chief
Department of Health & Human Services - Division of HealthDepartment of Health & Human Services - Division of Health
Department of Health & Human Services - Division of Health Department of Health & Human Services - Division of Health Assistant Professor, Dept. of Epidemiology, UAMS College of Public Assistant Professor, Dept. of Epidemiology, UAMS College of Public
Health Health
The “Arthritis” StoryThe “Arthritis” StoryThe “Arthritis” StoryThe “Arthritis” Story
70 million Americans 70 million Americans Leading cause of disability among Leading cause of disability among
Americans over age 15Americans over age 15 Affects nearly 300,000 children Affects nearly 300,000 children Baby boomers are now at prime Baby boomers are now at prime
risk, as more than half those risk, as more than half those affected are under age 65affected are under age 65
70 million Americans 70 million Americans Leading cause of disability among Leading cause of disability among
Americans over age 15Americans over age 15 Affects nearly 300,000 children Affects nearly 300,000 children Baby boomers are now at prime Baby boomers are now at prime
risk, as more than half those risk, as more than half those affected are under age 65affected are under age 65
The “Arthritis” Story The “Arthritis” Story Cont.Cont.
Second only to heart disease as a Second only to heart disease as a cause of work disabilitycause of work disability
39 million physician visits every 39 million physician visits every yearyear
More than a half million More than a half million hospitalizations per year hospitalizations per year
$86.2 billion annually $86.2 billion annually
Second only to heart disease as a Second only to heart disease as a cause of work disabilitycause of work disability
39 million physician visits every 39 million physician visits every yearyear
More than a half million More than a half million hospitalizations per year hospitalizations per year
Arthritis is an Arthritis is an umbrellaumbrella termterm
Rheumatoid Arthritis
Rheumatoid Arthritis
FibromyalgiaFibromyalgia
GoutGout Lyme DiseaseLyme Disease
BursitisBursitis
LupusLupus
Juvenile ArthritisJuvenile Arthritis
Ankylosing SpondylitisAnkylosing Spondylitis
OsteoarthritisOsteoarthritis
Figure 1. An estimated 1 million Arkansans have Arthritis
619,000
990,000
319,000
DiagnosedPossibleNo arthritis
* Source: BRFSS, 2004
Figure 2. Arthritis Prevalence in Arkansas and US *, 2003
27%32%
0%
10%
20%
30%
40%
50%
US Arkansas
Per
cen
tage
of
pop
ula
tion
* Source: BRFSS, 2003
Per
cen
tag
e o
f P
op
ula
tio
n
Figure 3. Trends in Arthritis Prevalence in Arkansas *, 2002-2004
33% 32% 32%
0%
10%
20%
30%
40%
50%
2002 2003 2004
Year
Perc
en
tag
e o
f p
op
ula
tio
n
* Source: BRFSS
Pe
rce
nta
ge
of
Po
pu
lati
on
Figure 4. Percentage of Adults with Arthritis,* 2003
* People 18 or older with self-reported, doctor-diagnosed arthritis. Source: CDC, Behavioral Risk Factor Surveillance System, 2003
Figure 5. Arthritis Prevalence In Arkansas By Age Figure 5. Arthritis Prevalence In Arkansas By Age Categories, 2004Categories, 2004
16%
41%56%
0%
20%
40%
60%
80%
100%
18-44 45-64 65+
Age groups* Source: BRFSS, 2004
Perc
en
tag
e w
ith
A
rth
riti
s
Figure 6. Arthritis Prevalence in Arkansas by gender, Figure 6. Arthritis Prevalence in Arkansas by gender, 20042004
28%36%
0%
20%
40%
60%
80%
100%
Male Female
* Source: BRFSS, 2004
Perc
en
tag
e w
ith
A
rth
riti
s
Figure 7. Arthritis Prevalence in Arkansas by race, Figure 7. Arthritis Prevalence in Arkansas by race, 20042004
32% 29%23%
31%
0%
20%
40%
60%
80%
100%
Race
White Black Hispanic Other
Pe
rce
nta
ge
wit
h A
rth
riti
s
Arthritis Prevalence in Arkansas, 2002 Arthritis Prevalence in Arkansas, 2002
Prevalence of Doctor- Diagnosed Arthritis*
24.6 – 29.9%
█ 30.0 – 34.9%
█ 35.0 – 39.9%
█ 40.0 – 48.6%* BRFSS 2002
Cost Due to Arthritis and Related Cost Due to Arthritis and Related ConditionsConditions
Cost Due to Arthritis and Related Cost Due to Arthritis and Related ConditionsConditions
Figure 8. Total* Cost Attributable to Arthritis and Other Rheumatic Conditions, Using Selected Categories, 50 States and D.C., U.S., 1997
Figure 8. Total* Cost Attributable to Arthritis and Other Rheumatic Conditions, Using Selected Categories, 50 States and D.C., U.S., 1997
* Total = direct (costs attributable to medical expenditures) + indirect (costs attributable to work loss)
Source: CDC Arthritis Program
$2.2 – $8.4 billion$1.5 - $2.2 billion
$750 million - $1.3 billion$121 million - $578 million
Direct Healthcare Expenses Due to Direct Healthcare Expenses Due to ArthritisArthritis
Site of ServiceSite of Service Costs Costs RankRank
Home Healthcare $ 2.49 B 1Home Healthcare $ 2.49 B 1
Ambulatory care $ 7.93 B 2Ambulatory care $ 7.93 B 2
In-patient $ 5.70 B 4In-patient $ 5.70 B 4
Prescription Meds $ 5.15 B 5Prescription Meds $ 5.15 B 5
Site of ServiceSite of Service Costs Costs RankRank
Home Healthcare $ 2.49 B 1Home Healthcare $ 2.49 B 1
Ambulatory care $ 7.93 B 2Ambulatory care $ 7.93 B 2
In-patient $ 5.70 B 4In-patient $ 5.70 B 4
Prescription Meds $ 5.15 B 5Prescription Meds $ 5.15 B 5
Source: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditionsSource: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditions
Direct Healthcare Expenses Due Direct Healthcare Expenses Due to Arthritis by Source of to Arthritis by Source of
PaymentPayment
Direct Healthcare Expenses Due Direct Healthcare Expenses Due to Arthritis by Source of to Arthritis by Source of
PaymentPayment
7.616.49
2.653.48
0
2
4
6
8
10
PrivateInsurance
Medicare Medicaid Self-pay
$
Bil
lion
s of
dol
lars
Source: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditionsSource: Healthcare Spending and Use Among United State Community-Dwelling Adults for the 20 most costly conditions
$ B
illion
s o
f d
ollars
Figure 9. Hospital Discharges with Primary Diagnosis of Arthritis, Arkansas
2002-2004
10010 10607 11518
0
5000
10000
15000
2002 2003 2004Year
Nu
mb
er o
f H
osp
ital
Dis
char
ges
Nu
mb
er o
f H
osp
ital
Dis
char
ges
Figure 11. Total Hospitalization Charges Due to Arthritis, Arkansas, 2002-2004
$197$230
$272
0
100
200
300
2002 2003 2004
Mil
lio
ns
of
Do
llar
s ($
)M
illi
on
s o
f D
oll
ars
($)
Year
Figure 12. Average Charges for Hospitalizations due to Arthritis, Arkansas,
Arthritis is the No. 1 cause of disability in the US and in AR
Figure 21. Health status* among people with arthritisFigure 21. Health status* among people with arthritisFigure 21. Health status* among people with arthritisFigure 21. Health status* among people with arthritis
63%
37%
Excellent/Good Health Fair/Poor Health
* Source: BRFSS, 2004
Figure 22. Health status among people with arthritis
67%
33%
0%
20%
40%
60%
80%
100%
Can doeverything/most
things
Can dosomethings/hardly
anything
* Source: BRFSS, 2004
Pe
rce
nta
ge
Pe
rce
nta
ge
Risk FactorsRisk Factors&&
Preventive Care Preventive Care ServicesServices
Figure 23. Role of Body weight in Figure 23. Role of Body weight in ArthritisArthritis
2%
36%
32% 31%
underweight normal overweight obese
* Source: BRFSS, 2004
Figure 24. Role of Physical Activity Figure 24. Role of Physical Activity in Arthritisin Arthritis
40%
37%
23%
Physically active Insufficient activity Inactive
* Source: BRFSS, 2003
Figure 25. Preventive care practices among people with Arthritis, 2004
13%
53%
28%
0% 20% 40% 60% 80%
Ever taken an arthritis self-help course
Advised by Doctor to be involved in PAor exercise for Arthritis
Advised by Doctor to lose weight forarthritis
Percentage of persons with arthritis* Source: BRFSS, 2004
ARARthritis thritis Health ProgramHealth Program
MissionMissionMissionMission
““Reduce the Impact of Reduce the Impact of Arthritis and other Arthritis and other
Rheumatic Conditions” Rheumatic Conditions” among Arkansansamong Arkansans
““Reduce the Impact of Reduce the Impact of Arthritis and other Arthritis and other
Rheumatic Conditions” Rheumatic Conditions” among Arkansansamong Arkansans
GoalsGoals Increase Awareness and Increase Awareness and