Number of Physically Inactive Adults With Arthritis in the United States

George A. Kelley, DA, FACSM; Kristi S. Kelley, MEd; Leigh F. Callahan, PhD

Prev Chronic Dis. 2020;17(9):e99

Abstract and Introduction

Abstract

We estimated the number of physically inactive US adults with arthritis by state and nationally who could improve their physical function and pain control by participating in an exercise program. Our calculations were based on number-needed-to-treat, arthritis prevalence, physical inactivity, and 2010 US Census data. Estimates were lowest in the District of Columbia (physical function, n = 4,412; pain, n = 2,451) and highest in Texas (physical function, n = 325,504; pain, n = 180,835). Overall estimates were 4,119,792 for physical function and 2,288,771 for pain control. State-level estimates are important for allocating resources, public health program planning, and future research.

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Abstract and Introduction
Objective
Methods
Results
Discussion
References
Sidebar

Table. Estimated Number, by State, of Physically Inactive Adults With Arthritis Who Could Improve Their Physical Function and Pain Control by Exercising ^a
State	Physical Function, Mean (95% CI)	Pain Control, Mean (95% CI)
Alabama	108,337 (102,265–114,653)	60,187 (56,814–63,696)
Alaska	6,823 (5,694–8,070)	3,791 (3,163–4,483)
Arizona	79,861 (75,695–84,028)	44,367 (42,053–46,682)
Arkansas	55,311 (50,271–60,352)	30,728 (27,928–33,529)
California	290,046 (259,515–321,667)	161,136 (144,175–178,704)
Colorado	39,884 (36,466–43,466)	22,158 (20,259–24,148)
Connecticut	40,633 (37,831–43,563)	22,574 (21,017–24,202)
Delaware	13,484 (12,153–14,885)	7,491 (6,752–8,269)
District of Columbia	4,412 (3,882–4,985)	2,451 (2,157–2,770)
Florida	289,212 (269,393–309,031)	160,673 (149,663–171,684)
Georgia	140,253 (130,304–150,524)	77,919 (72,391–83,624)
Hawaii	13,356 (11,892–14,909)	7,420 (6,607–8,283)
Idaho	17,964 (16,145–19,837)	9,980 (8,970–11,021)
Illinois	144,988 (131,678–158,774)	80,549 (73,154–88,208)
Indiana	109,387 (104,402–114,648)	60,770 (58,001–63,694)
Iowa	37,299 (34,789–40,036)	20,721 (19,327–22,242)
Kansas	37,918 (36,279–39,456)	21,066 (20,155–21,920)
Kentucky	99,395 (93,183–105,607)	55,219 (51,768–58,671)
Louisiana	79,520 (73,389–85,652)	44,178 (40,772–47,584)
Maine	20,189 (18,747–21,696)	11,216 (10,415–12,054)
Maryland	77,491 (72,648–82,554)	43,051 (40,360–45,864)
Massachusetts	78,035 (69,284–87,273)	43,353 (38,491–48,485)
Michigan	161,890 (152,691–171,088)	89,939 (84,828–95,049)
Minnesota	52,054 (49,189–55,079)	28,919 (27,327–30,599)
Mississippi	55,861 (51,584–60,138)	31,034 (28,658–33,410)
Missouri	95,656 (89,059–102,253)	53,142 (49,477–56,807)
Montana	13,280 (12,108–14,530)	7,378 (6,727–8,072)
Nebraska	21,065 (19,752–22,443)	11,703 (10,973–12,468)
Nevada	28,016 (24,214–32,066)	15,564 (13,452–17,814)
New Hampshire	16,910 (15,383–18,601)	9,395 (8,546–10,334)
New Jersey	122,925 (114,298–131,551)	68,291 (63,499–73,084)
New Mexico	23,541 (21,358–25,801)	13,078 (11,866–14,334)
New York	236,780 (221,131–253,790)	131,545 (122,850–140,995)
North Carolina	127,436 (115,754–139,825)	70,797 (64,308–77,681)
North Dakota	8,891 (8,206–9,628)	4,940 (4,559–5,349)
Ohio	195,261 (184,498–206,535)	108,478 (102,499–114,742)
Oklahoma	64,951 (60,872–69,030)	36,084 (33,818–38,350)
Oregon	47,473 (43,057–52,047)	26,374 (23,921–28,915)
Pennsylvania	201,986 (185,781–218,770)	112,214 (103,212–121,539)
Rhode Island	15,938 (14,576–17,300)	8,855 (8,098–9,611)
South Carolina	71,663 (67,495–75,832)	39,813 (37,497–42,129)
South Dakota	8,958 (7,926–10,044)	4,977 (4,404–5,580)
Tennessee	118,250 (109,491–127,010)	65,695 (60,828–70,561)
Texas	325,504 (292,798–358,210)	180,835 (162,665–199,005)
Utah	20,166 (18,558–21,919)	11,203 (10,310–12,177)
Vermont	7,784 (7,097–8,527)	4,325 (3,943–4,737)
Virginia	112,946 (105,849–120,661)	62,748 (58,805–67,034)
Washington	63,215 (59,001–67,925)	35,119 (32,778–37,736)
West Virginia	47,569 (44,926–50,327)	26,427 (24,959–27,959)
Wisconsin	62,103 (55,425–69,003)	34,502 (30,792–38,335)
Wyoming	7,918 (7,222–8,614)	4,399 (4,012–4,786)
Overall	4,119,792 (3,805,203–4,444,217)	2,288,771 (2,114,000–2,469,007)

^aCalculations based on 1) number-needed-to treat (NNT) data from a previous meta-analysis that examined the effects of community-based exercise on physical function and pain in adults ≥18 years of age with arthritis (NNT = 5 for physical function, NNT = 9 for pain control) (5), 2) 2017 state-level estimates of the prevalence of arthritis and physical inactivity in adults with arthritis (2), and 3) state-level population data from the 2010 US Census (6). For example, 2010 US Census data for the state of Alabama with a focus on physical function showed 3,647,277 adults aged ≥18, data that were not available in the 2017 Behavioral Risk Factor Surveillance System (BRFSS) study. The population of 3,647,277 was then multiplied by the crude prevalence estimate of those with arthritis reported in the 2017 BRFSS data for Alabama (33.3%). This resulted in an estimated 1,214,543 adults in Alabama with arthritis (3,647,277 × 0.333 = 1,214,543). We then multiplied the estimated number of adults in Alabama with arthritis (1,214,543) by the prevalence of physically inactive adults in Alabama based on the 2017 BRFSS study (44.6%), arriving at an estimate of 541,686 (1,214,543 × 0.446). The percentage to benefit, 20%, expressed as a proportion and derived as the reciprocal of an NNT of 5 from the authors' prior meta-analysis, was multiplied by 541,686, to arrive at a mean of 108,337 physically inactive adults with arthritis in Alabama who could improve their physical function by participating in a community-based exercise program.