10 worst states for arthritis

This article has been updated to include new arthritis prevalence data.

Arthritis can be a relentless enemy.

Some conditions that cause joint inflammation, such as lupus, may kill people quickly. In many other cases, a condition that starts out as a nuisance gradually takes over people’s lives, limiting their ability to handle the activities of daily living.

Chattanooga, Tennessee-based Unum has estimated that joint disorders cause 35% of its long-term disability insurance claims.

The Westlake Village, California-based American Association for Long Term Care Association says arthritis is the main cause of about 9% of long-term care insurance claims.

For insurance professionals, arthritis has two faces: in some cases, it can make getting clients the most helpful health-related insurance products difficult or impossible. In other cases, it can make clients keenly aware of health and disability risk without doing much to hurt their insurability. Closing a sale might be as simple as telling the client, “The underwriters approved your application.”

The effects of arthritis on underwriting and sales vary dramatically from condition to condition and from client to client.

Gout, for example, is a form of arthritis caused by the buildup of uric acid in the blood. It may have no effect on some people’s lifespan, but researchers in Japan reported in 2000 that it seemed to correlate with a 60% increase in the risk of dying in any given year.

Complications of rheumatoid arthritis, an inflammatory condition that can affect the whole body, might cut some people’s lifespans by about 10 to 15 years, but it might have no effects on others’ lifespans. Many people with the condition live into their 80s and 90s, according to the Atlanta-based Arthritis Foundation.

Osteoarthritis may have no effect on life expectancy at all.

One New York-based insurer says in a Web-based field underwriting manual that otherwise healthy people with mild osteoarthritis may be able to qualify for individual disability insurance at standard rates and typically can qualify for life insurance at preferred rates.

People with mild rheumatoid arthritis may be able to qualify for life insurance at standard rates and individual disability insurance at substandard rates.

When insurers write about how they think about the boundary between mild arthritis and moderate or severe arthritis, they typically mention warning signs such as use of narcotic drugs to control pain or recent joint surgery. They also talk about whether arthritic conditions such as ankylosing spondylitis have caused many of a client’s joints to fuse together.

For insurance professionals, one twist is that the prevalence of arthritis seems to vary widely from market to market.

In 2019, for example, the U.S. Centers for Disease Control and Prevention found that about 23.5% of U.S. adults ages 18 and older had arthritis, according to a CDC survey database.

One way to filter out the effects of age on the prevalence of a condition is to look just at the percentage of people ages 45 through 54 who have the condition.

At the state level, for adults ages 45 through 54, arthritis prevalence ranged from less than 18% in California and the District of Columbia up to almost 50% in West Virginia.