Chronic diseases and health promotion

Chronic rheumatic conditions

Rheumatic or musculoskeletal conditions comprise over 150 diseases and syndromes, which are usually progressive and associated with pain. They can broadly be categorized as joint diseases, physical disability, spinal disorders, and conditions resulting from trauma. Musculoskeletal conditions are leading causes of morbidity and disability, giving rise to enormous healthcare expenditures and loss of work.

Those conditions with the greatest impact on society include:

Rheumatoid Arthritis

Rheumatoid Arthritis is a chronic systemic disease that affects the joints, connective tissues, muscle, tendons, and fibrous tissue. It tends to strike during the most productive years of adulthood, between the ages of 20 and 40, and is a chronic disabling condition often causing pain and deformity.

  • The prevalence varies between 0.3% and 1% and is more common in women and in developed countries.
  • Within 10 years on onset, at least 50% of patients in developed countries are unable to hold down a full-time job.

Osteoarthritis

Osteoarthritis is a degenerative joint disease, which mainly affects the articular cartilage. It is associated with ageing and will most likely affect the joints that have been continually stressed throughout the years including the knees, hips, fingers, and lower spine region.

  • Osteoarthritis is already one of the ten most disabling diseases in developed countries.
  • Farming 1-9 years increases the risk of osteoarthritis 4.5 times; farming 10 or more years increases the risk 9.3 times.
  • Worldwide estimates are that 9.6% of men and 18.0% of women aged over 60 years have symptomatic osteoarthritis.
  • 80% of those with osteoarthritis will have limitations in movement, and 25% cannot perform their major daily activities of life.

Osteoporosis

Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist.

  • Based on measures of bone mineral density in Caucasians, osteoporosis is present in 15% of those 50–59 years of age, but these figures increase quickly to 70% of those over 80 years of age.
  • The most costly result of osteoporosis is the hip fracture, which nearly always requires hospitalization, is fatal 20% of the time and permanently disables a further 50%; only 30% fully recover.
  • 1.7 million hip fractures occurred worldwide in 1990; this figure is expected to rise to 6 million in 2050.

Spinal Disorders

Spinal Disorders include trauma, mechanical injury, spinal cord injury, inflammation, infection, and tumour. About 80–85% of back pain episodes have no known cause.

  • Low back pain, the most common spinal disorder, affects over 80% of persons at some point in their life, and from 4–33% of a population at any one time.
  • Back pain is the most common cause of disability among young adults.
  • Many factors, physical, psychological and occupational, contribute to the occurrence of back pain.

Severe limb trauma

Severe limb trauma that can result in permanent disability includes amputations, fractures, crushing injuries, dislocations, open wounds, blood vessel and nerve injuries.

  • In developed countries, serious limb trauma requiring hospitalization arises 50% of the time from falls, 15–20% from road traffic accidents, and about 20% from machinery and tool usage.
  • The highest rates for limb trauma occur in two distinct age groups: those 5–34 years of age and those over 75 years of age. In the elderly, falls represent the greatest threat for incurring limb injury, while road traffic accidents present the highest risk factor for adolescents and young adults.

Coming soon: new chronic rheumatic conditions website

A new WHO site with comprehensive information on chronic rheumatic conditions is currently under construction and will be available soon. In the meantime, if you need any further information please contact us at:

World Health Organization
Department of Chronic Diseases and Health Promotion
Chronic Respiratory Diseases and Arthritis (CRA)
20 Avenue Appia
CH-1211 Geneva 27
Switzerland
chronicdiseases@who.int

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