Susan Bartlett, Ph.D., Associate Professor of Medicine, Division of Rheumatology, Johns Hopkins University, explains how arthritis, aging, and obesity are combining to create a “perfect” storm for American Health Care.
If you read Sebastian Junger’s Perfect Storm or saw the Hollywood adaptation, you will probably recall the scene in which a weatherman stares in horror at the radar charts on his computer screen. He watches as three massive weather systems converge toward a point at which they will all collide with unprecedented force. The perfect storm is gathering.
Today, another sort of perfect storm -- I call it this because three forces are gathering into one -- is gaining momentum in American health care. The three factors that are converging with potentially unprecedented impact are:
- Arthritis. According to the Arthritis Foundation, in 1985 there were 35 million Americans with arthritis or chronic joint symptoms. By 1998, that number had increased to 43 million, and it jumped to 66 million in 2005. Nearly one in three adults now have arthritis. Women are particularly at risk for arthritis: Arthritis affects about twice as many women as men. Arthritis is now the leading cause of disability among older women in the United States and the second most common cause of disability among older men. The Arthritis Foundation estimates that the various forms of the disease cost the U.S. economy more than $86 billion annually.
- Age. Nearly 77 million Americans were born between 1946 and 1964, the years of the postwar baby boom. And that massive bulge in the American population is just hitting prime time as far as arthritis is concerned. More than 32 million boomers are now over age 50; by 2011, the leading edge of the boomer population will be turning 65, at which point any medical issues they have will exert a major influence on the American health care system.
- Obesity. A huge percentage of the boomer population is overweight or obese. Researchers from the Beth Israel Deaconess Medical Center and the Harvard School of Medicine compared the rates of obesity among baby boomers with the rates of obesity in the previous generation (those born between 1926 and 1945). Up to 32% of the boomers were obese by age 44, whereas in the previous generation fewer than 18% were obese at that age. In other words, boomers are spending more years of their lives obese, so the excess weight has a longer period during which to exert its destructive effects, which include the development of arthritis. It’s no secret that obesity has already reached epidemic proportions in the United States: Almost 65% of the U.S. population is currently overweight or obese.
When taken together, these numbers clearly indicate that arthritis will be one of the most important public health challenges we face in the next 20 years. However, there is reason for hope, not only for people who have arthritis, but also for people who struggle with their weight. Arthritis and obesity are indeed linked, but important progress is being made in research on both fronts, with reason to be hopeful about the future.
One thing in particular we have learned: The combined impact of aging, obesity, and arthritis is neither inevitable nor unbeatable. People with arthritis who manage to lose even modest amounts of weight can enjoy major reductions in pain, major increases in mobility, and the enhanced quality of life that results from these changes.
