Prevalence of Self-Reported Arthritis or Chronic Joint Symptoms Among Adults - United States, 2001

Morbidity and Mortality Weekly Report. 2002;51(42) 

In This Article

Editorial Note

The findings in this report provide the first direct measurements of arthritis/CJS prevalence for all states. Self-reports are required to estimate prevalence in the population because many persons with arthritis/CJS do not see a clinician for their symptoms, and their conditions remain undiagnosed.[5] Methods to capture self-reported arthritis at the national and state levels have evolved over time. An earlier definition of arthritis based on the International Classification of Diseases, Ninth Clinical Modification (ICD-9-CM) was used to generate the previous national estimate of 43 million (6) and to develop indirect, synthetic state estimates for 1990 by using age-, race/ethnicity-, and region-specific rates.[7]

Since 1996, a different set of self-report questions, developed in part by the National Arthritis Data Workgroup and not ICD-9-CM-based, has been used in BRFSS in selected states. The 2001 BRFSS estimate of 69.9 million persons with arthritis/CJS is considerably higher than earlier estimates, most likely because of differing case definitions, and does not indicate a substantial increase in arthritis and CJS prevalence.

The findings in this report are subject to at least five limitations. First, the estimates used self-reported data that were not confirmed by a physician. Second, the sample is drawn from the civilian, noninstitutionalized adult population and does not include military personnel and institutionalized persons. Third, BRFSS is a telephone survey and does not include persons who do not have telephone service. Fourth, the median response rate for 2001 was 51.4%; however, the distribution of demographic characteristics in the BRFSS sample was very similar to the distribution based on U.S. census data (i.e., sex, age, and race data). Finally, whereas previous estimates might have underestimated arthritis/CJS prevalence, BRFSS might overestimate prevalence because it might include persons with injuries rather than arthritis as the cause of CJS (CDC, unpublished data, 2001).

The questions used to define CJS and physician-diagnosed arthritis were modified for the 2002 BRFSS survey. As a result, these prevalence estimates might vary from the 2001 estimates. In 2002, the National Health Interview Survey began using these same case-defining questions; this change will allow better comparisons of national and state prevalence estimates.

BRFSS state-specific estimates of arthritis/CJS are important for planning and evaluating prevention programs and measuring progress toward meeting state and national health objectives for 2010. The CDC Arthritis Program funds arthritis programs in 36 states that rely on these data. These programs encourage interventions to reduce the impact of arthritis and CJS in state populations, including early detection and appropriate management of arthritis/CJS. Interventions include physical activity programs (e.g., the Arthritis Foundation's PACE [People with Arthritis Can Exercise] or Aquatics programs) and educational programs (e.g., the Arthritis Self-Help Course, which has helped persons with arthritis and CJS experience less pain and reduce the number of clinical visits they make).[8] Additional information about these programs is available at


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