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Life Health > Health Insurance

10 worst states for arthritis

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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 Group has estimated that joint disorders cause 7.2 percent of its short-term disability insurance claims and 9.2 percent 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 percent 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.”

Related: Disability insurance: Addressing the facts with clients

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 percent increase in the risk of dying in any given year.

Complications of rheumatoid arthritis, or joint inflammation caused by a wide variety of conditions, might cut some people’s lifespans by about 10 to 15 years, but it has no effects on others’ lifespans. Many people with the condition live into their 80s and 90s, according to the Atlanta-based Arthritis Foundation.

Osteoarthritis, or joint inflammation caused by some combination of cartilage problems, over-use of a joint, and ordinary wear and tear, 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.

This is a good month for insurance professionals who are interested in learning more about people with arthritis and arthritis risk, because many local Arthritis Foundation chapters host Bone Bash Halloween fundraisers this month. Getting to know people with arthritis may be as easy as attending a masquerade ball.

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

In 2014, for example, the U.S. Centers for Disease Control and Prevention found that about 27 percent of U.S. adults ages 18 and older had arthritis, according to a CDC survey database.

At the state level, however, prevalence ranged from less than 20 percent in Minnesota to more than 35 percent in Alabama, Arkansas, Kentucky, Tennessee and West Virginia.

To try to filter out some local variation that may be based on diagnostic practices or historic demographic factors, we looked at how the reported arthritis prevalence rate changes between 2009 and 2014.

The rate fell in 38 states and the District of Columbia. The median change was a decrease of about 1.6 percentage points 

But the rate increased a bit in Idaho and Virginia, and more in 10 other states. For a look at the 10 states with the biggest increases, read on:


Rheumatoid arthritis is an autoimmune disorder that can affect the whole body. (Photo: iStock)

5 bad states for arthritis

In most states, the prevalence of arthritis among adults ages 45 to 54 — the adults who may be the most likely to have the cash and life experience to understand the importance of long-term disability insurance, long-term care insurance and other disability-related products and services — declined between 2009 and 2014.

In these states, which rank fifth through 10th in terms of arthritis prevalence in the 45-54 age group, the percentage of people touched by arthritis actually increased.

10. Mississippi

2009 prevalence: 33 percent.

2014 Prevalence: 33.9 percent.

Prevalence change: 0.9 percentage points.

9. Arkansas

2009 prevalence: 35.8 percent.

2014 Prevalence: 36.8 percent.

Prevalence change: 1 percentage point.

8. Maine

2009 prevalence: 32.3 percent.

2014 Prevalence: 33.3 percent.

Prevalence change: 1 percentage point

7. Kansas

2009 prevalence: 26.4 percent.

2014 Prevalence: 27.5 percent.

Prevalence change: 1.1 percentage points.

6. Alabama

2009 prevalence: 38.1 percent

2014 Prevalence: 39.7 percent.

Prevalence change: 01.6 percentage points.

Related: Specialty drugs: A primer 


Osteoarthritis is a condition that occurs when people’s joints wear out. (Photo: iStock)

5 terrible states for arthritis

In the states that rank fifth through 10th in terms of arthritis prevalence, the percentage of people in the 45-54 age group touched by arthritis increased by 0.9 percentage points to 1.6 percentage points between 2009 and 2014.

In the states in first to fifth place, the percentage touched by arthritis went up much faster.

The increase in some states might be partly because of the introduction of lucrative new arthritis drugs.

Fighting arthritis can be a good moneymaker for pharmaceutical companies. The London-based International Federation of Health Plans says the full cost of one popular brand-name drug for fighting rheumatoid arthritis, Humira, cost about $30,000 to $36,000 per year in the United States in 2015. Zipsor, a drug for osteoarthritis, can cost about $12,000 per year.

That kind of money could encourage drug companies to push physicians to look harder for people with arthritis. Promotional campaigns might work better in some markets than others.

But factors such as nutrition, exercise habits or other factors could also increase the odds that people in some areas will develop arthritis.

Either way: The states on this page seem to have experienced a dramatic increase in arthritis prevalence.

5. Delaware

2009 prevalence: 26.8 percent.

2014 Prevalence: 28.8 percent.

Prevalence change: 2 percentage points.

4. Massachusetts

2009 prevalence: 25.5 percent.

2014 Prevalence: 29.1 percent.

Prevalence change: 3.6 percentage points

3. Georgia

2009 prevalence: 25.5 percent.

2014 Prevalence: 29.9 percent.

Prevalence change: 4.4 percentage points.

2. West Virginia

2009 prevalence: 38 percent.

2014 Prevalence: 42.5 percent.

Prevalence change: 4.5 percentage points

1. Tennessee

2009 prevalence: 29.7 percent.

2014 Prevalence: 36.6 percent.

Prevalence change: 6.9 percentage points.

Related: J&J raises 2016 profit forecast after drug sales increase 

Hip X-ray

Ankylosing spondylitis is an inflammatory condition that can cause vertebrae and other joints to fuse together. (Image: iStock)

50 states of data: Arthritis

This chart shows how the prevalence of arthritis among adults ages 45 to 54 changed in each state, and the District of Columbia, between 2009 and 2014. One good place to go to create health indicator tables of your own is the CDC’s Chronic Disease and Health Promotion Data & Indicators site.

  Adults, ages 45-54, who have had some form of arthritis  
  2009 2014 Change between 2009 and 2014, in percentage points
Alabama 38.1 39.7 1.6
Alaska 27.8 26.4 -1.4
Arizona 31.4 24.3 -7.1
Arkansas 35.8 36.8 1.0
California 23.2 21.2 -2.0
Colorado 24.9 23.8 -1.1
Connecticut 24.1 21.1 -3.0
Delaware 26.8 28.8 2.0
District of Columbia 27.1 20.9 -6.2
Florida 27.6 27.5 -0.1
Georgia 25.5 29.9 4.4
Hawaii 22.4 20.5 -1.9
Idaho 24.6 25.2 0.6
Illinois 28.2 26.6 -1.6
Indiana 33 31.9 -1.1
Iowa 26.2 23.6 -2.6
Kansas 26.4 27.5 1.1
Kentucky 41.4 39.4 -2.0
Louisiana 29.7 27.7 -2.0
Maine 32.3 33.3 1.0
Maryland 27.6 26.4 -1.2
Massachusetts 25.5 29.1 3.6
Michigan 35.6 32.6 -3.0
Minnesota 20.8 19.4 -1.4
Mississippi 33 33.9 0.9
Missouri 34.7 27.7 -7.0
Montana 29.3 25.6 -3.7
Nebraska 25.6 22.1 -3.5
Nevada 27.2 22.7 -4.5
New Hampshire 28.9 26 -2.9
New Jersey 22.3 20.9 -1.4
New Mexico 28.6 25.7 -2.9
New York 28.5 23.3 -5.2
North Carolina 30.8 30 -0.8
North Dakota 31.4 28.5 -2.9
Ohio 33.7 32.6 -1.1
Oklahoma 33.3 28 -5.3
Oregon 28.1 24.9 -3.2
Pennsylvania 33.2 31.2 -2.0
Rhode Island 30.3 29.3 -1.0
South Carolina 34 32.1 -1.9
South Dakota 25.3 25.1 -0.2
Tennessee 29.7 36.6 6.9
Texas 25.2 21.4 -3.8
Utah 26.5 23.9 -2.6
Vermont 28.4 27.9 -0.5
Virginia 26.9 27.6 0.7
Washington 28.9 25.3 -3.6
West Virginia 38 42.5 4.5
Wisconsin 25.4 24.2 -1.2
Wyoming 28.9 24.4 -4.5
Source: Chronic Disease and Health Promotion Data & Indicators (CDC: 2009 wave and 2014 wave).


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