The National Arthritis Action Plan: a public health strategy for a looming epidemic.

The disease burdens caused by arthritis in the United States are already enormous. Current estimates are that 43 million Americans have arthritis (1). It is the most common cause of disability in adults (2), and its economic impact exceeds $65 billion in medical and disability costs (3). These burdens will increase dramatically in the near future. By 2020, the prevalence of arthritis is projected to rise to 60 million, an increase of nearly 50% in two decades (4). The economic costs of arthritis are projected to exceed $100 billion by 2020. These remarkable increases indicate that we face a looming epidemic of arthritis. Epidemics call for a public health approach. One key element of the public health approach is population-based efforts to control a disease (5). These population-based efforts complement the medical treatment of individual cases (6). A second key element of the public health approach is an emphasis on prevention. This emphasis encompasses primary prevention (efforts to completely prevent new cases of a disease), secondary prevention (efforts oriented towards early diagnosis and curative intervention), and tertiary prevention (efforts to ameliorate the effects of established disease) (5). Recognizing that arthritis is an increasingly important public health problem, a consortium of national organizations has produced “The National Arthritis Action Plan: A Public Health Strategy.” This exciting new approach to arthritis was developed under the leadership of the Centers for Disease Control and Prevention (CDC), the Arthritis Foundation, and the Association of State and Territorial Health Officials. These 3 organizations were joined by nearly 90 other organizations, including governmental agencies, voluntary health associations, academic institutions, professional associations, and others with an interest in arthritis prevention. The result of this collaboration is a comprehensive, ambitious, and inspiring plan for addressing the looming epidemic of arthritis. The National Arthritis Action Plan is based on certain underlying principles, which include the following.